Objective To analyze the status quo of cognitive frailty (CF) in community elderly patients with chronic obstructive pulmonary disease (COPD) and its correlation with sleep quality, anxiety and depression. Methods Elderly patients with COPD receiving health management in the center were selected from July 2023 to June 2024. The general data of patients were collected and Mini-Mental State Examination (MMSE), Fried Frailty Phenotype (FP), Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depression Scale (HADS) were used for investigation, and the above scores were analyzed. All patients were divided into CF group (n=129) and non-CF group (n=319) according to MMSE score and FP score. Univariate and multivariate logistic analyses were used to analyze the influencing factors of CF in elderly COPD patients. Results Pearson correlation analysis showed that MMSE score was significantly negatively correlated with PSQI score and HADS score in elderly COPD patients (P<0.05), and FP score was significantly positively correlated with PSQI score and HADS score (P<0.05). After logistic regression analysis, it was found that education level, marital status and sleep time were protective factors of CF in elderly COPD patients (P<0.05), and PSQI score and HADS score were risk factors of CF in elderly patients with COPD (P<0.05). Conclusion CF in community elderly COPD patients is related to sleep quality, sleep duration and anxiety and depression. It is necessary to take clinical measures to improve the sleep quality and psychological status, so as to avoid or slow down the occurrence of CF.

Objective:To provide basis for personalized health interventions for military pilots by analyzing the longitudinal variation trend of waist circumference and its correlation with BMI and lipid metabolism indicators among military pilots.Methods:A retrospective analysis was used on the base of collecting the physical examination data of 323 pilots who had been consecutively recuperated for 3 times and completed 3 health indicator examinations in Air Force Healthcare Center for Special Services Hangzhou from January of 2017 to January of 2022. The pilots were divided into waist circumference <85 cm group, ≥85-90 cm group, and ≥90 cm group. According to their waist circumference change trend, they were divided into increased group (difference of waist circumference >0 cm) and decreased group (difference of waist circumference ≤0 cm). According to the 5-year change rate of waist circumference (Δ5), they were divided into waist circumference relative increased group (Δ5>3%), relative stable group (-3%≤Δ5≤3%), and relative decreased group (Δ5<-3%). The stratification of different waist circumference, the 5-year change rate of waist circumference and BMI, blood lipid indexes and abnormal rate of hyperlipidemia were compared. Waist circumference was measured and determined according to the relevant standards for flying personnel and adults.Results:①The mean waist circumference of 323 pilots was close to the value of pre-central obesity. The mean BMI had reached the overweight standard, and the mean TG and TC were at high end of normal values.②During the 5-year period, the values of blood lipid metabolism indicators were repeatedly measured 3 times, and the mean values of TG, TC, and LDL-C showed an increasing trend, with significant differences ( F=7.39, 9.49, 3.67, P=0.001,<0.001, =0.026) and the mean values of TG and TC of the third measurement had approached to high limit. ③The results of BMI, TG in 3 measurements, LDL-C in the first and third measurements, TC in the first measurement and the incidence of hyperlipidemia were all increased with the increase of waist circumference and the differences were significant ( F=3.06-133.39, χ2=9.08-22.99, all P<0.05); HDL-C decreased with the increase of waist circumference, with significant differences ( F=6.32, 9.78, 10.86, P=0.002, <0.001, <0.001). The mean BMI of the ≥85-90 cm group reached the overweight level in the 3 measurements. The mean values of TG and TC in the first 2 measurements were at high end of normal value, but the mean values in the third measurement were higher than the normal range. The mean values of BMI, TG, and TC in ≥90 cm group were all within the abnormal range. ④ The 5-year change rate of BMI and LDL-C in the waist circumference increased group were higher than those in the waist circumference decreased group ( F=26.02, 14.95, both P<0.001). ⑤The waist circumference relative stable and relative increased group had a higher incidence of new hyperlipidemia, with 27 cases (21.77%) and 24 cases (20.00%) respectively. The waist circumference relative decreased group had the highest improvement rate of hyperlipidemia in 5 cases (6.33%), but the difference was not significant (all P>0.05). Conclusions:The abnormal rates of waist circumference, BMI, and blood lipids in military pilots are relatively high and show an increasing trend. The changes in waist circumference are closely related to BMI and blood lipids, and maintaining waist circumference within a normal range helps to maintain stability of blood lipid metabolism.

Objective:To provide basis for personalized health interventions for military pilots by analyzing the longitudinal variation trend of waist circumference and its correlation with BMI and lipid metabolism indicators among military pilots.Methods:A retrospective analysis was used on the base of collecting the physical examination data of 323 pilots who had been consecutively recuperated for 3 times and completed 3 health indicator examinations in Air Force Healthcare Center for Special Services Hangzhou from January of 2017 to January of 2022. The pilots were divided into waist circumference <85 cm group, ≥85-90 cm group, and ≥90 cm group. According to their waist circumference change trend, they were divided into increased group (difference of waist circumference >0 cm) and decreased group (difference of waist circumference ≤0 cm). According to the 5-year change rate of waist circumference (Δ5), they were divided into waist circumference relative increased group (Δ5>3%), relative stable group (-3%≤Δ5≤3%), and relative decreased group (Δ5<-3%). The stratification of different waist circumference, the 5-year change rate of waist circumference and BMI, blood lipid indexes and abnormal rate of hyperlipidemia were compared. Waist circumference was measured and determined according to the relevant standards for flying personnel and adults.Results:①The mean waist circumference of 323 pilots was close to the value of pre-central obesity. The mean BMI had reached the overweight standard, and the mean TG and TC were at high end of normal values.②During the 5-year period, the values of blood lipid metabolism indicators were repeatedly measured 3 times, and the mean values of TG, TC, and LDL-C showed an increasing trend, with significant differences ( F=7.39, 9.49, 3.67, P=0.001,<0.001, =0.026) and the mean values of TG and TC of the third measurement had approached to high limit. ③The results of BMI, TG in 3 measurements, LDL-C in the first and third measurements, TC in the first measurement and the incidence of hyperlipidemia were all increased with the increase of waist circumference and the differences were significant ( F=3.06-133.39, χ2=9.08-22.99, all P<0.05); HDL-C decreased with the increase of waist circumference, with significant differences ( F=6.32, 9.78, 10.86, P=0.002, <0.001, <0.001). The mean BMI of the ≥85-90 cm group reached the overweight level in the 3 measurements. The mean values of TG and TC in the first 2 measurements were at high end of normal value, but the mean values in the third measurement were higher than the normal range. The mean values of BMI, TG, and TC in ≥90 cm group were all within the abnormal range. ④ The 5-year change rate of BMI and LDL-C in the waist circumference increased group were higher than those in the waist circumference decreased group ( F=26.02, 14.95, both P<0.001). ⑤The waist circumference relative stable and relative increased group had a higher incidence of new hyperlipidemia, with 27 cases (21.77%) and 24 cases (20.00%) respectively. The waist circumference relative decreased group had the highest improvement rate of hyperlipidemia in 5 cases (6.33%), but the difference was not significant (all P>0.05). Conclusions:The abnormal rates of waist circumference, BMI, and blood lipids in military pilots are relatively high and show an increasing trend. The changes in waist circumference are closely related to BMI and blood lipids, and maintaining waist circumference within a normal range helps to maintain stability of blood lipid metabolism.

H 1-antihistamines are widely used in the treatment of various allergic diseases, but there are still many challenges in the safe and rational use of H 1-antihistamines in pediatrics, and there is a lack of guidance on the prescription review of H 1-antihistamines for children.In this paper, suggestions are put forward from the indications, dosage, route of administration, pathophysiological characteristics of children with individual difference and drug interactions, so as to provide reference for clinicians and pharmacists.

Hypoxemia is a common complication of pneumonia, asthma, and bronchopulmonary dysplasia in children.Rapid identification of hypoxemia is of great significance for the disposal and management of critical children.Pulse oximetry is recognized by the World Health Organization as the best way to monitor hypoxemia in children, and it can monitor pulse oxygen saturation noninvasively and continuously.Based on the related literature at home and abroad, combined with the clinical needs of pediatrics, the " Expert consensus on clinical application of pulse oximetry in children" is formulated to improve the understanding of pediatricians and nurses on the application in pediatric clinical practice, principle, operation techniques, and limitations of pulse oximetry.

Objective:To investigate the knowledge, attitudes, and practices (KAP) of pulse oximetry among pediatric healthcare providers in China and analyze the factor influencing the KAP.Methods:A self-developed questionnaire was used for an online research on the KAP of 11 849 pediatric healthcare providers from 31 provinces, autonomous regions, and municipalities of China from March 11 to 14, 2022.The factors influencing the KAP of pulse oximetry among pediatric healthcare providers were examined by Logistic regression. Results:The scores of KAP, of pulse oximetry were 5.57±0.96, 11.24±1.25 and 11.19±4.54, respectively.The corresponding scoring rates were 69.61%, 74.95%, and 55.99%, respectively. Logistic regression results showed that the gender and working years of pediatric healthcare providers, the region they were located, and whether their medical institution was equipped with pulse oximeters were the main factors affecting the knowledge score (all P<0.05). Main factors influencing the attitude score of pediatric healthcare providers included their knowledge score, gender, educational background, working years, region, medical institution level, and whether the medical institution was equipped with pulse oximeters (all P<0.05). For the practice score, the main influencing factors were the knowledge score, gender, age, and whether the medi-cal institution was equipped with pulse oximeters (all P<0.05). Conclusions:Chinese pediatric healthcare providers need to further improve their knowledge about and attitudes towards pulse oximetry.Pulse oximeters are evidently under-used.It is urgent to formulate policies or guidelines, strengthen education and training, improve knowledge and attitudes, equip more institutions with pulse oximeters, and popularize their application in medical institutions.

Objective:To summarize and analyze the clinical data of Chinese patients with colony-stimulating factor 1 receptor (CSF1R)-related leukoencephalopathy, and clarify the phenotypic and genetic characteristics of Chinese patients.Methods:Medical history of patients with CSF1R-related leukoencephalopathy diagnosed from April 1, 2018 to January 31, 2021 in the department of neurology of 22 hospitals in China was collected, and scores of Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment Scale (MoCA), magnetic resonance severity scale were evaluated. Group comparison was performed between male and female patients.Results:A total of 62 patients were included, and the male-female ratio was 1∶1.95. The age of onset was (40.35±8.42) years. Cognitive impairment (82.3%, 51/62) and motor symptoms (77.4%,48/62) were the most common symptoms. The MMSE and MoCA scores were 18.79±7.16 and 13.96±7.23, respectively, and the scores of two scales in male patients (22.06±5.31 and 18.08±5.60) were significantly higher than those in females (15.53±7.41 , t=2.954, P=0.006; 10.15±6.26, t=3.328 , P=0.003). The most common radiographic feature was bilateral asymmetric white matter changes (100.0%), and the magnetic resonance imaging severity scale score was 27.42±11.40, while the white matter lesion score of females (22.94±8.39) was significantly higher than that of males (17.62±8.74 , t=-2.221, P<0.05). A total of 36 CSF1R gene mutations were found in this study, among which c.2381T>C/p.I794T was the hotspot mutation that carried by 17.9% (10/56) of the probands. Conclusions:The core phenotypic characteristics of CSF1R-related leukoencephalopathy in China are progressive motor and cognitive impairment, with bilateral asymmetrical white matter changes. In addition, there exist gender differences clinically, with severer cognitive impairment and imaging changes in female patients. Thirty-six CSF1R gene mutations were found in this study, and c.2381T>C/p. I794T was the hotspot mutation.

Objective To systematically evaluate the relation between prognostic nutrition index (PNI) and prognosis of bladder cancer (BC) patients treated with radical cystectomy (RC). Methods We searched the literatures about the relation between PNI and the prognosis of patients treated with radical cystectomy published from the inception to January 30, 2021 in PubMed, Embase, Web of Science, CNKI, Wanfang, VIP and Chinese Medical Journal Database, and used RevMan5.3 software for Meta analysis. Results We included six literatures which comprise a total of 1273 patients. The results showed that there was a significant correlation between low PNI and OS of BC patients treated with RC (HR=2.0, 95%CI: 1.56-2.56), and there was a significant difference in RFS, PFS and DSS between low PNI and BC patients treated with RC (HR=1.93, 95%CI: 1.51-2.48). In the subgroup analysis, there were statistical differences in PNI and the prognosis of BC patients treated with RC between the Chinese group (HR=2.13, 95%CI: 1.62-2.81) and the Japanese group (HR=1.78, 95%CI: 1.08-2.94), and the PNI cutoff value had a good predictive effect on the prognosis of patients in the range of 46.08-51.30. Conclusion There is a significant relation between the level of PNI and OS of bladder cancer patients treated with radical cystectomy. Low PNI can be used as an effective marker to predict the prognosis of patients.

Objective To understand the level of quality control in medical linear accelerator in Guangxi, and to provide technical support for the health administrative department to make related standards. Methods To select medical linear accelerators in Guangxi by random sampling method. Results A total of 118 accelerators were checked in 2017—2019, the initial inspection pass rates of medical linear accelerators were 56.8% and re-inspect pass rate were 96.6%. Conclusion The quality control level of the radiology institutions needs to be improved. The health administrative department should strengthen routine management，it is necessary to implement quality control in medical linear accelerator.