To analyze the relationship between serum non-HDL-C levels and cardiovascular disease (CVD) mortality in community populations. A retrospective cohort study was conducted using the Yuecheng District Health Information Platform in Shaoxing City, Zhejiang Province. The study cohort included individuals aged 40 years or older with no prior history of CVD who underwent physical examinations at Yuecheng District healthcare institutions between January and December 2019. A total of 39 038 participants were included, including 19 085 males (48.9%) and 19 953 females (51.1%), with a mean age of (73.64±9.10) years. The mean follow-up duration was 52.3 months. During follow-up, 1 227 CVD death events occurred. The results indicated a significant overall association between non-HDL-C levels and the risk of CVD mortality, including coronary heart disease (CHD) and stroke. Cox models indicated that, using the ideal level of non-HDL-C as the reference, the hazard ratios (HRs) for risk of CVD death in the suitable level, borderline elevated level and elevated level groups were 1.24 (95% CI: 1.08-1.42), 1.57 (95% CI: 1.34-1.85) and 2.31 (95% CI: 1.87-2.86), respectively. The corresponding HRs for CHD death were 1.39 (95% CI: 1.10-1.76), 1.69 (95% CI: 1.28-2.12) and 2.53 (95% CI: 1.76-3.64), respectively. Subgroup analysis revealed significant interaction effects between non-HDL-C and sex, smoking, alcohol consumption, and diabetes (all P interaction<0.05). Sensitivity analyses confirmed that results were consistent with the primary findings regarding the association between non-HDL-C and CVD mortality risk. In conclusion, increasing non-HDL-C levels are associated with higher risks of death from cardiovascular diseases, including stroke and CHD. The risk of CVD death associated with elevated non-HDL-C is greater among males, individuals with a history of diabetes, smokers or drinkers. In the future, attention should be paid to the monitoring of non-HDL-C in community health management, and the intensive and personalized management of blood lipids in high-risk population should be strengthened.

To analyze the relationship between serum non-HDL-C levels and cardiovascular disease (CVD) mortality in community populations. A retrospective cohort study was conducted using the Yuecheng District Health Information Platform in Shaoxing City, Zhejiang Province. The study cohort included individuals aged 40 years or older with no prior history of CVD who underwent physical examinations at Yuecheng District healthcare institutions between January and December 2019. A total of 39 038 participants were included, including 19 085 males (48.9%) and 19 953 females (51.1%), with a mean age of (73.64±9.10) years. The mean follow-up duration was 52.3 months. During follow-up, 1 227 CVD death events occurred. The results indicated a significant overall association between non-HDL-C levels and the risk of CVD mortality, including coronary heart disease (CHD) and stroke. Cox models indicated that, using the ideal level of non-HDL-C as the reference, the hazard ratios (HRs) for risk of CVD death in the suitable level, borderline elevated level and elevated level groups were 1.24 (95% CI: 1.08-1.42), 1.57 (95% CI: 1.34-1.85) and 2.31 (95% CI: 1.87-2.86), respectively. The corresponding HRs for CHD death were 1.39 (95% CI: 1.10-1.76), 1.69 (95% CI: 1.28-2.12) and 2.53 (95% CI: 1.76-3.64), respectively. Subgroup analysis revealed significant interaction effects between non-HDL-C and sex, smoking, alcohol consumption, and diabetes (all P interaction<0.05). Sensitivity analyses confirmed that results were consistent with the primary findings regarding the association between non-HDL-C and CVD mortality risk. In conclusion, increasing non-HDL-C levels are associated with higher risks of death from cardiovascular diseases, including stroke and CHD. The risk of CVD death associated with elevated non-HDL-C is greater among males, individuals with a history of diabetes, smokers or drinkers. In the future, attention should be paid to the monitoring of non-HDL-C in community health management, and the intensive and personalized management of blood lipids in high-risk population should be strengthened.

Objective:To understand the breastfeeding situation in the neonatal intensive care units (NICUs) in Qianxinan Prefecture, Guizhou Province, and to assess the knowledge, attitudes, and practices of doctors and nurses regarding breastfeeding, aiming to provide foundational data for improving breastfeeding quality.Methods:A questionnaire was developed to survey the knowledge, attitudes, and practices related to breastfeeding in NICUs. The questionnaire was divided into three dimensions: knowledge (seven items, total score of 7), attitudes (nine items, total score of 45), and practices (seven items, total score of 35). Lower scores indicated weaker recognition of breastfeeding. Additionally, five items were included to identify the most influential factors affecting breastfeeding. From November 25 to November 30, 2023, a survey was conducted among doctors and nurses with professional qualifications who had worked in the neonatal departments of nine hospitals in Qianxinan Prefecture for at least one year. Independent sample t-tests and Chi-square tests were used to compare the scores of doctors and nurses from different levels of hospitals and within the same level of hospitals across the three dimensions. Results:(1) Among the nine hospitals, three were tertiary grade A hospitals (referred to as "tertiary hospitals"), with 95.6% (43/45) of the doctors and 96.5% (110/114) of the nurses participating in the survey. Six were secondary grade A hospitals (referred to as "secondary hospitals"), with 95.0% (38/40) of the doctors and 97.6% (83/85) of the nurses participating. (2) All nine hospitals were baby-friendly hospitals and all had breastfeeding promotional materials. Six hospitals had NICUs that promoted breastfeeding, with an average NICU breastfeeding rate of 25.8% across the prefecture between year 2021 to 2023. (3) The proportion of doctors who had received breastfeeding training was higher than that of nurses within the same level of hospitals [tertiary hospitals: 69.8% (30/43) vs. 40.0% (44/110), χ 2=10.97, P=0.001; secondary hospitals: 47.4% (18/38) vs. 24.1% (20/83), χ 2=6.55, P=0.010], although the overall training rates were low. (4) In tertiary hospitals, doctors scored higher than nurses in the attitude dimension [(35.35±4.75) vs. (33.18±5.60) scores, t=－2.03, P=0.044] and also in the practice dimension [(26.98±3.00) vs. (25.60±3.75) scores, t=－2.17, P=0.032]. In secondary hospitals, the total knowledge dimension score of doctors was higher than that of nurses [(4.92±1.44) vs. (4.20±1.45) scores, t=－2.52, P=0.013]. In tertiary hospitals, the total scores for attitude and practice dimensions of doctors were higher than those of doctors in secondary hospitals, and the total scores for knowledge, attitude, and practice dimensions of nurses were higher than those of nurses in secondary hospitals (all P<0.05). (5) In the knowledge dimension, the lowest scoring item of doctors in the tertiary hospitals was "Breastfeeding is possible for maternal hepatitis B newborns after receiving vaccines and immunoglobulin"; the lowest scoring item of nurses in the tertiary hospital, and doctors and nurses in the secondary hospitals was "The duration of breastfeeding has a greater impact on neonatal outcomes". In the attitude dimension, the lowest scoring item for doctors and nurses in both tertiary and secondary hospitals was "You think the breastfeeding process is more troublesome than feeding preterm formula". In the practice dimension, the lowest scoring item of the doctors and nurses in the tertiary hospitals was "Your hospital had enough breastfeeding knowledge training", while for the doctors and nurses in the secondary hospitals were "You have more opportunities to participate in various breastfeeding-related training" and "Breast feeding should be started as soon as possible when the infant is stable after active treatment", respectively. (6) The most influential factors affecting breastfeeding were: lack of cooperation from parents (50.0%, 137/274), relative insufficient human resources for doctors and nurses (21.9%, 60/274), and the absence or poor implementation of breastfeeding management policies (18.3%, 50/274), etc. Conclusions:The breastfeeding rate in NICU of county-level hospitals is relatively low, and medical staff, especially nurses, have insufficient knowledge about breastfeeding. It is necessary to strengthen various breastfeeding training for medical staff to enhance their understanding of NICU breastfeeding.

Background:Autoimmune gastritis(AIG)is a CD4+T cell-mediated immune disease.In recent years,with increased awareness and understanding of the condition,reports of AIG cases in China have been gradually increasing.Aims:To analyze and summarize the clinical characteristics of AIG for better disease recognition and diagnosis.Methods:Data on AIG patients diagnosed at the First Affiliated Hospital of Zhejiang Chinese Medical University from August 2018 to December 2023 were collected and analyzed for their clinical,laboratory,endoscopic,and pathological features.Results:A total of 161 AIG patients were included,with the mean age of 56.81 years old,63 were males and 98 females.Most of the patients exhibited no characteristic clinical symptoms.The laboratory measurements were as follows:gastrin-17,44.68 pmol/L;pepsinogen(PG)Ⅰ,38.61 μg/L;PG Ⅱ,10.41 μg/L;PGⅠ/Ⅱ ratio,32.1;vitamin B12,344.45 pmol/L;and hemoglobin,125.15 g/L.The positivity rates of thyroglobulin antibody and thyroid peroxidase antibody were 46.0%and 30.0%,respectively.The main comorbid autoimmune diseases were Hashimoto's thyroiditis(8.1%)and rheumatoid arthritis(5.0%).One hundred and seven cases exhibited the"reverse atrophy"phenomenon,while 54 cases showed pan-gastric atrophy,predominantly in the fundus and body.Fifteen cases were diagnosed as gastric neuroendocrine tumors(NET)or gastric carcinoma.Pathological analysis of 90 gastric mucosal specimens showed 24 cases of lymphocyte and plasma cell infiltration without significant atrophy,42 cases of glandular atrophy and lymphocyte infiltration,and 24 cases of enterochromaffin cell hyperplasia and the formation of endocrine micro-nests.Conclusions:AIG is more common in middle-aged and elderly individuals,with a slightly higher prevalence in females and a frequent association with anemia.It should be suspected in patients with low PGⅠ level and hypergastrinemia.Due to the increased risk of gastric adenocarcinoma and NETs,regular endoscopic monitoring is recommended.

Background:Autoimmune gastritis(AIG)is a CD4+T cell-mediated immune disease.In recent years,with increased awareness and understanding of the condition,reports of AIG cases in China have been gradually increasing.Aims:To analyze and summarize the clinical characteristics of AIG for better disease recognition and diagnosis.Methods:Data on AIG patients diagnosed at the First Affiliated Hospital of Zhejiang Chinese Medical University from August 2018 to December 2023 were collected and analyzed for their clinical,laboratory,endoscopic,and pathological features.Results:A total of 161 AIG patients were included,with the mean age of 56.81 years old,63 were males and 98 females.Most of the patients exhibited no characteristic clinical symptoms.The laboratory measurements were as follows:gastrin-17,44.68 pmol/L;pepsinogen(PG)Ⅰ,38.61 μg/L;PG Ⅱ,10.41 μg/L;PGⅠ/Ⅱ ratio,32.1;vitamin B12,344.45 pmol/L;and hemoglobin,125.15 g/L.The positivity rates of thyroglobulin antibody and thyroid peroxidase antibody were 46.0%and 30.0%,respectively.The main comorbid autoimmune diseases were Hashimoto's thyroiditis(8.1%)and rheumatoid arthritis(5.0%).One hundred and seven cases exhibited the"reverse atrophy"phenomenon,while 54 cases showed pan-gastric atrophy,predominantly in the fundus and body.Fifteen cases were diagnosed as gastric neuroendocrine tumors(NET)or gastric carcinoma.Pathological analysis of 90 gastric mucosal specimens showed 24 cases of lymphocyte and plasma cell infiltration without significant atrophy,42 cases of glandular atrophy and lymphocyte infiltration,and 24 cases of enterochromaffin cell hyperplasia and the formation of endocrine micro-nests.Conclusions:AIG is more common in middle-aged and elderly individuals,with a slightly higher prevalence in females and a frequent association with anemia.It should be suspected in patients with low PGⅠ level and hypergastrinemia.Due to the increased risk of gastric adenocarcinoma and NETs,regular endoscopic monitoring is recommended.

Objective:To evaluate the efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP) after pancreaticoduodenectomy and endoscopic selection strategies.Methods:Clinical data of 34 patients treated with ERCP after pancreaticoduodenectomy at the Endoscopic Center of the First Affiliated Hospital of Air Force Medical University from January 2013 to December 2021 were retrospectively analyzed. The success rates of endoscopic insertion, diagnosis, treatment and ERCP, and the incidence of adverse events were analyzed.Results:Fifty ERCP treatments were performed in 34 patients. The success rates of endoscopic insertion, diagnosis, treatment, and ERCP after pancreaticoduodenectomy were 92.0% (46/50), 93.5% (43/46), 88.4% (38/43) and 76.0% (38/50), respectively. The success rates of ERCP assisted with colonoscope and balloon-assisted enterosocpe were 76.0% (19/25) and 75.0% (18/24), respectively. There were 3 adverse events, including 1 case of anastomotic mucosa tear during surgery, 1 case of cardiopulmonary arrest and 1 case of postoperative cholangitis.Conclusion:ERCP is effective and safe after pancreaticoduodenectomy in general. ERCP assisted with colonoscope and balloon-assisted colonoscope shows similar success rate after pancreaticoduodenectomy.

Middle-aged women experienced foreign body sensation in both eyes without obvious causes for many days. The clinician tried to diagnose the patient according to her physical and laboratory examinations. After detecting worm bodies in the patient′s eye, and examining the worms with a microscope, the diagnosis of conjunctival sucking nematodes was confirmed. After targeted treatment, the patient′s symptoms improved significantly.

Biosynthesis of nanomaterials has attracted much attention for its excellent characteristics such as low energy consumption, high safety, and environmental friendliness. As we all know, the toxic selenite can be transformed into higher-value nanomaterials by using bacteria. In this study, nano-selenium was synthesized by halophilic Bacillus subtilis subspecies stercoris strain XP in LB medium supplemented with selenite (electron acceptor). The physicochemical characteristics of nano-selenium were analyzed by scanning electron microscope (SEM), X-ray energy dispersive spectral analysis (EDAX), X-ray diffraction (XRD), and fourier transform infrared spectroscopy (FTIR). Meanwhile, the antifungal activity of nano-selenium to strawberry pathogens (fusarium wilt, erythema, and purple spot fungi) was determined. The products from reduction of selenite by strain XP was amorphous spherical selenium nanoparticles (SeNPs) with a diameter range of 135-165 nm. The production of SeNPs was positively correlated with time (0-48 h) and no changes were observed on cell morphology. Selenium was dominant in the surface of SeNPs where the organic elements (C, O, N, and S) existed at the same time. SeNPs were coated with biomolecules containing functional groups (such as -OH, C=O, N-H, and C-H) which were associated with the stability and bioactivity of particles. Although the highest concentration of SeNPs had significant (P<0.05) inhibitory effects on three strains of strawberry pathogens, antifungal activity to erythema and fusarium wilt pathogenic fungi was higher than that to purple spot pathogenic fungi from strawberry. In conclusion, strain XP not only has strong tolerance to high salt stress, but can be also used to synthesize biological SeNPs with good stability and biological activity. Thus, the strain XP has bright perspectives and great potential advantage in pathogens control and green selenium-rich strawberry planting as well as other fields.
Bacillus subtilis ; Fragaria ; Nanoparticles ; Selenious Acid ; Selenium

Objective: To identify the characteristics including clinical features and pulmonary computed tomography (CT) features of heart failure and novel coronavirus pneumonia(COVID-19). Methods: This study was a retrospective study. A total of 7 patients with Heart failure and 12 patients with COVID-19 in the Second Xiangya Hospital of Central South University between December 1, 2019 and February 15, 2020 were enrolled. The baseline clinical and imaging features of the two groups were statistically analyzed. Results: There was no significant difference in age and sex between the two groups, but the incidence of epidemiological contact history, fever or respiratory symptoms in the COVID-19 group was significantly higher than that in the heart failure group (12/12 vs. 2/7, P=0.001; 12/12 vs. 4/7, P<0.001). While the proportion of cardiovascular diseases and impaired cardiac function was significantly less than that of the heart failure group(2/12 vs.7/7, P<0.001; 0/12 vs.7/7, P<0.001). For imaging features, both groups had ground-glass opacity and thickening of interlobular septum, but the ratio of central and gradient distribution was higher in patients with heart failure than that in patients with COVID-19 (4/7 vs. 1/12, P=0.04). In heart failure group, the ratio of the expansion of small pulmonary veins was also higher (3/7 vs. 0, P=0.013), and the lung lesions can be significantly improved after effective anti-heart failure treatment. Besides, there are more disease with rounded morphology in COVID-19 (9/12 vs. 2/7, P=0.048) . Conclusions More patients with COVID-19 have epidemiological history and fever or respiratory symptoms. There are significant differences in chest CT features, such as enlargement of pulmonary veins, lesions distribution and morphology between heart failure and COVID-19.

Combined training is a new training mode which combines the education of profes-sional degree of clinical medicine graduate and the resident standardization training. Xiangya hospital of Central South University has tried this kind of training mode since 2012. We draw lessons from the advanced training concept in America in combination with the practical situation of our hospital and have established theXiangya-Yalemodel of resident standardization training featuring with the Six Xiangya goals which areprofessional ethics, professional skills, patient safety, medical ethics, teamwork spirit, innovation and self-improvement, highlighting the project manager responsibility system, 360 degree examination and assess-ment, assessment of the OSCE, Mini-CEX evaluation. Through comparing and analyzing the midterm exami-nation scores between the combined training group and non-combined training group, we have found that the combined training group is significantly superior to non-combined training group on clinical skills. In addition, the questionnaire survey results show that most graduate students have positive attitude tocombined training. They believe it will be helpful for them to improve the ability of clinical skills, med-ical practice, doctor-patient communication skills and theoretical knowledge, and contributes to the future career development. Combined training is one major initiative deepening the reform of medical health system and medical education which greatly promotes the development of our country health enterprise, although there still exist some flaws including training teachers, content, implementation, management and evaluation.