Objective To explore factors affecting blood pressure control in chronic disease patients in China's na-tional basic public health service chronic disease patient management program and to find their relationships with Bayesian network(BN)model,in order to provide a scientific basis for comprehensive hypertension management.Methods 5 577 Hypertensive patients were selected from eight provinces(including autonomous regions)covering eastern,central and western parts of China during a survey from 2021 to 2022.Researchers collected individual and community-management data to screen influencing factors by Logistic regression,and to describe factor dependencies and to identify key determinants of blood pressure control with BN in.blood pressure control.Results Logistic regression revealed that urban/rural status,education,alcohol use,exercise,overweight/obesity and com-munity-doctor advice on salt reduction,smoking cessation were significantly associated with blood pressure control(P＜0.05).The BN model identified 22 directed edges showing that urban residence and good hypertension knowl-edge were more correlated with better control,while community-doctor management and services directly affected patient lifestyle habits but not blood pressure control.Conclusions Research should focus more on urban-rural dis-parities and hypertension education.Additionally,improving patient habits and community-doctor services is essen-tial for better blood pressure control.

Objective To develop a home skin care guidance scheme for newborns,and initially implement it to reducing the risk of skin-related issues.Methods Searching both domestic and international databases,we identified relevant literature.Following a quality evaluation,evidence integration,and group discussions,we developed the con-tent of the home skin care guidance for newborns.Subsequently,we refined this content through 2 rounds of expert consultations to finalize the scheme.To initially implement the scheme,we conveniently selected 20 healthy new-borns born between August 1st and 15th,2024,at a tertiary-level comprehensive hospital in Fujian Province as an experimental group.Their parents received skin care guidance based on our scheme via a WeChat platform.In contrast,we selected another group of 20 healthy newborns delivered between July 1st and 15th,2024,at the same hospital as a control group;their parents were provided with conventional skin care guidance.We compared the in-cidence rates of diaper dermatitis and eczema between these 2 groups of newborns at a month of age.Results A total of 33 experts from 30 tertiary hospitals across 19 provinces(including autonomous regions and municipalities)were invited to participate in a questionnaire survey.The response rates for both rounds of expert questionnaires reached 100％.The authority coefficients for the experts were recorded at 0.78 and 0.83,while the Kendall concor-dance coefficients were found to be 0.188 and 0.142(all P＜0.001).The final newborn home skin care guidance scheme consists of 6 first-level items,41 second-level items,such as the selection of newborn care products,methods for neonatal bathing and prevention of neonatal diaper dermatitis,and so on.Preliminary application results indicated that the incidence of diaper dermatitis in the experimental group was significantly lower than that observed in the control group,with a statistically significant difference noted(P=0.047).There was no significant difference in the incidence of eczema between the 2 groups at the age of a month(P=0.201).Conclusion The Neonatal Home Skin Care Guidance Scheme for newborns has been demonstrated to be scientific,reliable and feasible.The implementa-tion of this scheme has proven beneficial in reducing the incidence of diaper dermatitis at a month of age.Howev-er,the sample size needs to be expanded to further verify its implementation effect.

Objective:To analyze the predictive factors associated with late-onset sepsis(LOS) in very low birth weight infants,and to develop a risk prediction score scale applicable to these infants three days postnatal.This will provide valuable insights for early diagnosis and timely intervention.Methods:Very low birth weight infants admitted to the Children's Hospital of Fudan University from January 1,2022,to June 30,2024,were selected as research subjects.These infants were categorized into two groups:the LOS group and the non-LOS group,based on whether they developed LOS.LASSO regression analysis,alongside univariate and multivariate regression analyses,was employed to identify predictive factors for LOS in this population.A Logistic model was constructed using the optimal combination of predictive variables,and a risk assessment scale was subsequently developed.The prediction performance of the model was evaluated using the Hosmer-Lemeshow chi-square test and the receiver operating characteristic curve.Results:A total of 444 cases of very low birth weight infants were included,of which 185 had LOS and 259 did not.After screening the variables,seven independent factors were included into the model:birth weight,gestational age,tracheal intubation,abnormal skin color,abdominal distension,elevated C-reactive protein levels,and right hand perfusion index.A predictive scoring scale was developed based on the regression coefficients of each variable,with corresponding risk scores assigned as follows:1,4,3,2,1,1,and 2; a score of ≥3.5 indicated high-risk groups.The Hosmer-Lemeshow test results demonstrated that χ2 = 7.602( P = 0.473).The area under the receiver operating characteristic curve was 0.792 ( P<0.001),with a sensitivity of 73.5% and specificity of 71.0%. Conclusion:The risk score scale developed in this study exhibits significant predictive capability,providing valuable insights for clinical medical personnel to assess the risk of LOS in very low birth weight infants during the early postnatal period.

Objective To develop a home skin care guidance scheme for newborns,and initially implement it to reducing the risk of skin-related issues.Methods Searching both domestic and international databases,we identified relevant literature.Following a quality evaluation,evidence integration,and group discussions,we developed the con-tent of the home skin care guidance for newborns.Subsequently,we refined this content through 2 rounds of expert consultations to finalize the scheme.To initially implement the scheme,we conveniently selected 20 healthy new-borns born between August 1st and 15th,2024,at a tertiary-level comprehensive hospital in Fujian Province as an experimental group.Their parents received skin care guidance based on our scheme via a WeChat platform.In contrast,we selected another group of 20 healthy newborns delivered between July 1st and 15th,2024,at the same hospital as a control group;their parents were provided with conventional skin care guidance.We compared the in-cidence rates of diaper dermatitis and eczema between these 2 groups of newborns at a month of age.Results A total of 33 experts from 30 tertiary hospitals across 19 provinces(including autonomous regions and municipalities)were invited to participate in a questionnaire survey.The response rates for both rounds of expert questionnaires reached 100％.The authority coefficients for the experts were recorded at 0.78 and 0.83,while the Kendall concor-dance coefficients were found to be 0.188 and 0.142(all P＜0.001).The final newborn home skin care guidance scheme consists of 6 first-level items,41 second-level items,such as the selection of newborn care products,methods for neonatal bathing and prevention of neonatal diaper dermatitis,and so on.Preliminary application results indicated that the incidence of diaper dermatitis in the experimental group was significantly lower than that observed in the control group,with a statistically significant difference noted(P=0.047).There was no significant difference in the incidence of eczema between the 2 groups at the age of a month(P=0.201).Conclusion The Neonatal Home Skin Care Guidance Scheme for newborns has been demonstrated to be scientific,reliable and feasible.The implementa-tion of this scheme has proven beneficial in reducing the incidence of diaper dermatitis at a month of age.Howev-er,the sample size needs to be expanded to further verify its implementation effect.

Objective:To analyze the predictive factors associated with late-onset sepsis(LOS) in very low birth weight infants,and to develop a risk prediction score scale applicable to these infants three days postnatal.This will provide valuable insights for early diagnosis and timely intervention.Methods:Very low birth weight infants admitted to the Children's Hospital of Fudan University from January 1,2022,to June 30,2024,were selected as research subjects.These infants were categorized into two groups:the LOS group and the non-LOS group,based on whether they developed LOS.LASSO regression analysis,alongside univariate and multivariate regression analyses,was employed to identify predictive factors for LOS in this population.A Logistic model was constructed using the optimal combination of predictive variables,and a risk assessment scale was subsequently developed.The prediction performance of the model was evaluated using the Hosmer-Lemeshow chi-square test and the receiver operating characteristic curve.Results:A total of 444 cases of very low birth weight infants were included,of which 185 had LOS and 259 did not.After screening the variables,seven independent factors were included into the model:birth weight,gestational age,tracheal intubation,abnormal skin color,abdominal distension,elevated C-reactive protein levels,and right hand perfusion index.A predictive scoring scale was developed based on the regression coefficients of each variable,with corresponding risk scores assigned as follows:1,4,3,2,1,1,and 2; a score of ≥3.5 indicated high-risk groups.The Hosmer-Lemeshow test results demonstrated that χ2 = 7.602( P = 0.473).The area under the receiver operating characteristic curve was 0.792 ( P<0.001),with a sensitivity of 73.5% and specificity of 71.0%. Conclusion:The risk score scale developed in this study exhibits significant predictive capability,providing valuable insights for clinical medical personnel to assess the risk of LOS in very low birth weight infants during the early postnatal period.

Objective:To study the life characteristics and related risk factors of patients with depression in Shandong Province.Methods:Based on the 2015 mental epidemiological survey database in Shandong Province,a total of 832 patients with depression,807 high-risk individuals with depression,and 819 low-risk individuals were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition(DSM-Ⅳ)and the Structured Clinical Interview for DSM-Ⅳ-TR Axis I Disorders,Research Version(SCID-I/P).In 2020,SCID-I/P was used for re diagnosis,and the General Health Questionnaire(GHQ-12),Simple Quality of Life question-naire,Pittsburgh sleep quality index(PSQI),Childhood Trauma Questionnaire(CTQ),Social Support Rating Scale(SSRS),Global Pain Scale(GPS),Montreal Cognitive Assessment(MoCA),Simplified Coping Style Question-naire(SCSQ)were used for evaluation.Compare changes in the quality of life of depression patients and construct a risk factor model.Results:Patients with depression had lower scores on the simple quality of life questionnaire at baseline and at retest after 5 years than those in the high-and low-risk groups,those in remission of depression had higher scores on the simple quality of life questionnaire at baseline and at retest after 5 years than those in non-re-mission,and those with new-onset disorder in the high-and low-risk groups had lower scores on the simple quality of life questionnaire at baseline and at retest after 5 years than those with no-onset disorder(Ps＜0.001).Depres-sion diagnosis and PSQI scale scores at baseline negatively predicted at retest after 5 years(β=-0.06,-0.15),while coping style tendencies at baseline positively predicted(β=0.06).The simple quality of life questionnaire at baseline negatively predicted depression diagnosis at retest after 5 years,GHQ-12 scores at retest after 5 years,and PSQI scale scores at retest after 5 years(β=-0.11,-0.17,-0.09),while the simple quality of life question-naire at baseline positively predicted coping style tendencies at retest after 5 years(β=0.13).Depression diagnosis at retest after 5 years,GHQ-12 scores at retest after 5 years,PSQI scale scores at retest after 5 years,coping style tendencies at retest after 5 years,SSRS scale scores,CTQ scale scores,GPS scale scores,and the simple quality of life questionnaire at baseline all influenced the simple quality of life questionnaire at retest after 5 years through ei-ther direct or indirect pathways.Conclusion:It suggest that the quality of life is lower in patients with depression than in the general population.Depression diagnosis,sleep,mental health,pain,social support,childhood trauma and coping are direct and indirect risk factors affecting life.

Objective:To evaluate the role of silent information regulator-1 (SIRT1)/nucleotide-binding domain (NOD)-like receptor protein-3 (NLRP3) signaling pathway in sevoflurane postconditioning-induced attenuation of oxygen-glucose deprivation and restoration (OGD/R) injury in mouse hippocampal neuronal cell line (HT22) cells.Methods:The HT22 cells were seeded in a culture plate (96-well plate, 100 μl/well; 6-well plate, 2 ml/well) at the density of 5×10 4 cells/ml or in a culture dish (6 cm in diameter) and then divided into 4 groups ( n=24 each) using a random number table method: control group (Control group), OGD/R group, sevoflurane postconditioning group (SPC group), and SIRT1 small interfering RNA group (si-SIRT 1 group). In Control group, cells were cultured at 37 ℃ in normal culture atmosphere. In OGD/R group, the culture medium was replaced with glucose-free serum-free culture medium, and cells were exposed to 95% N 2+ 5% CO 2 for 4 h in an incubator at 37 ℃, and then the glucose-free serum-free culture medium was replaced with the primary culture medium, and cells were cultured for 24 h at 37 ℃ in normal culture atmosphere. In SPC group, the glucose-free serum-free culture medium was replaced with the primary cell culture medium after 4-h oxygen and glucose deprivation, the cells were put into the hypoxia incubator chamber which was filled with 2% sevoflurane immediately after start of reoxygenation, then the chamber was placed in an incubator and the cells were cultured for 1 h at 37 ℃ in normal culture atmosphere, and finally the cells were removed from the chamber and cultured for 23 h at 37 ℃ in normal culture atmosphere. In si-SIRT1 group, SIRT1 small interfering RNA 150 pmol was added at 24 h before surgery, cells were then incubated, and the other procedures were the same as those previously described in group SPC. The cell survival rate was determined using MTT assay. TUNEL assay was used to detect cell apoptosis, and the apoptosis rate was calculated. The expression of SIRT1, NLRP3, IL-1β and IL-18 mRNA was determined using polymerase chain reaction. The expression of SIRT1, NLRP3, interleukin-1beta (IL-1β) and IL-18 was detected using Western blot. Results:Compared with Control group, the cell survival rate was significantly decreased, the apoptosis rate was increased, the expression of SIRT1 protein and mRNA was down-regulated, and the expression of NLRP3, IL-1β and IL-18 protein and mRNA was up-regulated in OGD/R group ( P<0.05). Compared with OGD/R group, the cell survival rate was significantly increased, the apoptosis rate was decreased, the expression of SIRT1 protein and mRNA was up-regulated, and the expression of NLRP3, IL-1β and IL-18 protein and mRNA was down-regulated in SPC group ( P<0.05). Compared with SPC group, the cell survival rate was significantly decreased, the apoptosis rate was increased, the expression of SIRT1 protein and mRNA was down-regulated, and the expression of NLRP3, IL-1β and IL-18 protein and mRNA was up-regulated in si-SIRT1 group ( P<0.05). Conclusions:Activation of SIRT1-NLRP3 signaling pathway is involved in sevoflurane postconditioning-induced attenuation of OGD/R injury in HT22 cells.

Objective:To evaluate the relationship between methyltransferase-like 3(METTL3)-mediated RNA N6-Methyladenosine (m6A) methylation modification and silent information regulator factor 1 (SIRT1) during sevoflurane post-conditioning-induced mitigation of cognitive impairments in a mouse model of hemorrhagic shock and resuscitation(HSR).Methods:Forty clean-grade healthy male C57BL/6 mice, aged 8-10 weeks, with a body weight ranging from 22-26 g, were assigned into 5 groups ( n=8 each) using a random number table method: sham operation group, HSR group, sevoflurane post-conditioning + HSR group (SP+ HSR group), over-expression of METTL3 gene rAAV + sevoflurane post-conditioning + HSR group (METTL3+ SP+ HSR group), and over-expression of METTL3 gene rAAV negative control + sevoflurane post-conditioning + HSR group (NC+ SP+ HSR group). The HSR model was established by withdrawing 40% of the total blood volume from mice through the right carotid artery within 30 min, followed by reinfusion of the withdrawn blood over 30 min 1 h later. The SP+ HSR group underwent HSR modeling first and then inhaled sevoflurane (end-tidal concentration 2.4%) for 30 min starting from the time point immediately after blood transfusion. The Sham group and HSR group inhaled a mixture of 70% O 2 and 30% CO 2 for 30 min at the corresponding time points. In METTL3+ SP+ HSR group and NC+ SP+ HSR group, the corresponding virus 450 nl was injected into bilateral hippocampus at 4 weeks before establishing the model.Morris water maze and novel object recognition tests were conducted at 72 h after developing the model to assess the learning and memory abilities. After the end of behavioral tests, the expression of METTL3 and SIRT1 in hippocampal tissues was detected using Western blot, the expression of SIRT1 mRNA was measured using qRT-PCR, and the methylation of RNA m6A was detected using Dot blot. Results:Compared to Sham group, the escape latency was significantly prolonged at 1-6 days, the time spent in the target quadrant was shortened, the number of crossing the original platform was decreased, the novel object recognition index was decreased, the expression of METTL3 was up-regulated, the expression of SIRT1 protein and mRNA was down-regulated, and the methylation of RNA m6A was increased in HSR group( P<0.05). Compared to HSR group, the escape latency was significantly shortened at 1-6 days, the time spent in the target quadrant was prolonged, the number of crossing the original platform was increased, the novel object recognition index was increased, the expression of METTL3 was up-regulated, the expression of SIRT1 protein and mRNA was down-regulated, and the methylation of RNA m6A was increased, the novel object recognition index was increased, the expression of METTL3 was down-regulated, the expression of SIRT1 protein and mRNA was up-regulated, and the methylation of RNA m6A was decreased in SP+ HSR group( P<0.05). Compared to SP+ HSR group, the escape latency was significantly prolonged at 2-6 days, the time spent in the target quadrant was shortened, the number of crossing the original platform was decreased, the novel object recognition index was decreased, the expression of METTL3 was up-regulated, the expression of SIRT1 protein and mRNA was down-regulated, and the methylation of RNA m6A was increased in METTL3+ SP+ HSR group( P<0.05), and no significant change was found in the aforementioned indicators in NC+ SP+ HSR group ( P>0.05). Conclusions:The mechanism by which sevoflurane post-conditioning alleviates cognitive dysfunction is associated with down-regulation of METTL3 expression, reduction of RNA m6A methylation, and up-regulation of SIRT1 expression in HSR mice.

Glucose monitoring is an important part of medical care in diabetes mellitus, which not only helps assess glycemic control and treatment safety, but also assists with treatment adjustment. With the development of continuous glucose monitoring (CGM), the use of CGM has increased rapidly. With the wealth of glucose data produced by CGM, new metrics are greatly needed to optimally evaluate glucose status and guide the treatment. One of the parameters that CGM provides, time in range (TIR), has been recognized as a key metric by the international consensus. Before the adoption of TIR in clinical practice, several issues including the minimum length of CGM use, the setting of the target range, and individualized TIR goals are summarized. Additionally, we discussed the mounting evidence supporting the association between TIR and diabetes-related outcomes. As a novel glucose metric, it is of interest to compare TIR with other conventional glucose markers such as glycated hemoglobin A1c. It is anticipated that the use of TIR may provide further information on the quality of glucose control and lead to improved diabetes management.

Objective Using the information - motivation - behavior model (IMB) to intervene with the alcohol dependence patients and provide a new strategy for implementing health education. Methods Eighty-nine patients with alcohol dependence, who clinically recovered or improved after the discharge, were randomly divided into a research group and a control group. Both groups received routine health education, rehabilitation guidance and a follow-up call. The research group implemented additional IMB health education. The implementation effect on alcohol dependence scale (ADS), Michigan alcoholism screening test (MAST), and alcohol dependence prevention and treatment knowledge (self-designed questionnaire) of the two groups before and after intervention was analyzed. Results The relapse rate of the research group was lower than that the control group, which was statistically significant (P＜0.05). MAST scale and ADS scale in the research group were lower than those in the control group within 3 months and 6 months after the discharge, which was significant (P values of both scales ＜0.05). After the 6-month follow-up, the knowledge of alcohol dependence patients in the research group and their families was significantly higher than that in the control group (P＜0.05). Conclusion IMB health education implementation for alcohol dependence patients significantly reduced the relapse rate, decreased physical and psychological dependence, and improved the ability of patients to prevent and control alcohol dependence.