Objective:To analyze the cost-effectiveness of high-flux hemodialysis compared to low-flux hemodialysis in the treat-ment of End-Stage Renal Disease(ESRD)patients.Methods:Based on a literature review,a cost-effectiveness analysis model was established,using the Incremental Cost-Effectiveness Ratio(ICER)as the outcome indicator to evaluate the economic value of high-flux versus low-flux hemodialysis.One-way sensitivity analysis and probabilistic sensitivity analysis were conducted to further assess the robustness of the results.Results:In the treatment of ESRD patients,compared to low-flux hemodialysis,the ICER of high-flux hemodialysis was 234 882 yuan per QALY.The key factors influencing the model results were the cost discount rate,ef-fect discount rate,utility value of high-flux hemodialysis,and treatment costs.Conclusion:Compared to low-flux hemodialysis,high-flux hemodialysis demonstrates a cost-effectiveness advantage at a willingness-to-pay threshold of three times GDP per capita.

Objective To explore the characteristics of the potential categories of traumatic psychological reactions in ICU patients and analyze the influencing factors of different potential categories,in order to provide ideas for the implementation of scientific and effective personalized intervention in the future.Methods A convenience sample of 300 patients treated in the ICU of a hospital from May 2023 to February 2024 was surveyed.The used instruments included a general information questionnaire,the Social Support Rating Scale,the Brief Resilience Scale,the Acute Stress Disorder Scale,and the Simplified Chinese version of the Post-Traumatic Growth Inventory.Data were analyzed using multivariate Logistic regression.Additionally,a purposive sampling method was used to conduct semi-structured interviews with 12 ICU patients,and the interview data were analyzed by interpretative phenomenological analysis.Results Quantitative research results showed that the traumatic psychological responses of ICU patients were categorized into 4 latent classes,including Trauma-Dependent Type(17.3％),Smooth-Transition Type(36.0％),External-Support Growth Type(25.3％),and Internal-Rooted Growth Type(21.3％).Factors influencing these responses included age,educational level,social support,psychological resilience,household income,and the number of used hormone medications(P＜0.05).Qualitative research results showed that 4 core themes were identified,including immersion in psychological trauma,rational cognition and acceptance of reality,seeking external support for personal growth,and independent exploration of inner self.Influencing factors included age,income level,history of major illness or ICU treatment,level of disease awareness,presence of underage children,and individual capacity for rumination.The quantitative and qualitative results were mutually corroborative and complemented each other.Conclusion The acute stress response of ICU patients is obvious,and there are multiple characteristics in the potential categories of traumatic psychological response,suggesting that medical and nursing staff can identify the characteristics of various types and influencing factors early,formulate personalized intervention programs,and promote their post-traumatic growth.

Objective:To analyze the cost-effectiveness of high-flux hemodialysis compared to low-flux hemodialysis in the treat-ment of End-Stage Renal Disease(ESRD)patients.Methods:Based on a literature review,a cost-effectiveness analysis model was established,using the Incremental Cost-Effectiveness Ratio(ICER)as the outcome indicator to evaluate the economic value of high-flux versus low-flux hemodialysis.One-way sensitivity analysis and probabilistic sensitivity analysis were conducted to further assess the robustness of the results.Results:In the treatment of ESRD patients,compared to low-flux hemodialysis,the ICER of high-flux hemodialysis was 234 882 yuan per QALY.The key factors influencing the model results were the cost discount rate,ef-fect discount rate,utility value of high-flux hemodialysis,and treatment costs.Conclusion:Compared to low-flux hemodialysis,high-flux hemodialysis demonstrates a cost-effectiveness advantage at a willingness-to-pay threshold of three times GDP per capita.

Objective To explore the characteristics of the potential categories of traumatic psychological reactions in ICU patients and analyze the influencing factors of different potential categories,in order to provide ideas for the implementation of scientific and effective personalized intervention in the future.Methods A convenience sample of 300 patients treated in the ICU of a hospital from May 2023 to February 2024 was surveyed.The used instruments included a general information questionnaire,the Social Support Rating Scale,the Brief Resilience Scale,the Acute Stress Disorder Scale,and the Simplified Chinese version of the Post-Traumatic Growth Inventory.Data were analyzed using multivariate Logistic regression.Additionally,a purposive sampling method was used to conduct semi-structured interviews with 12 ICU patients,and the interview data were analyzed by interpretative phenomenological analysis.Results Quantitative research results showed that the traumatic psychological responses of ICU patients were categorized into 4 latent classes,including Trauma-Dependent Type(17.3％),Smooth-Transition Type(36.0％),External-Support Growth Type(25.3％),and Internal-Rooted Growth Type(21.3％).Factors influencing these responses included age,educational level,social support,psychological resilience,household income,and the number of used hormone medications(P＜0.05).Qualitative research results showed that 4 core themes were identified,including immersion in psychological trauma,rational cognition and acceptance of reality,seeking external support for personal growth,and independent exploration of inner self.Influencing factors included age,income level,history of major illness or ICU treatment,level of disease awareness,presence of underage children,and individual capacity for rumination.The quantitative and qualitative results were mutually corroborative and complemented each other.Conclusion The acute stress response of ICU patients is obvious,and there are multiple characteristics in the potential categories of traumatic psychological response,suggesting that medical and nursing staff can identify the characteristics of various types and influencing factors early,formulate personalized intervention programs,and promote their post-traumatic growth.

Rheumatic diseases are a kind of chronic inflammatory diseases mainly involving joints and surrounding tissues. Most patients with rheumatic diseases need long-term treatment, which is difficult to be avoided during pregnancy. Treatment efficacy, as well as maternal and fetal safety should be taken into account in the medical decision. Based on the domestic and foreign guidelines, consensus, diagnosis and treatment experience, Chinese Rheumatology Association developed the standardization of medication use in patients with rheumatic diseases preparing and during pregnancy, aiming on the application and precautions of commonly used medicines for rheumatic diseases in preparing pregnancy, pregnancy and lactation.

Objective:To investigate the effect of endometrial thickness(EMT) on the clinical outcome of blastocyst hormone replacement freeze-thawed embryo transfer (HRT-FET) on the first progesterone day, and to analyze the threshold and optimal thickness interval corresponding to ideal clinical pregnancy rate by statistical method.Methods:The endometrial preparation protocols of 2 825 blastocyst HRT-FET cycles from January 2013 to December 2016 in Henan Provincial People′s Hospital and the Second Hospital of Hebei Medical University were studied retrospectively. According to EMT on the first progesterone day, they were divided into 5 subgroups: group Q1(EMT: 3.5-7.9 mm), group Q2(EMT: 8.0-8.9 mm), group Q3(EMT: 9.0-9.5 mm), group Q4(EMT: 9.6-10.7 mm), group Q5(EMT: 10.8-21.0 mm). Univariate analysis, classification multivariate Logistic regression analysis, curve fitting and threshold effect analysis were used to investigate the effect of endometrial thickness on clinical outcome of blastocyst HRT-FET.Results:Group Q1 was set as the control group in classification multivariate Logistic regression analysis, after adjusting for confounding factors, the clinical pregnancy rate and live birth rate in other groups were higher than the control group. The clinical pregnancy rate and live birth rate in group Q3 and Q4 were significantly increased and the differences were statistically significant(all P<0.05). The cut-off value of the endometrial thickness was 9.6 mm. When endometrial thickness was less than 9.6 mm, with 1 mm increase of endometrial thickness, the clinical pregnancy rate increased by 23%( OR=1.23, 95% CI=1.11-1.36) and the live birth rate increased by 21%( OR=1.21, 95% CI=1.10-1.33). When the endometrial thickness was thicker than the threshold, the clinical pregnancy rate did not increase significantly( OR=0.92, 95% CI=0.84-1.02), and the live birth rate showed a downward trend( OR=0.88, 95% CI=0.81-0.96). Conclusions:In the blastocyst HRT-FET cycle, endometrial thickness showes a curvilinear relationship with clinical outcome. The optimal endometrial thickness range for ideal clinical outcome is 9.0-11.0 mm.

Objective To explore the effects of mindfulness training combined with auricular acupressure on sleep quality and negative emotion in patients with stroke. Methods Totally 70 stroke patients hospitalized in Rehabilitation Department of the First Affiliated Hospital of Harbin Medical University between October and December 2018 were selected by convenient sampling, and randomly divided into the observation group (n=35) and the control group (n=35). Patients in the control group received routine rehabilitation nursing, while patients in the observation group received mindfulness training combined with auricular acupressure on this basis. The Pittsburgh Sleep Quality Index Scale (PSQI), Self-Depression Scale (SDS) and Self-Anxiety Scale (SAS) were used to evaluate the sleep quality and negative emotion of the two groups of patients before and after the intervention. Results After the intervention, the PSQI, SDS, and SAS scores of the observation group were lower than those of the control group, and the differences were statistically significant (P< 0.05). Conclusions Mindfulness training combined with auricular acupressure can effectively ameliorate the sleep quality and negative emotion in patients with stroke.

Objective:To explore the current status of self-perceived burden among patients with chronic wound and influencing factors and to analyze its influencing factors.Methods:From July 2018 to August 2019, we selected 113 patients with chronic wounds treated in Wound Clinic of the First Affiliated Hospital of Harbin Medical University as research objects. All patients were investigated with the General Information Scale, Self-perceived Burden Scale (SPBS) , Sense of Coherence-13 (SOC-13) , Social Support Rating Scale (SSRS) .Results:A total of 113 questionnaires were distributed in this study, and a total of 102 valid questionnaires were returned. Among patients with chronic wounds, the score of SPBS was (28.37±10.10) at a mild level. The total score and dimensions scores of SPBS of patients with chronic wounds had negative correlations with the total score of SOC-13, the total score and dimension scores of SSRS with statistical differences ( P<0.05) . Multiple linear regression analysis showed that the influencing factors of self-perceived burden were the age, occupation, social support and sense of coherence also with statistical differences ( P<0.05) . Conclusions:The self-perceived burden of patients with chronic wound is at a mild level. Clinical medical and nursing staff should carry out targeted nursing measures according to patients' self-perceived burden to reduce the self-perceived burden of patients so as to reducing the impact of psychological factors on wound healing.

Objective:To analyze the trend relevant factors leading to death and their patterns over a 10-year period in inpatients with connective tissue diseases (CTDs).Methods:All clinical data about death in inpatients with CTDs were retrospectively reviewed between 2005 and 2014 at the Department of Rheumatology and Immunology in Xiangya Hospital of Central South University.Results:In the 10-year time period,the overall hospital mortality was 15.689‰.The disease itself accounted for 44.71% of the total causes of death,infection accounted for 42.94%,and comorbidities accounted for 12.35%.The constituent ratio of deaths and the average hospital mortality caused by the disease itself declined gradually year by year,and the constituent ratio of deaths caused by infection and comorbidities increased gradually year by year (P<0.05).In 2013-2014,infection was the leading cause of death,which accounted for 51.06%.The survival time for CTDs inpatients with interstitial lung disease (ILD) was shorter than that of CTDs inpatients without ILD,and even the risk of death was 1.722 times of the latter.The proportion of deaths caused by the disease itself was the highest in systemic sclerosis and systemic lupus erythematosus,that by infection was the highest in idiopathic inflammatory myopathy (IIM),and that by comorbidities was the highest in rheumatoid arthritis.Conclusion:The proportion of deaths and the hospital mortality in CTDs inpatients caused by the disease itself show a declining trend,while the proportion of deaths caused by infection and comorbidities increase.CTDs patients with ILD have shorter survival time and an increase in risk of death.

Objective To investigate the relationship between wheezing and serum levels of 25-hydroxyvitamin D3.Methods 130 children with lower respiratory tract infection were selected as the subjects, the children with wheezing in group A([Abstract] Objective To investigate the relationship between wheezing and serum levels of 25-hydroxyvitamin D3.Methods 130 children with lower respiratory tract infection were selected as the subjects, the children with wheezing in group A(n=70),normal pneumonia (no wheezing) were group B(n=60); The healthy children who were examined in the hospital at the same period were selected as the control group (n=60). The serum levels of 25-hydroxyvitamin D3 were measured by ELISA in the control and hospitalized children. The pathogens and allergens of the two groups were also detected. Results The levels of serum 25-hydroxyvitamin D3 in group A and group B were (56.92±16.88) nmol/L, (70.68±21.96) nmol/L, respectively, which was significantly lower than that in control group (82.69±17.63) nmol/L, ( t=8.50, 3.30,P=0.00,0.00); compared with group A( t=3.85, P=0.00). The positive rate of group A was 65.71%, which was significantly higher than that of group B (35.00%, χ2=12.20,P=0.00). The positive rate of group A was 30.00% compared with the control group (35.00%, χ2=0.36,P=0.54). The serum level of 25-hydroxyvitamin D3 was 75.57% in group A, which was significantly higher than that in group B (60.00%,χ2=14.21, P=0.00). The positive rate of virus detection was 57.14% in 98 children with serum 25-hydroxy vitamin D3 level<75 nmol/L, which was significantly higher than that in serum 25-hydroxy vitamin D3 level≥75 nmol/L(18.75%, χ2=14.25, P=0.00). The positive rate of allergens in serum 25-hydroxy vitamin D3 level <75 nmol/L was 35.71%, which was significantly higher than that in serum 25-hydroxy vitamin D3 level≥75 nmol/L(21.88%, χ2=2.11, P=0.14). Conclusion The main risk factor for children with wheezing is viral infection, while the low level of serum 25-hydroxy vitamin D3 in children increases the risk of viral infection, resulting in increased risk of wheezing in patients,so the clinical can occur through the detection of serum 25- hydroxyvitamin D3 levels to predict and intervention for children with wheezing.