Objective To investigate the epidemiology of elderly respiratory tract infection (RTI) cases in a hospital in Xuzhou region from 2020 to 2022. Methods The cases of RTI patients in a hospital were screened from May 2020 to December 2022, and 548 cases that met the criteria were included in the study. Patient case data were analyzed for symptoms, pathogen distribution, and differences in patient distribution under different screening conditions (age, disease, and season). Results More than 90.00% of the included RTI patients presented with symptoms of cough, sputum, wet rales and pleural effusion was less common. The top three comorbidities were cardiovascular disease (153 patients, 27.92%), cerebrovascular disease (133 patients, 24.27%), and gastrointestinal disease (105 patients, 19.16%).All 548 elderly patients tested positive for respiratory pathogens (100.00%). There were 540 cases of single pathogen infection (98.54%) and 8 cases of mixed infection (1.46%). The top five single pathogen infections were Pseudomonas aeruginosa (92 cases, 16.76%), Escherichia coli (78 cases, 14.21%), drug-resistant Staphylococcus aureus (69 cases, 12.57%), Klebsiella pneumoniae (65 cases, 11.84%), and Mycoplasma pneumoniae (46 cases, 8.38%). The highest detection rate of respiratory pathogens was found in patients >90 years old, whose main pathogens were Pseudomonas aeruginosa, Klebsiella pneumoniae and drug-resistant Staphylococcus aureus. The next highest rates of pathogen detection were found in patients aged 86-91 and 81-85 years, unlike patients >90 years, who had a higher rate of Escherichia coli detection. Unlike other age groups, patients <75 years old had a higher percentage of influenza B virus detection. The highest incidence of pneumonia was found in 45.62% (250 cases). Escherichia coli had the highest detection rate in acute bronchitis/episodes and pneumonia, respiratory syncytial virus had the highest detection rate in wheezing bronchitis, Klebsiella pneumoniae had the highest detection rate in bronchopneumonia, and Pseudomonas aeruginosa had the highest detection rate in fever. The highest detection rate of pathogens was found in fall (36.50%), followed by spring (27.01%). The distribution of pathogen infections in all seasons was matched with the results of pathogenicity testing. Streptococcus oxysporus had the highest number of infections in the fall (χ²=20.33, P<0.001). Conclusion Elderly respiratory tract infections in this region are most common in patients over 90 years old, with the highest incidence of pneumonia and high incidence in fall, and the pathogens are mainly Pseudomonas aeruginosa, Escherichia coli and drug-resistant Staphylococcus aureus. Attention to distinguish the above characteristics can provide some support for early diagnosis and treatment of respiratory infections in the elderly in this region.

Objective To explore the impact of change in oxygen concentration on the expression of angiopoietin-like protein 8(ANGPTL8)by endothelial cells(HPAECs)of human pulmonary artery,and the role and mecha-nism of ANGPTL8 in pulmonary hypertension(PH).Methods HPAECs were treated under hypoxic and hyperoxic conditions,and the expression level of ANGPTL8 was detected using Western blot and PCR.The changes in endo-thelial-mesenchymal transition(EndMT)and ERK signaling pathway activity were analyzed.Simultaneously,new-born rats were exposed to hyperoxia to develop a bronchopulmonary dysplasia(BPD)model.The expression of ANGPTL8 protein and changes in the ERK signaling pathway in lung tissue were observed.Results Under hypoxic condition,the protein expression of ANGPTL8 in HPAECs was significantly increased accompanied by inhibition of the ERK signaling pathway.ANGPTL8 promoted the EndMT process induced by hypoxia(P<0.05)and silencing the expression of ANGPTL8 resulted in a partial reversal of EndMT.The protein expression of ANGPTL8 was decreased in hyperoxia-exposed HPAECs and rat lung tissues accompanied by the activation of the ERK signaling pathway(P<0.05).Conclusions ANGPTL8 is highly sensitive to the change of oxygen concentration in HPAECs and closely correlated to its expression level and to the activity of ERK signaling pathway.This result suggests that ANGPTL8 may have potential regulatory effects on the development of PH.

Objective To investigate an automated pretreatment technology for detecting levels of free silica in workplace dust. Methods An fully automated pretreatment workstation for detecting free silica levels in workplace dust was developed by integrating graphite-controlled digestion temperature, online-controlled dilution of digestion solutions, and filtration endpoint recognition based on monitoring technology, combined with multi-channel synchronous measurements. Results The fully automatic pretreatment workstation was used to digest and filter 14 standard samples of free silica produced by three institutions, and then detected by pyrophosphate method. The result range of high-, medium-, and low-level free silica standard samples detection was 66.5%-84.8%, 40.0%-44.5%, and 2.1%-24.8%, respectively. The mean relative standard deviations were 3.9%, 1.4% and 1.5%. Conclusion The fully automated pretreatment workstation produced results that met relevant requirements. It can effectively replace the manual digestion and filtration steps of the pyrophosphate method to measure free silica levels in workplace dust and enable rapid detection of free silica in dust samples.

Objective To study the influencing factors of intradialytic hypotension(IDH)in diabetic maintenance hemodialysis(MHD)patients,and to provide references for clinical prevention of IDH quality control.Methods A total of 200 diabetic patients from four hemodialysis centers in Beijing from March 2022 to September 2022 were collected as the research objects.According to the definition of IDH[systolic blood pressure during hemodialysis≤90 mmHg(1 mmHg=0.133 kPa)or systolic blood pressure reduction during dialysis≥30 mmHg],the patients were divided into IDH group(frequency of hypotension events during dialysis≥30%during 7 months of follow-up)and non-IDH group.Univariate analysis and multivariate Logistic regression were used to analyze the influencing factors of IDH.receive operating characteristic curve(ROC)curve analysis was used to evaluate the predictive value of each influencing factor for IDH.Results Univariate analysis showed that compared with non-IDH group,IDH group had higher systolic blood pressure,higher blood glucose and lower serum albumin before dialysis(P<0.05).There were more patients with orthostatic hypotension in the IDH group than in the non-IDH group(P<0.05).Multivariate Logistic regression analysis showed that pre-dialysis systolic blood pressure,orthostatic hypotension and serum albumin were the influencing factors of IDH(P<0.05).ROC curve was used to evaluate the diagnostic accuracy of pre-hemodialysis systolic blood pressure for IDH.The area under the ROC curve was 0.787(95%CI:0.720-0.854,P<0.001),the threshold of IDH predicted by the Jorden index was 153 mmHg,the sensitivity was 75.5%,and the specificity was 75.4%.Conclusion Pre-hemodialysis systolic blood pressure,blood albumin and postural hypotension are independent factors of IDH in diabetic patients.In order to predict the occurrence of IDH,the pre-hemodialysis systolic blood pressure threshold was 153 mmHg.

Objective To study the influencing factors of intradialytic hypotension(IDH)in diabetic maintenance hemodialysis(MHD)patients,and to provide references for clinical prevention of IDH quality control.Methods A total of 200 diabetic patients from four hemodialysis centers in Beijing from March 2022 to September 2022 were collected as the research objects.According to the definition of IDH[systolic blood pressure during hemodialysis≤90 mmHg(1 mmHg=0.133 kPa)or systolic blood pressure reduction during dialysis≥30 mmHg],the patients were divided into IDH group(frequency of hypotension events during dialysis≥30%during 7 months of follow-up)and non-IDH group.Univariate analysis and multivariate Logistic regression were used to analyze the influencing factors of IDH.receive operating characteristic curve(ROC)curve analysis was used to evaluate the predictive value of each influencing factor for IDH.Results Univariate analysis showed that compared with non-IDH group,IDH group had higher systolic blood pressure,higher blood glucose and lower serum albumin before dialysis(P<0.05).There were more patients with orthostatic hypotension in the IDH group than in the non-IDH group(P<0.05).Multivariate Logistic regression analysis showed that pre-dialysis systolic blood pressure,orthostatic hypotension and serum albumin were the influencing factors of IDH(P<0.05).ROC curve was used to evaluate the diagnostic accuracy of pre-hemodialysis systolic blood pressure for IDH.The area under the ROC curve was 0.787(95%CI:0.720-0.854,P<0.001),the threshold of IDH predicted by the Jorden index was 153 mmHg,the sensitivity was 75.5%,and the specificity was 75.4%.Conclusion Pre-hemodialysis systolic blood pressure,blood albumin and postural hypotension are independent factors of IDH in diabetic patients.In order to predict the occurrence of IDH,the pre-hemodialysis systolic blood pressure threshold was 153 mmHg.

Objective:To explore the latent classes of fatigue trajectories and influencing factors in elderly patients with chronic pneumonia.Methods:A convenience sampling method was used to select 188 elderly patients with chronic pneumonia admitted to the Department of Geriatrics at Zhejiang Provincial Tongde Hospital from January 2023 to January 2024. General Data Questionnaires, Nutrition Risk Screening 2002, Athens Insomnia Scale, Hamilton Anxiety Scale, Community Commitment Scale, and Fatigue Scale were used to assess the patients. Patients were followed up for fatigue Scale at the time of consultation (T0) , and at the third (T1) and sixth (T2) months after consultation. Latent class growth analysis was used to model the trajectory of fatigue changes in elderly patients with chronic pneumonia.Results:A total of 188 questionnaires were distributed, with 165 valid responses, yielding an effective response rate of 87.8% (165/188) . The Fatigue Scale scores at T0, T1, and T2 were (4.63±1.74) , (5.54±1.90) , and (7.82±2.84) , respectively. The fatigue trajectories could be classified into three latent classes: low fatigue-slow increase group (74.5%, 123/165) , low fatigue-worsening group (10.3%, 17/165) , and high fatigue-slow increase group (15.2%, 25/165) . Multivariate logistic regression analysis showed that age, smoking index, number of chronic diseases, sleep, anxiety, and duration of cough and sputum were significant influencing factors for the fatigue trajectory in elderly patients with chronic pneumonia ( P<0.05) . Conclusions:Fatigue trajectories in elderly patients with chronic pneumonia exhibit group heterogeneity. Healthcare providers should develop targeted nursing measures based on different trajectory classes to alleviate fatigue and improve quality of life.

Objective:To explore the latent classes of fatigue trajectories and influencing factors in elderly patients with chronic pneumonia.Methods:A convenience sampling method was used to select 188 elderly patients with chronic pneumonia admitted to the Department of Geriatrics at Zhejiang Provincial Tongde Hospital from January 2023 to January 2024. General Data Questionnaires, Nutrition Risk Screening 2002, Athens Insomnia Scale, Hamilton Anxiety Scale, Community Commitment Scale, and Fatigue Scale were used to assess the patients. Patients were followed up for fatigue Scale at the time of consultation (T0) , and at the third (T1) and sixth (T2) months after consultation. Latent class growth analysis was used to model the trajectory of fatigue changes in elderly patients with chronic pneumonia.Results:A total of 188 questionnaires were distributed, with 165 valid responses, yielding an effective response rate of 87.8% (165/188) . The Fatigue Scale scores at T0, T1, and T2 were (4.63±1.74) , (5.54±1.90) , and (7.82±2.84) , respectively. The fatigue trajectories could be classified into three latent classes: low fatigue-slow increase group (74.5%, 123/165) , low fatigue-worsening group (10.3%, 17/165) , and high fatigue-slow increase group (15.2%, 25/165) . Multivariate logistic regression analysis showed that age, smoking index, number of chronic diseases, sleep, anxiety, and duration of cough and sputum were significant influencing factors for the fatigue trajectory in elderly patients with chronic pneumonia ( P<0.05) . Conclusions:Fatigue trajectories in elderly patients with chronic pneumonia exhibit group heterogeneity. Healthcare providers should develop targeted nursing measures based on different trajectory classes to alleviate fatigue and improve quality of life.

Objective:To study the influence of the severity of diabetic retinopathy (DR) on the visual function of patients with type 2 diabetes, to provide scientific basis for the early prevention and control of DR.Methods:This study was designed as a cross-sectional study, recruiting already-diagnosed type 2 diabetes patients in four community health service centers in Guizhou Province between February and September 2022. Employing the Chinese version of the Visual Function Index-14 (VF-14), assess the participants′ near vision, visual adaptation, subjective visual perception, and stereo vision, with higher scores indicating poorer visual function. Categorize the severity of each eye′s damage into no diabetic retinopathy (DR), mild non-proliferative diabetic retinopathy (NPDR), moderate NPDR, severe NPDR, and proliferative diabetic retinopathy (PDR), and use a 5-level DR grading system to evaluate the overall severity of diabetic retinopathy in both eyes. Employing linear regression analysis to investigate the linear relationship between DR and visual function index. Local weighted regression evaluates the nonlinear relationship between the DR composite score and the scores of visual function, with a steeper slope indicating poorer visual function for that level.Results:A total of 542 patients with type 2 diabetes were investigated, including 244 (45.02%) males, 298 (54.98%) females, and 162 (29.89%) patients with DR. After adjusting for confounders, compared with those without DR, patients with binocular DR Had overall scores ( β=0.136, P=0.003), near vision ( β=0.163, P<0.001), visual adaptation ( β=0.092, P=0.042), subjective vision ( β=0.120, P=0.009) and stereo vision ( β=0.094, P=0.044) were higher than those without DR. There were no differences in visual functions between DR And monocular DR. The local weighted regression curve showed that near vision (slope: 23.78) and overall score (slope: 58.37) increased sharply from mild to moderate NPDR in both eyes. Visual adaptation (slope: 5.37, 7.72), subjective vision (slope: 6.53, 7.93), stereovision (slope: 0.74, 0.91) increased slowly in mild to moderate NPDR in both eyes and in moderate to severe NPDR/PDR in both eyes. Conclusion:Binocular DR is associated with impaired visual function, but there is no difference between monocular DR And non-DR visual function. The early damage of DR To visual function is mainly manifested in near vision. In the prevention and control of DR, more attention should be paid to visual function, especially the change of near vision, and retinal damage should not be assessed solely by visual status.

Objective:To study the influence of the severity of diabetic retinopathy (DR) on the visual function of patients with type 2 diabetes, to provide scientific basis for the early prevention and control of DR.Methods:This study was designed as a cross-sectional study, recruiting already-diagnosed type 2 diabetes patients in four community health service centers in Guizhou Province between February and September 2022. Employing the Chinese version of the Visual Function Index-14 (VF-14), assess the participants′ near vision, visual adaptation, subjective visual perception, and stereo vision, with higher scores indicating poorer visual function. Categorize the severity of each eye′s damage into no diabetic retinopathy (DR), mild non-proliferative diabetic retinopathy (NPDR), moderate NPDR, severe NPDR, and proliferative diabetic retinopathy (PDR), and use a 5-level DR grading system to evaluate the overall severity of diabetic retinopathy in both eyes. Employing linear regression analysis to investigate the linear relationship between DR and visual function index. Local weighted regression evaluates the nonlinear relationship between the DR composite score and the scores of visual function, with a steeper slope indicating poorer visual function for that level.Results:A total of 542 patients with type 2 diabetes were investigated, including 244 (45.02%) males, 298 (54.98%) females, and 162 (29.89%) patients with DR. After adjusting for confounders, compared with those without DR, patients with binocular DR Had overall scores ( β=0.136, P=0.003), near vision ( β=0.163, P<0.001), visual adaptation ( β=0.092, P=0.042), subjective vision ( β=0.120, P=0.009) and stereo vision ( β=0.094, P=0.044) were higher than those without DR. There were no differences in visual functions between DR And monocular DR. The local weighted regression curve showed that near vision (slope: 23.78) and overall score (slope: 58.37) increased sharply from mild to moderate NPDR in both eyes. Visual adaptation (slope: 5.37, 7.72), subjective vision (slope: 6.53, 7.93), stereovision (slope: 0.74, 0.91) increased slowly in mild to moderate NPDR in both eyes and in moderate to severe NPDR/PDR in both eyes. Conclusion:Binocular DR is associated with impaired visual function, but there is no difference between monocular DR And non-DR visual function. The early damage of DR To visual function is mainly manifested in near vision. In the prevention and control of DR, more attention should be paid to visual function, especially the change of near vision, and retinal damage should not be assessed solely by visual status.

Purpose To investigating the pathological characteristics of the heart and spleen in a Kawasaki disease(KD)model induced by candida albicans watersoluble fraction(CAWS)and to provide a research basis for the pathological mechanisms of KD.Methods Intraperitoneal injection of CAWS was used to establish a KD model in C57BL/6 mice.Specimens of the heart,aorta,and spleen were collected to measure body weight and the weights of the heart and spleen.HE staining was utilized to examine the morphological alterations in the heart,aorta,and spleen.The expression levels of the ma-ture macrophage marker(F4/80),TNF-α,and IL-1β in the spleen were measured using qRT-PCR and immunofluorescence.its clinical pathological characteristics were analyze and relevant literatures were reviewed.Results Compared to the control group,there were no significant differences in the heart and body mass of the model group mice,but their spleen mass signif-icantly increased(P＜0.05).In the myocardial interstitium of model group mice,there was infiltration of mononuclear cells,disorder of the elastic fibers in the aortic wall along with mucoid degeneration,disruption of the splenic red and white pulp struc-ture,and significant macrophage infiltration.In the model group mice,the mRNA levels and immunofluorescence staining inten-sity of spleen F4/80(2.58-fold,P＜0.000 1),TNF-α(1.43-fold,P＜0.001),and IL-1β(3.62-fold,P＜0.000 1)were significantly higher than those in the control group.Conclusion Mice with KD models induced by CAWS can exhibit patholog-ical alterations akin to KD in the heart and aorta,significant en-largement of the spleen,infiltration by macrophages,with ele-vated expressions of TNF-α and IL-1β.