Objective:To explore the correlation between pulmonary emphysema and coronary artery calcification (CAC) in a health screening population.Methods:This retrospective case-control study consecutively selected 55 762 individuals who underwent chest low-dose chest CT (LDCT) screening at the Health Management Center of Southwest Hospital from January 2019 to December 2023. Demographic data, history of chronic diseases, anthropometric measurements, laboratory indicators, LDCT and pulmonary function test results were collected. Exclusion criteria included age<40 years at baseline, a history of coronary heart disease, LDCT suspected coronary artery stent placement, incomplete baseline data, and duplicate examinations. Logistic regression models were used to analyze the association between pulmonary emphysema and CAC.Results:A total of 33 069 individuals were included, with a mean age of 52 (47, 58) years old. Among them, 20 114 (60.8%) were male, 2 967 (9.0%) had pulmonary emphysema, and 4 156 (12.6%) had coronary artery calcification. The proportion of CAC in patients with emphysema was higher than in those without (23.5% vs 11.5%; χ2=351.805, P<0.001). After adjusting for confounding factors, the risk of CAC remained significantly higher in patients with emphysema [ OR=1.239 (95% CI: 1.113-1.379), P<0.001]. Conclusion:Pulmonary emphysema was one of the independent risk factors for coronary artery calcification in a health screening population.

Objective:To compare the application effects of different approaches (bilateral approach, traditional intermediate approach) in laparoscopic radical resection of rectal cancer with preservation of left colonic artery (LCA).Methods:The data of 120 patients undergoing laparoscopic radical resection of rectal cancer from January 2021 to December 2023 were retrospectively analyzed. Based on the different surgical approaches chosen for preserving LCA, 67 patients who underwent traditional intermediate approach to preserve LCA were included in the control group, while the remaining 53 patients who underwent bilateral approach to preserve LCA were included in the study group. The results of the main outcome indicators were recorded and the differences between the groups were compared, including perioperative indicators; lymph node dissection; gastrointestinal hormones (gastrin and motilin) before operation and 2 d after operation; postoperative complications such as anastomotic bleeding, anastomotic leakage, and urinary dysfunction.Results:Compared with the control group, the study group had longer surgical time and more intraoperative bleeding: (132.68 ± 11.24) min vs. (126.54 ± 10.45) min, (78.41 ± 5.35) ml vs. (75.22 ± 5.10) ml, the difference was statistically significant ( P = 0.003 and 0.001). However, there was no significant difference in exhaust time and hospitalization time between the two groups ( P>0.05). There was no significant difference in total lymph node clearance between the two groups ( P>0.05). The number of lymph node dissection in the 253 groups of the study group was higher than that in the control group: (5.18 ± 1.26) pieces vs. (4.35 ± 1.32) pieces, the difference was statistically significant ( P = 0.001). On the second day after surgery, the serum gastrin and motilin in both groups decreased compared to before surgery, but there was no significant difference between the two groups ( P>0.05). The incidence of postoperative urinary dysfunction in the study group was lower than that in the control group: 0 vs. 10.45% (7/67), the difference was statistically significant ( P = 0.015). Conclusions:Compared with the traditional intermediate approach for laparoscopic radical resection of rectal cancer with preserved LCA, the bilateral approach, although having a longer surgical time and slightly more intraoperative bleeding, can effectively clean 253 lymph nodes and reduce postoperative urinary dysfunction.

Objective:To compare the application effects of different approaches (bilateral approach, traditional intermediate approach) in laparoscopic radical resection of rectal cancer with preservation of left colonic artery (LCA).Methods:The data of 120 patients undergoing laparoscopic radical resection of rectal cancer from January 2021 to December 2023 were retrospectively analyzed. Based on the different surgical approaches chosen for preserving LCA, 67 patients who underwent traditional intermediate approach to preserve LCA were included in the control group, while the remaining 53 patients who underwent bilateral approach to preserve LCA were included in the study group. The results of the main outcome indicators were recorded and the differences between the groups were compared, including perioperative indicators; lymph node dissection; gastrointestinal hormones (gastrin and motilin) before operation and 2 d after operation; postoperative complications such as anastomotic bleeding, anastomotic leakage, and urinary dysfunction.Results:Compared with the control group, the study group had longer surgical time and more intraoperative bleeding: (132.68 ± 11.24) min vs. (126.54 ± 10.45) min, (78.41 ± 5.35) ml vs. (75.22 ± 5.10) ml, the difference was statistically significant ( P = 0.003 and 0.001). However, there was no significant difference in exhaust time and hospitalization time between the two groups ( P>0.05). There was no significant difference in total lymph node clearance between the two groups ( P>0.05). The number of lymph node dissection in the 253 groups of the study group was higher than that in the control group: (5.18 ± 1.26) pieces vs. (4.35 ± 1.32) pieces, the difference was statistically significant ( P = 0.001). On the second day after surgery, the serum gastrin and motilin in both groups decreased compared to before surgery, but there was no significant difference between the two groups ( P>0.05). The incidence of postoperative urinary dysfunction in the study group was lower than that in the control group: 0 vs. 10.45% (7/67), the difference was statistically significant ( P = 0.015). Conclusions:Compared with the traditional intermediate approach for laparoscopic radical resection of rectal cancer with preserved LCA, the bilateral approach, although having a longer surgical time and slightly more intraoperative bleeding, can effectively clean 253 lymph nodes and reduce postoperative urinary dysfunction.

Objective:To explore the correlation between pulmonary emphysema and coronary artery calcification (CAC) in a health screening population.Methods:This retrospective case-control study consecutively selected 55 762 individuals who underwent chest low-dose chest CT (LDCT) screening at the Health Management Center of Southwest Hospital from January 2019 to December 2023. Demographic data, history of chronic diseases, anthropometric measurements, laboratory indicators, LDCT and pulmonary function test results were collected. Exclusion criteria included age<40 years at baseline, a history of coronary heart disease, LDCT suspected coronary artery stent placement, incomplete baseline data, and duplicate examinations. Logistic regression models were used to analyze the association between pulmonary emphysema and CAC.Results:A total of 33 069 individuals were included, with a mean age of 52 (47, 58) years old. Among them, 20 114 (60.8%) were male, 2 967 (9.0%) had pulmonary emphysema, and 4 156 (12.6%) had coronary artery calcification. The proportion of CAC in patients with emphysema was higher than in those without (23.5% vs 11.5%; χ2=351.805, P<0.001). After adjusting for confounding factors, the risk of CAC remained significantly higher in patients with emphysema [ OR=1.239 (95% CI: 1.113-1.379), P<0.001]. Conclusion:Pulmonary emphysema was one of the independent risk factors for coronary artery calcification in a health screening population.

Objective:To explore the influence of points system management on the career development of medical staff in health management discipline.Methods:Using a cross-sectional study design, medical staff in the health management discipline of tertiary hospitals in China were selected as the research objects from February 1 to March 1, 2024 through questionnaire star convenience sampling and snowball sampling, and their general information, performance appraisal satisfaction, professional identity, burnout, professional benefit, professional career management and other information were collected, and the correlation and influencing factors among them were explored. A total of 423 questionnaires were distributed, and 402 (95.0%) valid questionnaires were collected.Results:A total of 207 (51.5%) medical staff had job burnout, and 257 (63.9%) of them had medium or below level of professional identity. There were positive correlations among performance appraisal satisfaction, professional identity, career benefit and professional career management. There was a negative correlation between burnout and performance appraisal satisfaction ( r=-0.439), professional identity ( r=-0.356), career benefit ( r=-0.584), and professional career management ( r=-0.185) (all P<0.05). Higher age, working time, monthly income level, title level, position level, understanding of performance appraisal system, satisfaction with feedback results and application satisfaction were the protective factors of burnout, and under the points-based system, the scores of performance appraisal satisfaction, professional identity, career benefit, and professional career management were higher, and the differences were statistically significant (all P<0.05). A total of 310 medical staff (77.1%) believed that performance appraisal had a motivating effect on them. Conclusion:The performance appraisal of the point system has a good motivating effect on the medical staff of the health management discipline, and is closely related to professional identity, burnout, professional benefit, and professional career planning.

Objective:To investigate the impact of teacher-student language interaction behavior in the teaching quality of health management courses in lecture competitions by using the Flanders interaction analysis method.Methods:The Flanders interaction analysis model was used to collect and analyze the data on teacher-student interaction behavior of three teachers during the lecture competitions of health management courses, and the three teachers were analyzed in terms of behavior in classroom interaction, student reactions, and features of interaction mode.Results:During the lecture competition, it was found that region E in the FIAS matrix was positive and qualified, and the frequency ratio of positive and qualified to defective grids was much greater than 1 for the three teachers. The teaching methods of all three teachers could alleviate the tense atmosphere in the classroom, enhance interaction between teachers and students, and improve the learning effectiveness of students. The speech behaviors of Teacher C and Teacher S were 91.87% and 81.48%, respectively, which were higher than the norm, while the speech behaviors of Teacher Y was 52.63%, which was lower than the norm. The integrated teaching method was better than the teaching methods of case-based learning and problem-based learning and could better help students master health knowledge and skills, cultivate a healthy lifestyle, promote physical and mental health, and improve health literacy.Conclusions:By using the Flanders interaction analysis method, teachers can observe and analyze interactions with students, evaluate teaching effectiveness, and provide targeted feedback and improvement suggestions to improve teaching quality and the learning outcomes of students. At the same time, teachers and students can also understand their strengths and weaknesses through observation and analysis of interaction methods and make corresponding improvements to teaching methods and contents, so as to encourage students to actively participate in classroom interaction and improve learning effectiveness and student satisfaction.

Objective To investigate the correlation between lipid accumulation index (LAP),visceral fat index (VFI) and insulin resistance (IR) in healthy check-up population.Methods A total of 9121 subjects who underwent physical examination in the Health Management Center of the First Affiliated Hospital of Ar-my Medical University from October 2016 to June 2023 were selected as the study subjects,including 5988 males and 3133 females.The age,waist circumference (WC),body mass index (BMI),LAP,VFI,blood lipid, blood glucose and homeostasis model assessment of insulin resistance (HOMA-IR) were compared between different genders.Obesity was assessed according to BMI.LAP,VFI and HOMA-IR were compared between obese (BMI≥28 kg/m2) and non-obese patients (BMI<28 kg/m2).Pearson correlation analysis was used to analyze the relationship between LAP,VFI and HOMA-IR in all healthy subjects.Multiple logistic regression analysis was used to analyze the independent influencing factors of HOMA-IR in all healthy subjects. Results The age and high-density lipoprotein cholesterol (HDL-C) of male healthy subjects were significant-ly lower than those of female,while WC,BMI,triglyceride (TG),total cholesterol (TC),low-density lipopro-tein cholesterol (LDL-C),LAP,VFI,fasting blood glucose (FBG),fasting insulin (FINS),glycosylated hemo-globin (HbA1c) and HOMA-IR were significantly higher than those of female (P<0.05).There were 1733 cases of obesity in all healthy subjects,accounting for 19％.The LAP,VFI and HOMA-IR of obese people were significantly higher than those of non-obese people (P<0.05).Pearson correlation analysis showed that HOMA-IR was positively correlated with WC,BMI,TG,TC,LDL-C,LAP and VFI,and negatively correlated with HDL-C (P<0.05).The correlation coefficient r value of LAP was the highest,reaching 0.367,followed by WC,BMI,TG and VFI.Multivariate logistic correlation analysis showed that BMI,LAP and VFI were in-dependent influencing factors of HOMA-IR in all healthy subjects (P<0.05).Conclusion Obesity should not be ignored in health check-up population.LAP and VFI are associated with IR,especially LAP,which can reliably evaluate body fat accumulation and blood glucose metabolism.

Objective To investigate the risk of diabetes mellitus in ABO blood type.Methods The da-ta of 1306397 healthy physical subjects in the Department of Health Management of the First Affiliated Hos-pital of Army Medical University from 2006 to 2018 were retrospectively analyzed,including gender,age, height,weight,blood glucose,blood lipid and ABO blood type.A total of 61296 subjects with both blood type and fasting blood glucose data were selected as the study population.Multivariable logistic regression was used to analyze the risk of diabetes in different ABO blood types.Results There were significant differences in gender,age and BMI distribution between the total population and the study population (P<0.05).The num-ber of patients with diabetes and prediabetes in the study population was 2649 (4.3％) and 3979 (6.5％),re-spectively.There were significant differences in the distribution of cholesterol,low-density lipoprotein choles-terol (LDL-C),diabetes and pre-diabetes among people with different blood types (P<0.05).Multivariate lo-gistic regression analysis showed that compared with type O blood,type A blood had an increased risk of dia-betes (OR=1.38,95％CI:1.02-1.86,P=0.04),while type B blood (OR=1.28,95％CI:0.93-1.77,P=0.13) and type AB blood (OR=1.33,95％CI:0.83-2.11,P=0.23) did not increase the risk of diabetes. Conclusion Early screening of type A blood population and preventive treatment and intervention can be used to reduce the incidence of diabetes.

Objective To explore the correlation between serum detection indicators abnormality of in-testinal barrier function with metabolic diseases.Methods A total of 26 838 individuals undergoing serum de-tection of intestinal barrier function in the physical examination center of this hospital from January 2020 to August 2023 were selected as the study subjects and grouped based on whether D-lactic acid(DLC),bacterial endotoxin(BT)and diamine oxidase(DAO)were abnormal.Their clinical data of the patients with abnormal DLC,BT and DAO were collected,including the body weight,blood pressure[systolic blood pressure(SBP)and diastolic blood pressure(DBP)],fasting blood glucose(GLU),pulse rate,total bilirubin(TBIL),direct bilirubin(DBIL),indirect bilirubin(IBIL),total protein(TP),alanine aminotransferase(ALT),aspartate aminotransferase(AST),and human plasma protein phospholipase(Lp-PLA2),etc.;the incidence rate of fat-ty liver in the subjects with abnormal DLC,BT and DAO was statistically analyzed,and the correlation be-tween abnormal DLC,BT and DAO with the fatty liver occurrence was analyzed.Results Among the 26 838 individuals undergoing physical examination,there were 544 cases(2.03％)of abnormal DLC,927 cases(3.45％)of abnormal BT and 649 cases(2.42％)of abnormal DAO.In the populations with abnormal DLC,BT and DAO,the detection rate in the male patients was significantly higher than that in the females,moreo-ver which were often accompanied by obesity,increased blood pressure and elevated blood sugar.68.08％of the patients with abnormal BT had high SBP,51.02％of the patients had high DBP,and 40.72％of the pa-tients had high GLU.99.58％of patients with abnormal DLC had abnormal IBIL.The population with abnor-mal serum DLC,BT and DAO had the high incidence rate of fatty liver,which were 43.57％,44.77％and 38.83％,respectively.The Spearman's rank correlation analysis showed that the DLC,BT and DAO levels were correlated with the occurrence of fatty liver(P＜0.05).Conclusion The DLC,BT and DAO levels could early warn hypertension,diabetes and liver function damage caused by metabolic disorders,and predict the risk of fatty liver occurrence.

Objective    To evaluate the safety and efficacy of mitral valve surgery and cryoablation in elderly patients with mitral valve disease and persistent or long-term persistent atrial fibrillation. Methods    From May 2014 to July 2018, 144 patients with mitral valve diseases combined with persistent or long-term persistent atrial fibrillation in the Department of Cardiothoracic Surgery, General Hospital of Northern Theater Command were selected. Among them, there were 69 patients in a non-elderly group (<60 years) including 18 males and 51 females aged 52.07±5.56 years, and 75 patients in an elderly group (≥60 years) including 32 males and 43 females aged 65.23±4.29 years. A propensity-score matching (PSM) study was conducted to eliminate confounding factors. Both groups underwent mitral valve surgery and cryoablation at the same time. A 2-year follow-up was conducted after discharge from the hospital, and the perioperative and postoperative efficacy indexes were compared between the two groups. Results    After PSM analysis, there were 56 patients in each group. The sinus rhythm conversion rate of the two groups at each follow-up time point was above 85%, and the cardiac function was graded asⅠorⅡ, which was significantly improved compared with that before the surgery, but there was no statistical difference between the two groups (P>0.05). Among the perioperative indicators of the two groups, the elderly group had more coronary artery bypass graft surgeries and longer postoperative ICU stay time compared with the non-elderly group (P<0.05), and the differences in other indicators were not statistically different (P>0.05). Conclusion    The mitral valve surgery and cryoablation in elderly patients with mitral valve diseases combined with persistent or long-term persistent atrial fibrillation are safe, and the short-term outcome is satisfactory.