Objective To investigate the predictive value of plasma von Willebrand factor(VWF)antigen levels for the long-term prognosis of patients with acute myocardial infarction(AMI).Methods A total of 150 elderly patients diagnosed with AMI were selected and treated with percutaneous coronary intervention(PCI)at admission.The plasma VWF antigen level of the patients was detected within 24 hours after PCI.Patients were followed up for 12 months and were divided into the major adverse cardiac events(MACE)group and the non-MACE group according to the occurrence of MACE.The risk factors for MACE in AMI patients within 12 months were analyzed.The prognostic value of VWF antigen level in AMI patients were evaluated.The optimal cut-off value of plasma VWF antigen level was determined by receiver operating characteristic(ROC)curve.Patients were groups according to the optimal cut-off value.Kaplan-Meier curve was drawn to compare the occurrence of MACE in patients with different plasma VWF antigen levels.Results Among the 150 observed patients,7 patients were lost to follow-up,and eventually 143 patients were included.In 143 patients there were 53 patients(37.1%)in the MACE group and 90 cases(63.9%)in the non-MACE group.The age,B-type natriuretic peptide(BNP),D-dimer and VWF antigen levels were significantly higher in the MACE group than those in the non-MACE group.The results of the Cox proportional hazards model showed that age increase(HR=1.085,95%CI:1.014-1.160),increased plasma VWF antigen level(HR=1.030,95%CI:1.017-1.045)and increased BNP(HR=1.016,95%CI:1.004-1.027)were risk factors for elderly patients in the MACE group one year after surgery.The maximum approximately Youden index of plasma VWF antigen level for predicting MACE was 0.616,the optimal cut-off value was 162.5 μg/L,the sensitivity was 84.9%and the specificity was 76.7%.The results of survival analysis showed that the average time to MACE in the group with plasma VWF antigen≥162.5 μg/L was shorter than that in the group with plasma VWF antigen＜162.5 μg/L(7.7 months vs.11.6 months,Log-rank χ2=63.060,P＜0.001).Conclusion The increased plasma VWF antigen is an independent risk factor for AMI and can be used as a predictor of long-term prognosis in patients with AMI.

Objective To develop a toolkit suitable for assisting community health institutions in the early identification and inter-vention of mild cognitive impairment(MCI)among older adults.Methods A literature review was conducted to construct a draft of the identification and intervention toolkit.Tools with an expert approval rate above 70%were included after expert consultation.The final version of the toolkit was developed by integrating these tools with officially recommended tools in China.Results The expert consultation yielded an authority coefficient of 0.84.The finalized toolkit included the assessment tools of Mini-Mental State Examination,Montreal Cognitive Assessment,General Practitioner Assessment of Cognition,Cognitive Abilities Screening Instrument and Clock Drawing Test,and 18 intervention measures in-cluding pharmacological treatment,cognitive training and psychological interventions,etc.Conclusion The MCI Identification-Intervention Toolkit may serve as a reference for guiding the identification and inter-vention of MCI among older adults for community health institutions.

Objective To develop a toolkit suitable for assisting community health institutions in the early identification and inter-vention of mild cognitive impairment(MCI)among older adults.Methods A literature review was conducted to construct a draft of the identification and intervention toolkit.Tools with an expert approval rate above 70%were included after expert consultation.The final version of the toolkit was developed by integrating these tools with officially recommended tools in China.Results The expert consultation yielded an authority coefficient of 0.84.The finalized toolkit included the assessment tools of Mini-Mental State Examination,Montreal Cognitive Assessment,General Practitioner Assessment of Cognition,Cognitive Abilities Screening Instrument and Clock Drawing Test,and 18 intervention measures in-cluding pharmacological treatment,cognitive training and psychological interventions,etc.Conclusion The MCI Identification-Intervention Toolkit may serve as a reference for guiding the identification and inter-vention of MCI among older adults for community health institutions.

Objective To investigate the predictive value of plasma von Willebrand factor(VWF)antigen levels for the long-term prognosis of patients with acute myocardial infarction(AMI).Methods A total of 150 elderly patients diagnosed with AMI were selected and treated with percutaneous coronary intervention(PCI)at admission.The plasma VWF antigen level of the patients was detected within 24 hours after PCI.Patients were followed up for 12 months and were divided into the major adverse cardiac events(MACE)group and the non-MACE group according to the occurrence of MACE.The risk factors for MACE in AMI patients within 12 months were analyzed.The prognostic value of VWF antigen level in AMI patients were evaluated.The optimal cut-off value of plasma VWF antigen level was determined by receiver operating characteristic(ROC)curve.Patients were groups according to the optimal cut-off value.Kaplan-Meier curve was drawn to compare the occurrence of MACE in patients with different plasma VWF antigen levels.Results Among the 150 observed patients,7 patients were lost to follow-up,and eventually 143 patients were included.In 143 patients there were 53 patients(37.1%)in the MACE group and 90 cases(63.9%)in the non-MACE group.The age,B-type natriuretic peptide(BNP),D-dimer and VWF antigen levels were significantly higher in the MACE group than those in the non-MACE group.The results of the Cox proportional hazards model showed that age increase(HR=1.085,95%CI:1.014-1.160),increased plasma VWF antigen level(HR=1.030,95%CI:1.017-1.045)and increased BNP(HR=1.016,95%CI:1.004-1.027)were risk factors for elderly patients in the MACE group one year after surgery.The maximum approximately Youden index of plasma VWF antigen level for predicting MACE was 0.616,the optimal cut-off value was 162.5 μg/L,the sensitivity was 84.9%and the specificity was 76.7%.The results of survival analysis showed that the average time to MACE in the group with plasma VWF antigen≥162.5 μg/L was shorter than that in the group with plasma VWF antigen＜162.5 μg/L(7.7 months vs.11.6 months,Log-rank χ2=63.060,P＜0.001).Conclusion The increased plasma VWF antigen is an independent risk factor for AMI and can be used as a predictor of long-term prognosis in patients with AMI.

Purpose/Significance To explore the application and predictive accuracy of various models in predicting the risk of ather-osclerosis in diabetic patients.Method/Process Based on the biochemical data table from the"Diabetes Complications Warning Dataset"provided by the National Population Health Science Data Center,MATLAB software is used to construct risk prediction models for diabe-tes-induced atherosclerosis.The models are built by using k-nearest neighbors(KNN),decision trees,backpropagation(BP)neural networks,and Naive Bayes algorithms,and which are subjected to comparative analysis.Result/Conclusion In terms of effectiveness,the predictive accuracy of Naive Bayes algorithm is the highest(61.6％),followed by the decision tree model(58.2％),the KNN mod-el(57.7％),and the BP neural network model(55.9％).The results of the confusion matrix and the receiver operating characteristic(ROC)curve indicate that the Naive Bayes model performs best.When comparing the models in terms of effectiveness,performance and stability,the Naive Bayes model is superior.

Objective: To construct an evaluation index system of public health emergency preparedness capacity in county-level centers for disease control and prevention (CDC), so as to provide the evidence for improving the public health emergency preparedness capacity in county-level CDC. Methods: An index system framework was created based on review of health emergency policies, laws and regulations released in China from 2003 to 2023. The importance, sensitivity and accessibility of indicators were scored and screened through two rounds of Delphi expert consultations, and the weights of indicators were calculated using precedence charts. The efficiency of Delphi expert consultations was evaluated using the active coefficient, authority coefficient and coordination coefficient. Results: Eighteen experts participated in consultations, including 9 men, 15 with educational levels of master degree and higher, 12 with preventive medicine or public health as the specialty, and 12 with deputy senior professional titles and higher. The active coefficients of two rounds of consultations were 100.00% and 94.44%, and the authority coefficients were 0.83 and 0.84, respectively. The coordination coefficients of secondary and tertiary indicators during the second round consultation were 0.341 and 0.241, which were both higher than those during the first round (both P<0.05). The final evaluation index system included 8 primary indicators, 21 secondary indicators and 58 tertiary indicators. Among primary indicators, health emergency organization and management (0.203 1), health emergency team building (0.203 1) and financial support for health emergency (0.203 1) had the highest weights, and of secondary indicators, completion degree of health emergency administration regulations (initial weight/global weight: 0.750 0/0.152 3), health emergency team building (0.750 0/0.152 3) and financial support for emergency (0.750 0/0.152 3) had the highest weights, while among tertiary indicators, defining the duty of health emergency administration sectors had the highest weight (0.750 0/0.114 2). Conclusion The created evaluation index system is feasible for evaluation of the public health emergency preparedness capacity in county-level CDC.

Objective    To investigate the diagnostic value and safety of electromagnetic navigation bronchoscopy combined with radial endobronchial ultrasound in peripheral pulmonary nodules. Methods    The clinical imaging, surgical and pathological data of 60 patients with 76 peripheral pulmonary nodules who underwent electromagnetic navigation bronchoscopy combined with radial endobronchial ultrasound guided biopsy in the Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School from June 2020 to June 2021 were retrospectively analyzed. The diagnosis rate and complications were analyzed and summarized. The 76 pulmonary nodules were divided into a small pulmonary nodules group (10 nodules, diameter≤1 cm) and a pulmonary nodules group (1 cm

Objective:To identify the key convergence points in the medical-nursing combined care among literature, and establish a mechanism for medical-nursing combined care integration from the perspective of the synergy theory, for the purpose of promoting the integrated development of such care in China.Methods:Relevant literature on the medical-nursing combined care were retrieved from the CNKI database from September 2013 to September 2021. The search formula used was TI= "the medical-nursing care integration" AND SU=(convergence+ transformation+ coordination+ mechanism), while supplementary searches were made using " pkulaw.com database" and Baidu Scholar database. The method of literature content analysis was used to screen key points of the medical-nursing combined care, and the convergence mechanism was built based on the perspective of the synergy theory.Results:A total of 42 literatures were included in this study, 8 key convergence points of medica-nursing combined care integration were identified. Namely the 4 key horizontal convergence points of medical care, aging care, rehabilitation and nursing, the 3 key vertical convergence points of home care, institution care and community care, and the one key convergence point of institutional medical care. Based on the synergy theory and the 8 key convergence points, the " 431" convergence mechanism of medical-nursing combined care was constructed. This mechanism refered to the horizontal linkage of healthcare, nursing, rehabilitation and aging care, the vertical redirection among home care, institution care and community care modes, and the development mode focusing on institutional aging care.Conclusions:At present, the poor convergence between aging care and nursing care in China is a key roadblock hindering the integrated development of aging and nursing care. Medical-nursing combined care should be conducive to the " 431" convergence development, achieving horizontal linkage, vertical redirection, and resource sharing, for the purpose of high-quality development of China′s aging care system.

Objective To study the clinical, endoscopic and pathological features of gastrointestinal and mesenteric reactive nodular fibrous pseudotumor (RNFPT). Methods A retrospective analysis was conducted on data of 24 RNFPT patients in Nanjing Drum Tower Hospital admitted from October 2008 to June 2016. The clinical, endoscopic, pathological and immunohistochemical characteristics were analyzed. Results Among the 24 patients, 16 complained about discomfort in the upper abdomen and 10 had a history of surgery or trauma. Twenty-one had isolated masses and 3 had multiple masses, with diameter of 0. 5-4. 0 cm. Endoscopically, the tumors were mainly hard submucosal masses with broad base, and smooth surface with no mucosal bridge. Seventeen patients underwent endoscopic ultrasonography, which showed low echoes in lesions and nonuniform echoes partly. Among them, 13 lesions derived from muscularis, 4 others from submucosa. Microscopically, the tumors had clear boundary with no envelope, and most areas showed disorderly arranged spindle cells and extensively collagenous degenerated mesenchyma. The spindle cells had shuttle fibroblast-like morphology and elongated nucleus with no visible necrosis or mitosis. Inflammatory cells scattered between the tumor cells, and lymphoid follicles and calcium deposition could be seen in local areas. Immunohistochemically, SMA was focally positive in 7 cases and only 4 cases expressed CD117 scattered. Desmin, Dog-1, CD34, ALK-1 and S-100 were all negative, and Ki-67 proliferation index was lower than 1％. Conclusion RNFPT has diverse clinical manifestations, with a good prognosis and unlikely recurrences, and should be distinguished from spindle cell tumors.

Objective To analyze the status, trends and issues of professionals in rehabilitation institutions in China, and provide policy recommendations on rehabilitation professional development.Methods The data from database and statistical bulletin of CDPF has been analyzed using descriptive analysis and deviation analysis.Results The quantity of professionals of rehabilitation institutions increased 24,900 (12.62%) in 2016. Average professionals per institution had been decreased from 33.89 in 2012 to 28.33 in 2016. In regard to the structure of distribution, the rehabilitation professionals at provincial level had been decreased 21.95% in 2015 than that of in 2012. Both training programs and the number of trainees from rehabilitation institutions had decreased.Conclusion There were big gap between services provision and needs of professionals. The distribution of professionals at provincial, city and county level was under optimization. The on-job training for rehabilitation professionals should be improved. It is recommendated to develop national plan for professionals development to meet the needs of rehabilitation services, advance the on-job training for professionals, develop the higher education of rehabilitation and improve attractiveness of rehabilitation to retain and recruit more professionals.