Objective To investigate the risk factors associated with prolonged hospitalization in patients diagnosed with diabetic foot ulcers(DFU),to develop a predictive model,and to conduct internal validation of the model.Methods The clinical data of DFU patients admitted to West China Hospital,Sichuan University between January 2012 and December 2022 were retrospectively collected.The subjects were randomly assigned to a training cohort and a validation cohort at a ratio of 7 to 3.Hospital stays longer than 75th percentile were defined as prolonged length-of-stay.A thorough analysis of the risk factors was conducted using the training cohort,which enabled the development of an accurate risk prediction model.To ensure robustness,the model was internally validated using the validation cohort.Results A total of 967 inpatients with DFU were included,among whom 245 patients were identified as having an extended length-of-stay.The training cohort consisted of 622 patients,while the validation cohort comprised 291 patients.Multivariate logistic regression analysis revealed that smoking history(odds ratio[OR]=1.67,95%confidence interval[CI],1.13 to 2.48,P=0.010),Wagner grade 3 or higher(OR=7.13,95%CI,3.68 to 13.83,P＜0.001),midfoot ulcers(OR=1.99,95%CI,1.07 to 3.72,P=0.030),posterior foot ulcers(OR=3.68,95%CI,1.83 to 7.41,P＜0.001),multisite ulcers(OR=2.91,95%CI,1.80 to 4.69,P＜0.001),wound size≥3 cm2(OR=2.00,95%CI,1.28-3.11,P=0.002),and white blood cell count(OR=1.11,95%CI,1.05 to 1.18,P＜0.001)were associated with an increased risk of prolonged length of stay.Additionally,a nomogram was constructed based on the identified risk factors.The areas under the receiver operating characteristic(ROC)curves for both the training cohort and the validation cohort were 0.782(95%CI,0.745 to 0.820)and 0.756(95%CI,0.694 to 0.818),respectively,indicating robust predictive performance.Furthermore,the calibration plot demonstrated optimal concordance between the predicted probabilities and the observed outcomes in both the training and the validation cohorts.Conclusion Smoking history,Wagner grade≥3,midfoot ulcers,posterior foot ulcers,multisite ulcers,ulcer area≥3 cm2,and elevated white blood cell count are identified as independent predictors of prolonged hospitalization.Therefore,it is imperative that clinicians conduct a comprehensive patient evaluation and implement appropriate diagnostic and therapeutic strategies to effectively shorten the length of stay for DFU patients.

Background::Urticaria is a common skin disease characterized by episodes of wheals, and it has a negative effect on patients’ quality of life. Large-scale population-based epidemiological studies of urticaria are scarce in China. The aim of this survey was to determine the prevalence, clinical forms, and risk factors of urticaria in the Chinese population.Methods::This survey was conducted in 35 cities from 31 provinces, autonomous regions, and municipalities of China. Two to three communities in each city were selected in this investigation. Participants completed questionnaires and received dermatological examinations. We analyzed the prevalence, clinical forms, and risk factors of urticaria.Results::In total, 44,875 questionnaires were distributed and 41,041 valid questionnaires were collected (17,563 male and 23,478 female participants). The lifetime prevalence of urticaria was 7.30%, with 8.26% in female and 6.34% in male individuals ( P < 0.05). The point prevalence of urticaria was 0.75%, with 0.79% in female and 0.71% in male individuals ( P < 0.05). Concomitant angioedema was found in 6.16% of patients. Adults had a higher prevalence of urticaria than adolescents and children. Living in urban areas, exposure to pollutants, an anxious or depressed psychological status, a personal and family history of allergy, thyroid diseases, and Helicobacter pylori infection were associated with a higher prevalence of urticaria. Smoking was correlated with a reduced risk of urticaria. Conclusion::This study demonstrated that the lifetime prevalence of urticaria was 7.30% and the point prevalence was 0.75% in the Chinese population; women had a higher prevalence of urticaria than men. Various factors were correlated with urticaria.

Objective:To explore the effect of comprehensive nursing intervention based on time nursing on dangerous behaviors and psychiatric symptoms of schizophrenic patients.Methods:From April 2018 to January 2019, we selected 128 schizophrenic patients admitted to our hospital for research. All patients were divided into observation group and control group with the random number table, 64 cases in each group. Patients of both groups were given routine nursing. On this basis, observation group implemented the comprehensive nursing intervention model based on time nursing. We compared the occurrence of dangerous behaviors, mental symptoms and cognitive function of patients between two groups.Results:Before nursing, there were no statistically significant differences in the occurrence of dangerous behaviors, scores of Positive and Negative Symptom Scale (PANSS) and Montreal Cognitive Assessment (MoCA) of patients between two groups ( P>0.05) . After nursing, the occurrence of dangerous behaviors, scores of PANSS and MoCA of patients in observation group were better than those in control group with statistical differences ( P<0.01) . Conclusions:Comprehensive nursing intervention based on time nursing can reduce the risk of dangerous behaviors of schizophrenic patients, improve their psychiatric symptoms and cognitive function which has high clinical promotion value.

Objective To study the effect of baseline clinical characteristics of elderly female patients on their long-term ischemic cardiovascular events.Methods Of the 614elderly patients admitted to our center from April 2008to July 2010,144elderly female patients were divided into female cardiovascular events group(n=43)and female control group(n=101),470elderly male patients were divided into male cardiovascular events group(n=127)and male control group(n= 343).Their baseline clinical characteristics were compared.The patients were followed up for 4.5-6.7(5.6±0.9)years,during which the relationship between first ever acute ischemic cardiovascular events and their clinical factors were analyzed.Results The incidence of grade 2hypertension,grade 3hypertension and hypercholesterolemia,the ratios of antiplatelet drug therapy,CCB therapy and hypoglycemic drug therapy were significantly higher while the history of smoking was significantly shorter,the incidence of chronic renal insufficiency and the ratios of statins therapy,nitrates therapy and ACEI/ARB therapy were significantly lower in female patients than in male patients.The incidence of chronic renal insufficiency was significantly higher in female cardiovascular events group than in female control group(9.3％vs 1.0％,P=0.03).The age was significantly older,the incidence of CHD,ischemic cerebral stroke,chronic obstructive pulmonary disease and the ratio of nitrates therapy were significantly higher in male cardiovascular events group than in male control group.Cox multivariate regression analysis showed that the endpoint events were related with CHD,grade 2hypertension,grade 3hypertension,hypercholesterolemia,chronic renal insufficiency in female patients(HR=2.56,95％CI:1.19-5.54,P=0.017;HR=3.29,95％ CI:1.14-9.52,P=0.028;HR=2.77,95％CI:1.08-7.12,P=0.034;HR=2.61,95％CI:1.27-5.36,P=0.009;HR=22.70,95％CI:5.22-98.78,P=0.000)and were related with age,CHD and ischemic cerebral stroke in male patients(P＜0.05,P＜0.01).Conclusion The effect of baseline clinical characteristics of elderly patients on their long-term ischemic cardiovascular events is different in males and females.The incidence of long-term cardiovascular events is closely related with the risk factors for cardiovascular disease in elderly females.

Objective To understand the human papilloma virus (HPV) infection status in men who have sex with men (MSM) recruited from gay bathhouses and HIV voluntary counseling and testing (VCT) clinics in Urumqi,Xinjiang Uygur autonomous region,and identify the associated risk factors.Methods A total of 200 MSM aged ≥≥ 18 years were recruited by using the "snowballing" sampling method from gay bathhouses and VCT clinics in Urumqi during March-May,2016.The MSM recruited completed questionnaires after filling in the informed consent form.The information about their demographic characteristics and sexual behaviors were collected,and anal swabs were collected from them for HPV genotyping.Results The overall HPV infection rate was 54.0％.The HPV infection rate was 66.7％(74/111) in MSM from gay bathhouses and 38.2％(34/89) in MSM from VCT clinics and the high risk type HPV infection rate was 39.6％ (44/111) in MSM from gay bathhouses and 14.6％(13/89) in MSM from VCT clinics,the differences were significant (x2=16.112,P＜0.05;x2=15.190,P＜0.05).Multiple logistic regression analysis indicated that the major risk factors for HPV infection included activity in gay bathhouse (OR=3.732,95％CI:1.950-7.141) and anal sexual behavior (OR=2.555,95％ CI:1.329-4.912).Conclusion The prevalence of HPV in MSM from gay bathhouses was higher than that in MSM from VCT clinics,indicating that close attention should be paid to the behavior intervention in MSM.

Objective: To investigate the clinical characteristics of early term and full term neonates, and analyze the risk factors associated with short term outcomes in early term neonates. Method: Neonates with birth weight (BW) ≥2 500 g from year 2013 were analyzed retrospectively based on American Congress of Obstericians & Gynecologists (ACOG) latest definition of term infants. According to inclusion and exclusion criteria, early term (gestational age 37-38 weeks) and full term(gestational age 39-40 weeks) neonates were included, whose morbidity constituent proportion was analyzed by χ² test or Fisher accuracy test or t test or Wilcoxon test. Risk factors associated with short term outcomes in early term population were analyzed by Logistic regression analysis. Result: There were 3 002 discharged term infants being investigated, among whom 1 303 cases were included(768 males and 535 females), and 37, 38, 39 and 40 weeks′ gestational age newborns were 160, 324, 450 and 369 respectively. Compared with full term neonates(n=819), early term neonates (n=484) had longer length of hospital stay (LOS)(6.0(5.0, 9.0) vs. 6.0(4.0, 8.0), Z=2.830, P=0.005), higher usage rate of intravenous antibiotics(86.4%(418/484) vs. 80.1%(656/819), χ²=8.009, P=0.005), higher assisted ventilation rate(9.5%(46/484) vs. 2.9%(24/819), χ²=25.528, P<0.01), higher pulmonary surfactant administration rate(4.3%(21/484) vs. 1.1%(9/819), χ²=14.006, P<0.01), as well as higher hypoglycemia incidence(3.9%(19/484) vs. 1.2%(10/819), χ²=10.226, P=0.001). There were no statistically significant differences in 1 min Apgar score (9(9, 10)vs. 9(9, 10), Z=0.860, P=0.390), 5 min Apgar score (10(9, 10) vs. 10(9, 10), Z=0.810, P=0.418), white blood cell count (15 (11, 21) ×10⁹ /L vs.15 (11, 22) ×10⁹ /L, Z=0.880, P=0.379), hemoglobin count(180 (159, 205) vs. 182 (160, 204) g/L, Z=0.560, P=0.576), or platelet count(303(234, 372) ×10⁹/L vs. 301(237, 391) ×10⁹/L, Z=0.550, P=0.584). BW between 2 500 g and 2 999 g(OR 1.69, 95% CI: 1.10-2.62, χ² =5.614, P=0.018), wet lung(OR=2.61, 95% CI: 1.61-4.24, χ²=15.023, P=0.000)and pneumonia(OR 1.88, 95% CI: 1.14-3.08, χ²=6.192, P=0.013) were risk factors in early term neonates′ short term adverse outcomes. Conclusion Early term newborns are still at their "immature" state, and respiratory disorders are major risk factors associated with short term outcomes. Hence, early delivery during 37-38 weeks should be avoided as possible as we can.

Objective To understand the infection status and gene types of Cryptosporidium among HIV/AIDS patients in Guangxi Zhuang Autonomous Region. Methods The fecal samples were collected from 285 HIV/AIDS cases in Nanning,Gui?lin,Qinzhou,Baise,Hechi cities of Guangxi and 150 HIV negative persons in Nanning City. The modified acid?fast staining and nested?PCR based on 18S rRNA were employed to detect the infection status of Cryptosporidium. The nested PCR products were sequenced,and the homology searches and identification for the gene types of Cryptosporidium were done by DNAStar soft?ware. Results The infection rate of Cryptosporidium in HIV/AIDS patients was 0.70%(2/285),and the rate of those with chronic diarrhea was 6.67%(2/30),the latter was significantly higher than that of the HIV negative persons(0,0/150)(P=0.002). Both the two HIV/AIDS patients infected with Cryptosporidium were from Guilin City. By molecular identification,the Cryptosporidium strains which the above 2 patients were infected with were Cryptosporidium andersoni and Cryptosporidium hominis respectively. Conclusions Cryptosporidium co?infection can be found in HIV/AIDS patients in Guangxi. The geno?types of the infection strains include Cryptosporidium andersoni and Cryptosporidium hominis.

Objective:To explore the hemodynamic changes in aged patients with essential hypertension (EH).
Methods: Our research included 2 groups, EH group, n=180 patients and Control group, n=100 subjects without cardiovascular diseases. The relevant indexes were recorded and compared by BioZ.com noninvasive hemodynamic monitor between 2 groups.
Results: With statistic processing, the cardiac output/index (CO/CI), cardiac index, thoracic lfuid content (TFC), systemic vascular resistance/index (SVR/SVRI) were signiifcantly different between EH group and Control group, all P<0.05.
Conclusion: The hemodynamic changes exist at certain degree indicating the potential injury of cardiac function in aged EH patients, such changes might be helpful for clinical diagnosis and treatment in EH patients.

The national examination of doctors' qualification is the examination which assesses the medical students' knowledge and skills for doctors' work. This paper introduced autorities concerned, implementing agencies, examination forms and procedures, examination contents and keypoints, pass-ing criteria and matters needing attention of national examination of doctors's qualification be tween Canada and Australia expecting to provide references for the revolution of Chinese Examination of Doctors' Qualification.

Point prevalence rate of complete stroke on December 31, 1986 in China was investigated using a retrospecive section study for 5 814 851 people of 29 provinces and cities (excluding Taiwan province), and 14275 stroke cases were found. Point prevalence rate was 245.49 per 100000 people with 95% CI (confidence interval) 241.57-249.61 per 100000 people. The rate standardized by the constituent ratio of population between city and rural area of China in 1986 was 247.66 per 100000 people. The rate age-standardized by the population of China in 1982 accounted for 191.92 per 100000 and the rate agestandardized by the world standard population was 259.86 per 100000 people.It has also been found that there was a tendency for the prevalence rates to increase gradually from south to north and to decrease progressively from east to west. The linear regression models have been fitted between the point prevalence rates and latitude or longitude respectively. The results were Y= 12.3819?-1107.38 (tb = 4.65 df = 5 P = 0.0056) for longitudes and Y = 12.6279?-146.6266 (tb = 11.7517 df = 4 P = 0.0003) for latitudes. There was a difference statistically among various topographic areas. The prevalence rate was much higher in urban areas than rural areas and much higher in men than in women. The prevalence rate increased with age and their relationships have been fitted well with the logistic curve.