BACKGROUND: Changes in N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels may not fully translate into patient-reported health status in patients with heart failure (HF). We aimed to evaluate the correlation between NT-proBNP levels and patient-reported health status changes at one month after discharge of patients, and their associations with risk of death and rehospitalization in patients with acute HF. METHODS: We used data from the China Patient-centered Evaluative Assessment of Cardiac Events Prospective Heart Failure Study (PEACE 5p-HF Study). Patient-reported health status was measured by the 12-item Kansas City Cardiomyopathy Questionnaire (KCCQ-12). Patients who were hospitalized for HF and completed the KCCQ-12 and NT-proBNP tests before and one month after discharge were eligible in our study. We stratified patients into different groups based on NT-proBNP levels (i.e., improved, stable, and deteriorated) and KCCQ-12 scores (i.e., not deteriorated and deteriorated). We also examined the associations of the joint NT-proBNP and KCCQ-12 change with the risk of one-year and four-year clinical outcomes. RESULTS: A total of 2461 patients were included in the analysis. The mean age was 64.06 ± 13.51 years, and 36.37% (895/2461) of the study population were female. Among patients with improved NT-proBNP levels, 115 (10.95%) patients had deteriorated KCCQ-12 scores. The correlation between the change in the KCCQ-12 score and NT-proBNP level was weak ( r2 = 0.002, P = 0.013). Stratification by changes in the KCCQ-12 score revealed subgroups with distinctive risks, such that patients with deteriorated KCCQ-12 scores in any of the NT-proBNP change groups exhibited an increased risk of one-year all-cause death than participants with not deteriorated KCCQ-12 scores in any of the NT-proBNP change groups. Patients with improved NT-proBNP levels and deteriorated KCCQ-12 scores presented greater risks of one-year all-cause death (hazard ratio [HR]: 2.45, 95% confidence interval [CI]: 1.34-4.48) than patients with stable NT-proBNP levels and not deteriorated KCCQ-12 scores (HR [95% CI], 1.77 [1.25-2.53]). CONCLUSIONS: A discrepancy between changes in NT-proBNP levels and KCCQ-12 scores was common. The change in NT-proBNP levels was not sufficient to characterize critical aspects related to HF during one month after discharge of patients. Changes in the KCCQ-12 score exhibit complementary information to NT-proBNP levels for the prediction of clinical outcomes in patients with acute HF. REGISTRATION www.clinicaltrials.gov (No. NCT02878811).
Aged ; Female ; Humans ; Male ; Middle Aged ; Health Status ; Heart Failure/metabolism* ; Natriuretic Peptide, Brain/metabolism* ; Peptide Fragments/metabolism* ; Prospective Studies

With societal development and accelerated population aging in China, the demand for high-quality nursing services continues to grow, placing the nursing sector in a dual scenario of challenges and opportunities that necessitate parallel advancements in development and reform. Clinical practice guidelines (CPGs), as critical tools for enhancing nursing quality and standardizing evidence-based care, face multifaceted challengesincluding complexities in evidence integration, methodological and reporting irregularities, barriers to multidisciplinary collaboration, and suboptimal clinical adherence. However, emerging opportunities—such as optimized methodological frameworks, the application of implementation science, and the integration of digital and intelligent technologies—are creating new pathways for advancing high-quality nursing practice. This article elaborates on the necessity of developing rigorous nursing CPGs and analyzes the current opportunities and challenges in their formulation, dissemination, and implementation, aiming to provide theoretical insights for strengthening guideline-driven nursing care.

Plastic surgery is characterized by high degree of specialization, a broadscope of diseases inclusion and rapid advancements in knowledge. It is closely related to many disciplines, and there is great heterogeneity among different patients, which requires comprehensive abilities of doctors. However, plastic surgery teaching in China is currently marked by a short training cycle, a uniform training mode, and students’ time constraints and heavy tasks. Chat generative pre-trained transformer (ChatGPT), a large-scale language model introduced by the artificial intelligence company OpenAI, can use deep learning technology to generate natural language texts, understand the context of a conversation and then generate responses similar to those of humans, and is widely used in various industries, including the medical field. This review began by identifying the current challenges in plastic surgery teaching, introduced potential applications of ChatGPT in the field, and outlined its advantages. It also discussed the limitations and potential future directions for its development.

Plastic surgery is characterized by high degree of specialization, a broadscope of diseases inclusion and rapid advancements in knowledge. It is closely related to many disciplines, and there is great heterogeneity among different patients, which requires comprehensive abilities of doctors. However, plastic surgery teaching in China is currently marked by a short training cycle, a uniform training mode, and students’ time constraints and heavy tasks. Chat generative pre-trained transformer (ChatGPT), a large-scale language model introduced by the artificial intelligence company OpenAI, can use deep learning technology to generate natural language texts, understand the context of a conversation and then generate responses similar to those of humans, and is widely used in various industries, including the medical field. This review began by identifying the current challenges in plastic surgery teaching, introduced potential applications of ChatGPT in the field, and outlined its advantages. It also discussed the limitations and potential future directions for its development.

Objective To investigate the situation of food contamination by lead,cadmium,mercury,copper and aluminum in Ningxia Region.Methods Ten categories of food samples up to 712 copies including dairy,edible mushrooms,eggs,preserved egg,meat,organs,aquatic products,vegetables,grains and pasta from supermarkets of five administrative cities of Ningxia Autonomous Region were selected in 2010.The contents of lead,cadmium and mercury in food were detected in 646 samples of 9 categories of food,and copper content of the 30 meat samples were detected.Aluminum content in 66 samples of flour food was tested.According to the methods of national food safety standards (GB 5009.12-2010) and national food hygiene standards (GB/T 5009.13-2003,GB/ T 5009.15-2003 and GB/T 5009.17-2003),lead,copper,cadmium and mercury in various foods were tested.Aluminum was determined using the method for determination of spectrophotometry.Results The detection rates of lead,cadmium,mercury in the nine categories of food were 52.8％ (341/646),62.1％ (401/646),51.7％ (334/646);the detection rates of copper in the meat was 90.0％ (27/30);the aluminum in flour food was 84.8％ (56/66),respectively.Compared with the national standards,the eligible rates of lead,cadmium,mercury,copper and aluminum were 97.1％ (627/646),98.2％ (539/549),100.0％ (646/646),100.0％ (30/30) and 75.8％ (50/66),respectively.Food contaminated by lead and cadmium were mainly distributed in preserved egg [lead detection rate 9.5％ (2/21)],organs [lead detection rate 6.7％ (2/30),cadmium detection rate 30.0％ (9/30)],vegetables [lead detection rate 9.9％ (8/90)] and a small amount of food products [lead detection rate 4.7％ (7/150)].The levels of lead in fried flour food and fine dried noodles were higher [40.9％ (9/22),36.4％ (4/11)].Conclusions Food contamination by lead,cadmium,mercury and copper is not serious in Ningxia.The monitoring results of lead,cadmium,mercury and copper in food are satisfying in Ningxia.But there is aluminum contamination in flour food.It is important to do the risk evaluation of aluminum contamination in food as quickly as possible.