Objective:Against the backdrop of population aging and air pollution,this study examined the re-gional distribution of depressive symptoms among middle-aged and elderly people in China and explores the influ-ence of patrticulate matter 2.5(PM2.5)concentration on these symptoms.This study examined the regional distri-bution of depressive symptoms in middle-aged and elderly people in China and explores the influence of PM2.5 concentration and related factors on these symptoms.Methods:Middle-aged and elderly people aged 45 years and above in CHARLS database in 2013,2015 and 2018 were selected as research objects,and the Center for Epidemio-logic Studies Depression Scale(CESD-10)to obtain the detection rate of depressive symptoms.The PM2.5 concen-tration data were derived from the annual data of the China Environmental Monitoring Station.t-test,x2 test and DID model were used to analyze the related factors of depressive symptoms.Stata17.0 and Arc GIS10.8 were used for spatial autocorrelation analysis to explore the regional distribution and relationship of depressive symptoms in mid-dle-aged and elderly people in China.Results:From east to west,the detection rate of depressive symptoms in mid-dle-aged and elderly people in China showed an increasing trend.The regional distribution of PM2.5 mainly showed that the central region was higher than the northern and southern regions and the western region(except Xinjiang)was higher than the eastern region.Conclusion:Both the PM2.5 concentration and depression symptoms exhibit spatial clustering across China.PM2.5 has a negative impact on depression symptoms in middle-aged and elderly people,with other related factors including gender,age,education level,marital status,living area,smoking status.

Pulmonary vascular remodeling is the core pathological feature in the onset and pro-gression of pulmonary arterial hypertension(PAH).Currently,there is no well-defined therapeutic strategy that can effectively delay or reverse this process.Despite the widespread clinical application of targeted vasodilator drugs,patients still face a high risk of mortality and adverse cardiovascular e-vents,suggesting an urgent need to explore new pathological mechanisms and therapeutic targets.In recent years,the relationship between dyslipidemia and PAH has garnered increasing attention.This article aimed to review the role of lipid metabolism disorders in pulmonary vascular remodeling in pul-monary arterial hypertension and its underlying mechanism,with the hope of providing new interven-tion targets for the treatment of PAH,thereby improving patient survival rates and quality of life.

Objective:To design one kind of adjustably assistive walking wheelchair with multi postures,so as to improve the quality of life of people with motion disorders,disabilities or semi disabilities on lower limbs.Methods:The adjustably assistive walking wheelchair with multi postures composed of walking mechanism,mechanism of adjusting posture,and chair,which can achieve five postures,including sitting,low sitting,high sitting,standing and lying.One kinematic model of the wheelchair mechanism was established,and Admas software was used to conduct kinematic simulation.Aimed at key components,the statics simulation was analyzed.The test for adjustment of 5 kinds of postures,the test for the reachable range of hands and the test for the stability of adjusted postures were conducted on the physical prototype of the wheelchair.Results:The results of kinematic simulation showed that the method and formula derivation of motion analysis were correct.Static simulation showed that the seat cushion bracket of key load-bearing component did not affect the normal use of wheelchair under the effect of 100 kg load on seat posture.Experimental tests showed that all parameters of posture transformation were consistent with the design objectives and theoretical analysis.The reachable range of hands was between 500 mm and 2300 mm.The tested results of transformation between sitting and lying postures showed that the stability of the system of adjusting posture of wheelchair was favorable.Conclusion:The adjustably assistive walking wheelchair with multi postures can meet the requirement of user in getting things at low and high position through adjusts the height of sitting posture,which can suit the requirement of user at different home scenarios with larger difference at height,such as table,stove and cabinet.

Objective To investigate the prevalence of specific IgE antibodies against Alternaria alternata and Aspergillus fumigatus in serum samples from clinical allergy patients across selected provinces in China.Methods Data on specific IgE antibodies for Alternaria A.and Aspergillus F.were collected from 20 hospital laboratories in 17 cities spanning 11 provinces.The study analyzed the levels of specific IgE and their variations across different provinces and seasons.Results A total of 27 471 cases of Alternaria A.and 32 843 cases of Aspergillus F.specific IgE data were included.The national average positive rate of Alternaria A.IgE was 10.40%,with the highest rate of 22.68%in Jiangsu and the lowest rate of 2.06%in Guangxi.For Aspergillus F.specific IgE,the average positive rate was 4.24%,with Hubei province having the highest rate(7.25%)and Hunan province the lowest(1.23%).The difference in IgE levels for both Alternaria A.and Aspergillus F.among provinces were statistically significant(H=9 955,16 993,all P<0.0001).Among patients,5.85%had Alternaria A.specific IgE levels at grade 3 or above,while only 0.57%had Aspergillus F.specific IgE levels at this level.When examining seasonal variations using data from Liaoning,Hunan and Anhui provinces,significant seasonal changes were observed for both Alternaria A.and Aspergillus F.IgE antibodies(HAlternaria A=347.6,338.0,401.3,HAspergillus F=196.6,133.7,231.7,all P<0.0001).Conclusion The sensitization to Alternaria A.and Aspergillus F.exhibits distinct geographical characteristics and vary significantly with seasons.Given the relatively high IgE levels associated with Alternaria A.,it should be given adequate clinical attention.

Stress urinary incontinence is one of the common symptoms of women during pregnancy and postpartum, which has a lasting impact on the life of patients, and is also one of the public health issues of concern in the world. In this study, the generation, development, construction process, prediction performance and management application of stress urinary incontinence risk prediction models during pregnancy and postpartum were reviewed, with a view to improving the understanding of health care workers on stress urinary incontinence risk prediction models during pregnancy and postpartum, and providing references for promoting the health management of female patients.

Objective:Against the backdrop of population aging and air pollution,this study examined the re-gional distribution of depressive symptoms among middle-aged and elderly people in China and explores the influ-ence of patrticulate matter 2.5(PM2.5)concentration on these symptoms.This study examined the regional distri-bution of depressive symptoms in middle-aged and elderly people in China and explores the influence of PM2.5 concentration and related factors on these symptoms.Methods:Middle-aged and elderly people aged 45 years and above in CHARLS database in 2013,2015 and 2018 were selected as research objects,and the Center for Epidemio-logic Studies Depression Scale(CESD-10)to obtain the detection rate of depressive symptoms.The PM2.5 concen-tration data were derived from the annual data of the China Environmental Monitoring Station.t-test,x2 test and DID model were used to analyze the related factors of depressive symptoms.Stata17.0 and Arc GIS10.8 were used for spatial autocorrelation analysis to explore the regional distribution and relationship of depressive symptoms in mid-dle-aged and elderly people in China.Results:From east to west,the detection rate of depressive symptoms in mid-dle-aged and elderly people in China showed an increasing trend.The regional distribution of PM2.5 mainly showed that the central region was higher than the northern and southern regions and the western region(except Xinjiang)was higher than the eastern region.Conclusion:Both the PM2.5 concentration and depression symptoms exhibit spatial clustering across China.PM2.5 has a negative impact on depression symptoms in middle-aged and elderly people,with other related factors including gender,age,education level,marital status,living area,smoking status.

Objective To investigate the prevalence of specific IgE antibodies against Alternaria alternata and Aspergillus fumigatus in serum samples from clinical allergy patients across selected provinces in China.Methods Data on specific IgE antibodies for Alternaria A.and Aspergillus F.were collected from 20 hospital laboratories in 17 cities spanning 11 provinces.The study analyzed the levels of specific IgE and their variations across different provinces and seasons.Results A total of 27 471 cases of Alternaria A.and 32 843 cases of Aspergillus F.specific IgE data were included.The national average positive rate of Alternaria A.IgE was 10.40%,with the highest rate of 22.68%in Jiangsu and the lowest rate of 2.06%in Guangxi.For Aspergillus F.specific IgE,the average positive rate was 4.24%,with Hubei province having the highest rate(7.25%)and Hunan province the lowest(1.23%).The difference in IgE levels for both Alternaria A.and Aspergillus F.among provinces were statistically significant(H=9 955,16 993,all P<0.0001).Among patients,5.85%had Alternaria A.specific IgE levels at grade 3 or above,while only 0.57%had Aspergillus F.specific IgE levels at this level.When examining seasonal variations using data from Liaoning,Hunan and Anhui provinces,significant seasonal changes were observed for both Alternaria A.and Aspergillus F.IgE antibodies(HAlternaria A=347.6,338.0,401.3,HAspergillus F=196.6,133.7,231.7,all P<0.0001).Conclusion The sensitization to Alternaria A.and Aspergillus F.exhibits distinct geographical characteristics and vary significantly with seasons.Given the relatively high IgE levels associated with Alternaria A.,it should be given adequate clinical attention.

Stress urinary incontinence is one of the common symptoms of women during pregnancy and postpartum, which has a lasting impact on the life of patients, and is also one of the public health issues of concern in the world. In this study, the generation, development, construction process, prediction performance and management application of stress urinary incontinence risk prediction models during pregnancy and postpartum were reviewed, with a view to improving the understanding of health care workers on stress urinary incontinence risk prediction models during pregnancy and postpartum, and providing references for promoting the health management of female patients.

Objective:To design one kind of adjustably assistive walking wheelchair with multi postures,so as to improve the quality of life of people with motion disorders,disabilities or semi disabilities on lower limbs.Methods:The adjustably assistive walking wheelchair with multi postures composed of walking mechanism,mechanism of adjusting posture,and chair,which can achieve five postures,including sitting,low sitting,high sitting,standing and lying.One kinematic model of the wheelchair mechanism was established,and Admas software was used to conduct kinematic simulation.Aimed at key components,the statics simulation was analyzed.The test for adjustment of 5 kinds of postures,the test for the reachable range of hands and the test for the stability of adjusted postures were conducted on the physical prototype of the wheelchair.Results:The results of kinematic simulation showed that the method and formula derivation of motion analysis were correct.Static simulation showed that the seat cushion bracket of key load-bearing component did not affect the normal use of wheelchair under the effect of 100 kg load on seat posture.Experimental tests showed that all parameters of posture transformation were consistent with the design objectives and theoretical analysis.The reachable range of hands was between 500 mm and 2300 mm.The tested results of transformation between sitting and lying postures showed that the stability of the system of adjusting posture of wheelchair was favorable.Conclusion:The adjustably assistive walking wheelchair with multi postures can meet the requirement of user in getting things at low and high position through adjusts the height of sitting posture,which can suit the requirement of user at different home scenarios with larger difference at height,such as table,stove and cabinet.

Objective:To investigate the impact of simulator-multidisciplinary treatment (MDT)-problem-based learning (PBL) integrated teaching on the quality of clinical internship teaching in the Gynecology Department.Methods:A retrospective analysis was conducted on the data of 86 clinical interns in the Gynecology Department who completed one month of internship at Xijing Hospital, Air Force Medical University from May 2021 to May 2022. The interns who received routine teaching from May to October 2021 were enrolled into control group ( n=43), and those who received simulator-MDT-PBL integrated teaching from November 2021 to May 2022 were enrolled into observation group ( n=43). The two groups were compared for differences in professional abilities (measured by Readiness for Interprofessional Learning Scale [RIPLS]), humanistic care ability (measured by humanistic care ability scale), critical thinking ability (measured by critical thinking disposition inventory-Chinese version [CTDI-CV]), and autonomous learning ability (measured by college student autonomous learning scale) after one month of teaching. The chi-square test and t-test were conducted using SPSS 19.0. Results:The two groups showed significantly increases in RIPLS scores [team collaboration: (38.45±6.72) vs. (36.39±5.65); professional identity: (28.11±5.85) vs. (26.43±5.33); role responsibilities: (10.83±1.24) vs. (9.52±1.46)], humanistic care ability scale scores [understanding: (68.73±8.15) vs. (61.55±8.93); patience: (53.45±6.03) vs. (49.57±6.74); encouragement: (56.83±7.24) vs. (52.75±7.46)], and all dimensions of CTDI-CV scale and college student autonomous learning scale, with all scores higher in the observation group than in the control group (all P<0.05). Conclusions:The simulator-MDT-PBL integrated teaching can help improve the professional ability, humanistic care ability, critical thinking ability, and autonomous learning ability of clinical interns in the Gynecology Department, thus improving the quality of clinical internship teaching in the Gynecology Department.