Objective To investigate the distribution of traditional Chinese medicine(TCM)syndrome types in patients with primary Sj?gren's syndrome(PSS),and to explore the correlation between TCM syndrome types and laboratory findings of immunological parameters and inflammatory cytokines.Methods A retrospective study was conducted on 326 patients with PSS who attended the Department of Rheumatology of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,from January 2018 to December 2022.Analysis was carried out for the distribution of TCM syndrome types,namely yin deficiency and blood dryness syndrome,deficiency of qi and yin syndrome,internal retention of damp-heat syndrome,and stagnant heat in the collateral syndrome,in PSS patients.The gender,age of onset,and duration of disease of PSS patients with different TCM syndrome types were compared.And then an exploration was performed in the correlation between TCM syndrome types and laboratory findings of Sj?gren's syndrome antigen A antibody(anti-SSA),Sj?gren's syndrome antigen B antibody(anti-SSB),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),immunoglobulin G(IgG),immunoglobulin A(IgA),interleukin 6(IL-6),complement 3(C3)and complement 4(C4).Results(1)The analysis of the distribution of TCM syndrome types showed that among the 326 patients,106 cases(32.5%)were differentiated as internal retention of damp-heat syndrome,which accounted for the most,and then came yin deficiency and blood dryness syndrome(84 cases,25.8%),stagnant heat in the collateral syndrome(78 cases,23.9%),and deficiency of qi and yin syndrome(58 cases,17.8%)in descending order.(2)There was no statistically significant difference in the gender among the PSS patients with different TCM syndrome types(P>0.05),but the differences of age of onset and the duration of disease among the PSS patients with different TCM syndrome types were statistically significant(P<0.05).The distribution of duration of disease and age of onset in the PSS patients with yin deficiency and blood dryness syndrome,deficiency of qi and yin syndrome,and stagnant heat in the collateral syndrome,internal retention of damp-heat syndrome was in descending order.(3)The analysis of the correlation between TCM syndrome types and laboratory findings showed that yin deficiency and blood dryness syndrome was positively correlated with anti-SSB,IgA,IgG,and C4;deficiency of qi and yin syndrome was positively correlated with anti-SSB,IgG,and C4;internal retention of damp-heat syndrome was positively correlated with CRP,ESR,IL-6,anti-SSA,and IgA;stagnant heat in the collateral syndrome was positively correlated with CRP,ESR,IL-6,and anti-SSA.The differences were all statistically significant(P<0.05 or P<0.01).Conclusion The patients with PSS are usually differentiated as internal retention of damp-heat syndrome,patients with yin deficiency and blood dryness syndrome and deficiency of qi and yin syndrome usually have longer duration of disease and older age of onset,and the patients with internal retention of damp-heat syndrome and stagnant heat in the collateral syndrome usually have shorter duration of disease and younger age of onset.The laboratory findings such as immunological parameters and inflammatory cytokine are correlated with TCM syndrome types of PSS patients to some extent,which will supply guidance for the clinical differentiation of TCM syndromes of PSS.

Objective To explore the developmental trajectories of oral hygiene compliance and its influencing factors in children after dental caries surgery.Methods A prospective cohort study design was adopted.A total of 268 children who underwent dental caries surgery were selected as the research subjects.General and clinical data of the children were collected.The oral hygiene compli-ance changes after surgery were evaluated using the Oral Hygiene Compliance Scale.The develop-mental trajectories of oral hygiene compliance after surgery were described using the group-based traj-ectory model.Multivariate Logistic regression analysis was used to explore the influencing factors of the compliance developmental trajectories.Results The oral hygiene compliance of children after dental caries surgery could be divided into three types of developmental trajectories:the high-compliance slow-decline group[49(18.28％)],the medium-compliance slow-decline group[56(20.90％)],and the low-compliance stable-change group[163(60.82％)].Multivariate Logistic regression analysis showed that the child's gender,mother's educational level,fathers smoking history,annual per capi-ta household income,Social Support Scale score,Oral Health Self-Efficacy Scale score,and Expec-ted Social Impact Scale score were all independent influencing factors for the oral hygiene compliance to present different types of developmental trajectories(P＜0.05).Conclusion The oral hygiene compliance of children after dental caries surgery presents different types of developmental trajectories,and there are individual differences in their initial compliance levels and rates of change.Clinically,oral hygiene care intervention measures should be implemented according to the specific conditions of children to maintain their oral health.

Objective To explore the relationship between vancomycin therapeutic drug monitoring(TDM)and short-term and long-term prognosis in patients with sepsis.Methods Clinical data of sepsis patients treated in the intensive care unit were obtained from the MIMIC-Ⅳ database.Patients were divided into the TDM group and the non-TDM group based on the status of vancomycin TDM.A 1∶1 propensity score matching(PSM)was employed.The association between vancomycin TDM and the risk of 28 d and 90 d mortality of patients before and after PSM was analyzed using Kaplan-Meier survival curves and multivariate Cox regression models.Meanwhile,the relationship between vancomycin TDM and the risk of mortality within 28 d and 90 d was investigated.Results A total of 3,525 patients were included,with 2,474 in the TDM group and 1,051 in the non-TDM group.After PSM,848 patients were included in each group.The mortality rates at 28 d and 90 d in the TDM group were lower than those in the non-TDM group both before and after PSM(P＜0.005).The Kaplan-Meier curve results showed that the survival rates at 28 d and 90 d in the TDM group were higher than those in the non-TDM group both before and after PSM(P＜0.001).Multivariate COX regression analysis showed that vancomycin TDM was an independent protective factor against mortality risk at 28 d[HR=0.74,95％CI(0.65,0.84),P＜0.001]and 90 d[HR=0.79,95％CI(0.70,0.89),P＜0.001]in sepsis patients.Conclusion Vancomycin TDM reduces the short-term and long-term mortality risk in sepsis patients and is worthy of clinical promotion and application.

Objective To explore the relationship between vancomycin therapeutic drug monitoring(TDM)and short-term and long-term prognosis in patients with sepsis.Methods Clinical data of sepsis patients treated in the intensive care unit were obtained from the MIMIC-Ⅳ database.Patients were divided into the TDM group and the non-TDM group based on the status of vancomycin TDM.A 1∶1 propensity score matching(PSM)was employed.The association between vancomycin TDM and the risk of 28 d and 90 d mortality of patients before and after PSM was analyzed using Kaplan-Meier survival curves and multivariate Cox regression models.Meanwhile,the relationship between vancomycin TDM and the risk of mortality within 28 d and 90 d was investigated.Results A total of 3,525 patients were included,with 2,474 in the TDM group and 1,051 in the non-TDM group.After PSM,848 patients were included in each group.The mortality rates at 28 d and 90 d in the TDM group were lower than those in the non-TDM group both before and after PSM(P＜0.005).The Kaplan-Meier curve results showed that the survival rates at 28 d and 90 d in the TDM group were higher than those in the non-TDM group both before and after PSM(P＜0.001).Multivariate COX regression analysis showed that vancomycin TDM was an independent protective factor against mortality risk at 28 d[HR=0.74,95％CI(0.65,0.84),P＜0.001]and 90 d[HR=0.79,95％CI(0.70,0.89),P＜0.001]in sepsis patients.Conclusion Vancomycin TDM reduces the short-term and long-term mortality risk in sepsis patients and is worthy of clinical promotion and application.

ObjectiveTo explore the compliance related factors of repeated screening for colorectal cancer in Jiading District， and to provide a scientific basis for the prevention and control of colorectal cancer. MethodsBased on the natural population cohort in Jiading District， and the screening situation in 2017‒2019 and 2020‒2022， the study subjects were divided into the groups of never participating in screening and participating in screening. Subjects in the participating group were further divided into participating in one round of screening or having repeated screening. SPSS 21.0 software was used to analyze the demographic characteristics of each group. χ² test or Fisher precise probability test were used to conduct univariate analysis of the factors such as gender， age， education level， marital status， retirement status， and type of medical insurance. Factors with the significant difference （P<0.05） were selected for inclusion in multivariate analysis， and factors related to compliance with repeated screening were analyzed by multivariate logistic regression. ResultsA total of 8 179 subjects were included in the study， including 3 323 males （40.6%） and 4 856 females （59.4%）. The average age of the subjects was （61.26±6.06） years old. A total of2 652 （32.4%） had educated in primary school or below， 4 242 （51.9%） in secondary school， and 1 285 （15.7%） in higher secondary school. Mostly， 7 579 （92.7%） were married. Among the participants， 4 062 people had never participated in screening， 4 117 people had participated in screening， and 1 485 of them had repeated screening， with a repeated screening rate of 18.2%. Multivariate logistic regression analysis showed that women had better compliance with repeated screening than men （OR=1.31， 95%CI： 1.14‒1.50）. Compared with the population aged 50 to 54 years， the population aged 55‒59 years （OR=1.57， 95%CI： 1.19‒2.08）， 60-64 years （OR=2.77， 95%CI： 2.13‒3.61）， and 65-69 years （OR=3.31， 95%CI： 2.51‒4.36） had higher compliance with repeated screening. Compared with employees' medical insurance， residents' medical insurance group had worse compliance with repeated screening （OR=0.76， 95%CI： 0.66‒0.87）. People with a history of intestinal polyps were more likely to undergo repeat screening than those without （OR=2.07， 95%CI： 1.50‒2.87）. ConclusionCompliance with repeated screening for colorectal cancer still needs to be improved， and there are differences in compliance with repeated screening for different populations with different characteristics. Identifying groups that are unlikely to adhere to community-based colorectal cancer screening and taking targeted interventions can help improve the continued compliance of residents with colorectal cancer screening.

The food effect(FE)on drug absorption is an important part of clinical pharmacological studies of new drugs.The caloric ratios for each component of a high-fat meal are specified in the"Technical Guidelines for Food Bioavailability and Postprandial Bioequivalence Studies"approved by the US Food and Drug Administration(FDA)and the"Technical Guidelines for Food Effect Studies in New Drug Development"approved by the National Medical Products Administration.However,the recipes for high-fat meals vary among clinical research centers,showing their advantages and disadvantages.Thus,we present a modified version of high-fat meal recipes with easy-to-quantify calories,which is a combination of Western and Chinese flavors,easy to prepare,and meets Chinese tastes.The center satisfaction surveys showed that our modified version of the high-fat meal recipe greatly improved subject satisfaction and compliance,thus better safeguarding the quality of the trial.

Objective To investigate the clinical characteristics of primary Sj?gren's syndrome (pSS) complicating atherosclerosis(AS).Methods The clinical data of the patients with PSS in the rheumatology department of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine of Shanghai Univer-sity of Traditional Chinese Medicine from January 2019 to January 2022 were retrospectively analyzed.The pa-tients were divided into the complication group (n=108) and non-complicating group (n=106) according to whether or not complicating AS.The differences in the general data,laboratory indicators and carotid intima-media thickness (IMT) were compared between the two groups.The risk factors were analyzed.Results Compared with the non-complicating group,the age in the complicating group was bigger[66.00(61.25,69.00)years old vs. 59.00(50.75,65.25)years old],the disease course was longer[128.00(108.25,141.75)months vs. 94.00 (74.75,112.25)months],the levels of ESR,monocyte count,interleukin-6 (IL-6),interleukin-2 receptor (IL-2R),total cholesterol and low density lipoprotein-cholesterol were higher[27.00(14.10,48.00)mm/h vs. 22.00(12.00,36.50)mm/h;0.40(0.30,0.50)×109/L vs. 0.30(0.30,0.50)×109/L;3.56(2.17,5.95)pg/mL vs. 2.62(1.00,5.15)pg/mL;519.00(403.00,662.00)U/mL vs. 441.00(348.00,592.00)U/mL;(4.86±1.17)mmol/L vs. (4.55±1.10)mmol/L;(3.07±0.80)mmol/L vs. (2.82±0.78)mmol/L],IMT was larger[left side:0.80(0.80,0.90)mm vs. 0.80(0.78,0.80)mm;right side:0.80(0.80,0.90)mm vs. 0.80 (0.80,0.80)mm],and the differences were statistically significant (P<0.05).The multivariate logistic re-gression analysis results showed that the long disease course (OR=1.080) and ERS level increase (OR=1.021) were the independent risk factors of AS occurrence in pSS (P<0.05).Conclusion There are differ-ences in the serologic indicators between the pSS patients with complicating AS and the pSS patients without complicating AS,and the disease course and ESR level have the influence on it.

Objective To explore the relationship between the use of proton pump inhibitors(PPIs)and the short-term and long-term prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods Clinical data of AECOPD patients admitted to the intensive care unit(ICU)from January 2008 to December 2019 were extracted from the MIMIC-Ⅳ database.Patients were divided into PPIs group and non PPIs group based on whether PPIs were used during ICU treatment.Compare the general conditions of two groups of patients and plot survival curves using Kaplan-Meier method to compare the differences in survival rates between the two groups at 28 d and 90 d,respectively.Cox proportional hazards regression was used to analyze the association between PPIs usage and 28 d and 90 d mortality risk in two groups of patients.Results A total of 447 patients were included,including 358 in the PPIs group and 89 in the non PPIs group.The 28 d mortality rate and 90 d mortality rate of the PPIs group were 15.64％and 23.46％,respectively,which were lower than those of the non PPIs group(31.46％and 40.45％,respectively)(P＜0.05).The Kaplan-Meier curve analysis showed that the 28 d and 90 d survival rates of the PPIs group were higher than those in the non PPIs group(P＜0.001).The Cox proportional hazards regression analysis showed that after adjusting for all included variables,the hazard ratio(HR)for 28 d and 90 d mortality in the PPIs group were 0.58(95％CI 0.35 to 0.94,P=0.030),0.63(95％CI 0.41 to 0.96,P=0.022),respectively,compared to the non PPIs group.Conclusion In AECOPD patients,the use of PPIs may be reduce the 28 d and 90 d mortality risks.

Objective:To explore the impact of PM 2.5 concentration in Shanghai on the incidence of allergic rhinitis（AR） in the population, and provide strategies for early warning and prevention of AR. Methods:Collect daily average concentrations of atmospheric pollutants monitored in Shanghai from January 1, 2017 to December 31, 2019, and clinical data of AR patients from five hospitals in Shanghai during the same period. We used a time-series analysis additive Poisson regression model to analyze the correlation between PM 2.5 levels and outpatient attendance for AR patients. Results:During the study period, a total of 56 500 AR patients were included, and the daily average concentration of PM 2.5 was（35.28±23.07）μg/m³. There is a correlation between the concentration of PM 2.5 and the number of outpatient attendance for AR cases. There is a positive correlation between the daily average number of outpatient for AR and levels of PM 2.5 air pollution（（P<0.05）） . We found that every 10 μg/m³ increase in PM 2.5, the impact of on the number of AR visits was statistically significant on the same day, the first day behind, and the second day behind, with the strongest impact being the exposure on the same day. Every 10 μg/m³ increases in PM 2.5, the number of outpatient visits increased by 0.526% on the same day（95%CI 1.000 50-1.010 04）. Conclusion:The atmospheric PM 2.5 concentration in Shanghai is positively correlated with the number of outpatient for AR, and PM 2.5 exposure is an independent factor in the onset of AR. This provides an important theoretical basis for AR.
Humans ; Particulate Matter/analysis* ; Air Pollutants/adverse effects* ; Incidence ; China/epidemiology* ; Air Pollution/adverse effects* ; Rhinitis, Allergic/etiology*