Objective To systematically analyze the characteristics of the disease burden of hypertensive heart disease (HHD) in the elderly (≥60 years) globally and in China from 1990 to 2021, and to predict its future trends from 2022 to 2040, with the aim of providing data support for optimizing comprehensive prevention and control strategies for HHD. Methods Based on the Global Burden of Disease (GBD) 2021 database, the number of prevalent cases and disability-adjusted life years (DALYs) of HHD in the elderly were extracted for the world, China, and five regions categorized by sociodemographic index (SDI). Joinpoint regression was used to analyze the temporal trends of age-standardized prevalence rate and age-standardized DALYs rate of HHD in the elderly. A three-factor decomposition method was applied to evaluate the relative contributions of aging, population growth, and epidemiological changes to the variations in the elderly HHD burden. Additionally, a Bayesian age-period-cohort model was used to predict the elderly HHD burden from 2022 to 2040. Results In 2021, the number of prevalent elderly HHD cases reached 10 283 000 globally and 3 412 400 in China, representing increases of 179.20% and 159.20% respectively, compared with 1990. The DALYs of elderly HHD were 18 812 700 person-years globally and 4 731 400 person-years in China, rising by 76.08% and 29.45% respectively from 1990. Meanwhile, the growth rates of the number of prevalent cases and DALYs of elderly HHD varied across different SDI regions. From 1990 to 2021, the age-standardized prevalence rate of elderly HHD in China, as well as the age-standardized DALYs rate of elderly HHD both globally and in China, showed significant downward trends (all average annual percentage changes<0, all P<0.001). In 2021, the 70-74 years age group accounted for the highest proportion of prevalent cases and DALYs of elderly HHD, both globally and in China. Decomposition analysis revealed that population growth was the dominant factor driving the increase in the elderly HHD burden across all regions. The prediction model results indicated that the number of prevalent cases and DALYs of elderly HHD would continue to rise globally and in China from 2022 to 2040, with the growth rate of the elderly HHD burden in China between 2021 and 2040 expected to exceed the global average. Conclusion Over the past 32 years, although the age-standardized disease rates of elderly HHD have mainly shown a downward trend globally and in China, the absolute number of the disease burden has increased substantially. The projection model indicates a continued upward trajectory, with the growth rate in China higher than the global average. Therefore, there is an urgent need to implement precise prevention and control strategies to effectively mitigate the disease burden of elderly HHD.

[Objective] To perform genetic analysis on samples with weak agglutination and mixed agglutination of ABO blood group antigens in neonates, and to investigate the molecular biological characteristics of ABO subtypes in neonates. [Methods] Serological identification of ABO blood group was performed by tube method and microcolumn gel method. The ABO exons 2-7 were amplified by PCR, and the amplified products were sequenced by Sanger sequencing method to determine the genotype. [Results] Among the ABO blood group serological results of 14 neonates, 8 cases showed weakened A antigen, and 6 cases showed weakened B antigen. Seven samples were identified with ABO subtype alleles, with genotypes as A102/B101+c.538C>T, Aw26/B102, A205/O02, A205/B101(2 cases), Aw26/O02, B(A)06/O01, B101/O01(3 cases), A102/O01(2 cases), A102/B101 and B101/O02. Additionally, three other family members were also found to carry B(A)06 allele in a pedigree investigation. [Conclusion] For samples showing weakened antigens in ABO blood type identification of neonates, it is necessary to consider the possibility of ABO subtype in addition to age factors, and genetic testing can be used to prevent missed detection of ABO subtypes in neonates.

Objective To investigate the relationship between traditional Chinese medicine(TCM)syndromes and biological indicators of neutrophil-to-lymphocyte ratio(NLR),systemic immune-inflammatory index(SII),systemic inflammation response index(SIRI),and aggregate index of systemic inflammation(AISI)in obese type 2 diabetes mellitus(T2DM)patients complicated with Helicobacter pylori(Hp)infection.Methods From January 2023 to July 2024,an investigation was carried out in 200 cases of obese T2DM patients complicated with Hp infection,20 cases of obese T2DM patients without Hp infection(Hp-negative),and 20 obese individuals without Hp infection(Hp-negative)who met the inclusion criteria and were treated at Linhai Hospital of Traditional Chinese Medicine.The relationships between different groups of obese individuals and biological indicators of NLR,SII,SIRI,and AISI were observed.And the correlation of TCM syndromes and the presence of chronic complications with biological indicators of NLR,SII,SIRI,and AISI in obese T2DM patients complicated with Hp infection was also explored.Results(1)The levels of NLR,SII,SIRI,and AISI in obese T2DM patients complicated with Hp infection were higher than those in obese T2DM patients(Hp-negative)and obese individuals(Hp-negative)(P＜0.05).(2)Among the 200 cases of obese T2DM patients with Hp infection,the distribution of TCM syndromes in descending order was as follows:phlegm-turbidity blocking the middle energizer syndrome(29.50%)＞phlegm blended with heat syndrome(21.50%)＞qi stagnation and blood stasis syndrome(20.00%)＞liver depression and spleen deficiency syndrome(19.00%)＞qi and yin deficiency syndrome(10.00%).(3)The levels of NLR,SII,SIRI,and AISI varied in obese T2DM patients with Hp infection of various TCM syndrome types,and they were in descending order in the following types:phlegm blended with heat syndrome＞qi stagnation and blood stasis syndrome＞liver depression and spleen deficiency syndrome＞phlegm-turbidity blocking the middle energizer syndrome＞qi and yin deficiency syndrome(P＜0.05).(4)Logistic regression analysis showed that NLR,SII,SIRI,and AISI were the risk factors of chronic complications in obese T2DM patients complicated with Hp infection,and all were positively correlated with the chronic complications(P＜0.05 or P＜0.01).Conclusion NLR,SII,SIRI,and AISI are correlated with the severity of obese T2DM complicated with Hp infection,which may serve as potential biological indicators for TCM syndrome differentiation and identification of chronic complications in obese T2DM patients complicated with Hp infection.

Objective To summarize and quantitatively analyze the academic literatures in the field of pulmonary rehabilitation for chronic obstructive pulmonary disease(COPD),and track the international research foci and trends.Methods Relevant research in the field of COPD pulmonary rehabilitation from 2012 to 2021 was retrieved from the Web of Science core database.Microsoft Excel 2019 and GraphPad Prism 8.0 were used for quantitative analysis of the search results,and Cite Space(5.8.R3)and VOS viewer were used for visual analysis.Results A total of 5 752 articles were obtained.The relevant articles increased gradually from 2012 to 2021.America and the United Kingdom issued a large number of publications,and dominated in this field.The League of European Research Universities was the most productive and influential institution.International Journal of Chronic Obstructive Pulmonary Disease was the journal with the largest number of publications.The most cited journal was the European Respiratory Journal.The essential articles in this field were diagnosis and treatment scheme,clinical guidelines,and evidence-based medicine.The main literature topics were pulmonary rehabilitation,mechanical ventilation,triple therapy,physical activity,and obesity.The research foci were COPD exacerbation,respiratory failure,mechanical ventilation,and oxygen therapy.Conclusion Pulmonary rehabilitation of COPD is a research field with great development.The current researches mainly focus on respiratory support therapy for patients with COPD exacerbation and respiratory failure,which may represent an emerging trend in this field.In the future,academic exchanges and research cooperation between regional institutions should be strengthened to remedy the imbalance in development between regions.

OBJECTIVE: To observe the effect of acupuncture at "pelvic floor six needles" for mild to moderate female stress urinary incontinence (SUI). METHODS: A total of 60 patients with mild to moderate female SUI were randomly divided into an observation group and a control group, 30 cases each group. The control group received Kegel exercise. The observation group received acupuncture at "pelvic floor six needles" on the basis of the treatment as the control group, bilateral Zhongliao (BL33), Zhibian (BL54), Huiyang (BL35), Shuidao (ST28), Dahe (KI12) and Guanyuan (CV4) were selected, once every other day, 3 times a week, 4 weeks as a course of treatment, a total of 2 courses were required. Before treatment and after 4, 8 weeks of treatment, urine leakage in 1 hour, International Consultation on Incontinence questionnaire short form (ICI-Q-SF) score, and incontinence quality of life questionnaire (I-QOL) score were observed in the two groups, and the clinical efficacy was evaluated. RESULTS: After 8 weeks of treatment, urine leakage in 1 hour and ICI-Q-SF scores in both groups were decreased compared with those before treatment (P<0.05), and urine leakage in 1 hour and ICI-Q-SF score in the observation group were lower than those in the control group (P<0.05). After 4, 8 weeks of treatment, I-QOL scores were increased compared with those before treatment in both groups (P<0.05), and the I-QOL scores in the observation group were higher than those in the control group (P<0.01, P<0.001). The total effective rate of the observation group was 93.3% (28/30), which was higher than 73.3% (22/30) in the control group (P<0.05). CONCLUSION Acupuncture at "pelvic floor six needles" could improve the clinical symptoms and quality of life in patients with mild to moderate female SUI to a certain degree.
Humans ; Female ; Acupuncture Therapy/instrumentation* ; Urinary Incontinence, Stress/physiopathology* ; Middle Aged ; Adult ; Exercise Therapy ; Acupuncture Points ; Pelvic Floor/physiopathology* ; Aged ; Treatment Outcome ; Quality of Life

Objective: To analyze the results of national external quality assessment (EQA) for transfusion compatibility test from 2018 to 2023, with the aim of providing references for improving laboratory testing quality and ensuring the safety of clinical blood transfusion. Methods: Three EQA programs were conducted annually, each distributing 22 quality assessment samples. Participating transfusion laboratories were required to complete testing within specified deadlines and to submit results along with documentation of testing methodologies, reagents, and equipment used. National Center for Clinical Laboratories (NCCL) conducted statistical analysis of laboratory results, evaluated testing outcomes and related circumstances, and provided feedback to participating laboratories. EQA data from transfusion laboratories across China from 2018 to 2023 were collected and systematically analyzed. Results: From 2018 to 2023, the qualification rates for all five items (ABO forward typing, ABO reverse typing, Rh blood group typing, antibody screening, and cross-matching) were 67.59%, 77.11%, 77.38%, 72.78%, 79.96%, and 85.16%, respectively. The mean qualification rates for ABO forward typing, ABO reverse typing, RhD blood group typing, antibody screening, and cross-matching over the past six years were 96.25%±0.59%, 90.45%±4.52%, 96.05%±0.71%, 90.88%±2.86%, and 88.34%±3.48%, respectively. The qualification rates in 2019, 2020, 2022, and 2023 all showed a stable trend of "blood stations>tertiary hospitals>secondary hospitals". The mean qualification rate of laboratories in secondary hospitals from 2018 to 2023 was significantly lower than those of laboratories in tertiary hospitals and blood stations (P<0.05), while no significant difference was observed between laboratories in tertiary hospitals and blood stations (P>0.05). The micro column agglutination method was the most widely used in all five tests. In the four test items, namely ABO forward typing, ABO reverse typing, antibody screening, and cross-matching, there was a statistically significant difference in the qualification rate of micro column agglutination method compared to other methods (P<0.05). There was a statistical difference in the qualification rate between manual and automated detection using micro column agglutination method in the cross-matching tests (P<0.05), whereas no significant difference was noted for the other test items (P>0.05). Conclusion: From 2018 to 2023, the number of laboratories participating in EQA activities has been increasing year by year, and the qualification rate has shown an overall upward trend. The type of laboratory is a key factor affecting the qualification rate, and the testing capabilities of some laboratories still need to be improved. The micro column agglutination method is widely used in transfusion compatibility tests. The established EQA program effectively monitors quality issues in laboratories, drives continuous improvement, and ensures sustained enhancement of testing standards to safeguard clinical blood safety.

Objective: To explore the positive rate and distribution characteristics of unexpected antibodies in hospitalized children. Methods: A total of 22 336 hospitalized pediatric patients admitted to Henan Children's Hospital from August 2018 to September 2022 were selected as the research subjects, and their relevant clinical data were collected. Blood samples of the patients were subjected to blood type identification and unexpected antibody screening. For samples with positive screening results, further antibody specificity identification was conducted using panel cells. The distribution patterns of unexpected antibodies across different genders, age groups, blood types, and disease categories were analyzed, and inter-group differences were compared. Results: Of the 22 336 patients, 286 (1.3%) tested positive for unexpected antibodies. The most frequently identified specificities belonged to the MNS blood group system (45.1%, 129/286), followed by the Rh system (24.5%, 70/286) and antibodies of undetermined specificity (24.5%, 70/286). Less common specificities included those from the P blood group system (2.4%, 7/286), Lewis blood group system (1.4%, 4/286), mixed antibodies from multiple systems (0.9%, 3/286), drug-induced antibodies (0.7%, 2/286), and LW blood group system (0.3%, 1/286). Within the MNS blood group system, anti-M was the most prevalent (129 cases). In the Rh blood group system, anti-E (30 cases, 10.5%) and anti-D (28 cases, 9.8%) were the main antibodies detected; other antibodies included anti-DE (4 cases, 1.4%), anti-DC (3 cases, 1.0%), anti-Ec (3 cases, 1.0%), and anti-c (2 cases, 0.7%). Only anti-P was identified in the P blood group system (7 cases), while anti-Lea was found in the Lewis blood group system (4 cases) and anti-LW in the LW blood group system (1 case). Mixed antibodies from multiple systems consisted of anti-D+Fy , anti-e+Fy , and anti-Le +P , with 1 case (0.3%) each. Among the antibodies with undefined specificity, 26 cases were autoantibodies. All drug-induced antibodies were anti-CD38 (2 cases). The distribution of unexpected antibodies showed statistically significant differences among different genders, ages, and ABO blood types (P<0.05). Regarding age distribution, Rh blood group antibodies associated with hemolytic disease of the fetus and newborn (HDFN) were predominant in the 0-1 month group, which differed significantly from all other age groups (P<0.001). In contrast, anti-M was predominant in children over 1 year of age (89.0%), while anti-E was detected in only 3 cases (10.0%) in children over 3 years old. After Bonferroni correction (α' = 0.003 3), a statistically significant difference was observed only between the 6-17 year group and the 1-3 year group (P=0.003). Among ABO blood types, type B had the highest antibody detection rate. Following Bonferroni correction (α' ≈ 0.008 3), a significant difference in detection rates was found solely between type B and type O blood (P=0.005), with no statistically significant differences among other blood types (P>0.008 3). Conclusion: In hospitalized pediatric patients, unexpected antibodies were mainly distributed in the MNS and Rh blood group systems, with anti-M being the most commonly detected specificity and anti-E the most prevalent within the Rh system.. Sex, age and blood type significantly influence the development of unexpected antibodies. Clinically, it is necessary to pay attention to the prenatal monitoring of unexpected antibodies in pregnant women, so as to achieve homotypic transfusion of other Rh antigens as early as possible.

Objective:To summarize the single-center experience of serial transverse enteroplasty (STEP) in children with intestinal failure.Methods:The clinical data of 13 children who underwent STEP surgery at our department from Jan 2016 to Dec 2022 was retrospectively analyzed.Results:Eight children were females ,5 were males. There were 10 premature infants and 3 full-term infants. The gestational age was 26 +3-39 +5 weeks, and the birth weight was 860 -3 700 g. The median age of surgery was 12 months, the median length of small intestine was 70 (50-130) cm, the diameter of preoperative intestinal dilation was about 4.5 to 7.5 cm, and the operation interval was 2.5 to 3.0 cm. Continuous transverse enteroenteroplasty resulted in an average increase of 75% (66% to 100%) in the length of the dilated intestinal segment. The total length of the small intestine increases by 16.0% (12.5%-30.0%). After the operation, 12 of the 13 children (92.3%) were removed from parenteral nutrition to achieve intestinal adaptation of the remaining bowel, and the mean time of withdrawal from parenteral nutrition was 138(20-1 011) days after the operation. Intestinal dilatation occurred in 2 patients, and gastrointestinal bleeding occurred in 4 patients, which healed after conservative treatment. Conclusions:STEP operation is suitable for children with short intestinal length and obvious expansion of intestinal tube. STEP can not only reduce the diameter of the enlarged intestine, but also extend the length of the intestine, increase the feeding tolerance, improve the clinical effect of enteral nutrition, and shorten the time for children to achieve intestinal adaptation.

Objective:To explore the psychological development process of suicide ideation-to-action in male prisoners,providing a basis for suicide prevention and intervention for them.Methods:Thirty-five male prisoners with self-reported or prison police assessment of suicide risk and history of self-injury and suicide were selected for in-depth interviews.Using grounded theory to code data,explore the evolution process and influencing factors of prisoners from suicidal ideation to suicide-related actions.Results:Prisoners were divided into three stages from the emergence of suicidal ideation to suicide-related actions,namely the seed stage of cumulative environmental effects(stage 1),the germination and development stage of suicidal ideation(stage 2),and the action strategy selection stage(stage 3).The process mainly contained 4 dimensions,namely situational risk factors,negative psychological experiences,psychological risk factors and psychological protection factors.Conclusion:The suicide psychological development process of prisoners is a gradual process.Suicide intervention should prioritize prevention,remove risk factors,enhance protective factors,and carry out personalized intervention based on different pathways.

Summarize the nursing experience of 9 children with X-linked agammaglobulinemia who were first treated with subcutaneous infusion of human immunoglobulin in mainland China. Nursing points: there is no precedent in mainland China for high-dose subcutaneous infusion of human immunoglobulin, therefore, it is necessary to make sufficient preparation and care before infusion, pay attention to the observation and care of drug infusion, provide guidance on home medication, pay attention to psychological care, and ensure that patients smoothly transition from hospital medication to home medication. All 9 patients successfully completed subcutaneous injection of human immunoglobulin treatment, ensure smooth transition of patients from hospital medication to home medication. and no serious adverse reactions occurred, resulting in good results.