Objective To explore the potential categories of frailty development trajectories in patients undergoing cardiac surgery from pre-operation to 6 months post-operation,and analyze the influencing factors.Methods By a longitudinal study design,patients undergoing elective heart valve replacement surgery or coronary artery bypass grafting in a tertiary general hospital in Zunyi City from August 2022 to June 2023 were selected by the convenience sampling method.Tilburg frailty scale was used to investigate the frailty level of cardiac surgery patients 1 day before surgery(T0),1 month(T1),3 months(T2)and 6 months after surgery(T3).The growth mixture model was used to identify the trajectory categories,and the influencing factors of different frailty trajectories were analyzed by binary Logistic regression.Results 261 patients were enrolled at T0,with 22,9,and 3 patients lost at T1 to T3,and 227 patients were finally included in the analysis.There were 2 types of trajectories being identified as the low frailty decline group and the high frailty maintenance group.Age,use of sedative and analgesic drugs,pace,and depression were the factors influencing the frailty in cardiac surgery patients(P＜0.05).Conclusion There are 2 kinds of frailty development trajectories in patients undergoing cardiac surgery.Medical staff should fonnulate precise interventions and nursing measures according to the factors influencing frailty,so as to improve frailty degree and quality of life of patients undergoing cardiac surgery.

Objective:To explore the value of magnetic resonance examination in distinguishing invasive and non-invasive pancreatic solid pseudopapillary neoplasms (SPN).Methods:The clinical and MRI data of 167 patients with SPN who underwent surgery and were pathologically diagnosed at Zhongshan Hospital ,Fudan University from Oct 2013 to Oct 2023 were retrospectively analyzed.Results:There was no statistically significant difference between invasive and non-invasive SPN in terms of age, gender, clinical symptoms, laboratory tests, location, growth pattern, tumor size, relationship with the pancreas, bleeding, and pancreatic duct dilation ( P>0.05). However, there were statistically significant differences between the two groups in terms of tumor morphology, margins, capsule, cystic solid ratio, pancreatic atrophy, enhancement pattern, and enhancement features ( P<0.05). The area under the ROC curve for the combined indicators (tumor morphology, margins, capsule, cystic solid ratio, and pancreatic atrophy) was 0.679 (95% CI: 0.594-0.764), with a sensitivity of 73.7% and specificity of 70.9%. Conclusion:Magnetic resonance examination is helpful in distinguishing invasive and non-invasive pancreatic solid pseudopapillary neoplasms.

Objective:To explore the risk fall death associated with compound hot extremes.Methods:This study collected data on fall deaths in Guangdong, Hunan, and Zhejiang Provinces from 2013 to 2018 and matched their exposure to meteorological data. Based on a time-stratified case-crossover design, a conditional logistic regression model embedded with a cross-basis function of the distributed lag nonlinear model was applied to estimate the risk of fall to death due to compound hot extremes.Results:Compared with regular days, compound hot extremes significantly increased the risk of death from falls ( OR=1.19, 95% CI: 1.09-1.30), and women ( OR=1.27, 95% CI: 1.11-1.45) and the elderly age 65 and above ( OR=1.24, 95% CI: 1.12-1.39) were more sensitive to compound hot extremes. The maximum duration of compound hot extremes was 7 days, and the maximum intensity was 6.2 ℃, and the duration and intensity were proportional to the risk of death from falls. The risk of death from falls increased by 12% ( OR=1.12, 95% CI: 1.06-1.18) each day, increasing in duration after linearization. The risk of death from falls increased by 16% ( OR=1.16, 95% CI: 1.10-1.22) for each 1 ℃ increase in linearized intensity. Conclusion:Compound hot extremes increase the risk of death cases from falls.

Objective To explore the potential categories of frailty development trajectories in patients undergoing cardiac surgery from pre-operation to 6 months post-operation,and analyze the influencing factors.Methods By a longitudinal study design,patients undergoing elective heart valve replacement surgery or coronary artery bypass grafting in a tertiary general hospital in Zunyi City from August 2022 to June 2023 were selected by the convenience sampling method.Tilburg frailty scale was used to investigate the frailty level of cardiac surgery patients 1 day before surgery(T0),1 month(T1),3 months(T2)and 6 months after surgery(T3).The growth mixture model was used to identify the trajectory categories,and the influencing factors of different frailty trajectories were analyzed by binary Logistic regression.Results 261 patients were enrolled at T0,with 22,9,and 3 patients lost at T1 to T3,and 227 patients were finally included in the analysis.There were 2 types of trajectories being identified as the low frailty decline group and the high frailty maintenance group.Age,use of sedative and analgesic drugs,pace,and depression were the factors influencing the frailty in cardiac surgery patients(P＜0.05).Conclusion There are 2 kinds of frailty development trajectories in patients undergoing cardiac surgery.Medical staff should fonnulate precise interventions and nursing measures according to the factors influencing frailty,so as to improve frailty degree and quality of life of patients undergoing cardiac surgery.

Objective:To explore the risk fall death associated with compound hot extremes.Methods:This study collected data on fall deaths in Guangdong, Hunan, and Zhejiang Provinces from 2013 to 2018 and matched their exposure to meteorological data. Based on a time-stratified case-crossover design, a conditional logistic regression model embedded with a cross-basis function of the distributed lag nonlinear model was applied to estimate the risk of fall to death due to compound hot extremes.Results:Compared with regular days, compound hot extremes significantly increased the risk of death from falls ( OR=1.19, 95% CI: 1.09-1.30), and women ( OR=1.27, 95% CI: 1.11-1.45) and the elderly age 65 and above ( OR=1.24, 95% CI: 1.12-1.39) were more sensitive to compound hot extremes. The maximum duration of compound hot extremes was 7 days, and the maximum intensity was 6.2 ℃, and the duration and intensity were proportional to the risk of death from falls. The risk of death from falls increased by 12% ( OR=1.12, 95% CI: 1.06-1.18) each day, increasing in duration after linearization. The risk of death from falls increased by 16% ( OR=1.16, 95% CI: 1.10-1.22) for each 1 ℃ increase in linearized intensity. Conclusion:Compound hot extremes increase the risk of death cases from falls.

Objective:To explore the value of magnetic resonance examination in distinguishing invasive and non-invasive pancreatic solid pseudopapillary neoplasms (SPN).Methods:The clinical and MRI data of 167 patients with SPN who underwent surgery and were pathologically diagnosed at Zhongshan Hospital ,Fudan University from Oct 2013 to Oct 2023 were retrospectively analyzed.Results:There was no statistically significant difference between invasive and non-invasive SPN in terms of age, gender, clinical symptoms, laboratory tests, location, growth pattern, tumor size, relationship with the pancreas, bleeding, and pancreatic duct dilation ( P>0.05). However, there were statistically significant differences between the two groups in terms of tumor morphology, margins, capsule, cystic solid ratio, pancreatic atrophy, enhancement pattern, and enhancement features ( P<0.05). The area under the ROC curve for the combined indicators (tumor morphology, margins, capsule, cystic solid ratio, and pancreatic atrophy) was 0.679 (95% CI: 0.594-0.764), with a sensitivity of 73.7% and specificity of 70.9%. Conclusion:Magnetic resonance examination is helpful in distinguishing invasive and non-invasive pancreatic solid pseudopapillary neoplasms.

Abstract Allergic diseases can occur in all systems of the body, covering the whole life cycle, from children to adults and to old age, can be lifelong onset and even fatal in severe cases. Children account for the largest proportion of the victims of allergic disease, Children s allergies start from scratch, ranging from mild to severe, from less to more, from single to multiple systems and systemic performance, so the prevention and treatment of allergic diseases in children is of great importance, which can not only prevent high risk allergic conditions from developing into allergic diseases, but also further block the process of allergy. At present, there is no consensus on the management system of allergic children in kindergartens and primary schools. The "Consensus on Allergy Management and Prevention in Kindergartens and Primary Schools", which includes the organizational structure, system construction and management of allergic children, provides evidence informed recommendations for the long term comprehensive management of allergic children in kindergartens and primary schools, and provides a basis for the establishment of the prevention system for allergic children.

Objective To investigate the impact of the electroacupuncture treatment in Jiao's scalp acupuncture balance area on the walking ability of patients with stroke. Methods The stroke patients who met the inclusion criteria were randomly divided into the control group (ordinary acupuncture group) and the treatment group (Jiao's scalp group). The two groups were scored before treatment, after 1 course of treatment and 2 courses of treatment, by using Fugl-Meyer lower limb score, Berg balance score and Holden walking grading. Results After 1 course of treatment, the Fugl-Meyer, Berg, and Holden walking grading of the two groups were higher than those before treatment (P<0.01). The Fugl-Meyer, Berg, and Holden walking grading of the treatment group were better than those of the control group, and the difference was significant (P<0.01). The Fugl-Meyer, Berg, Holden walking grading of the two groups after treatment for 2 courses were significantly higher than those before treatment and after 1 course of treatment (P<0.01). There was no difference between the two groups (P>0.05). Conclusion Electroacupuncture treatment of Jiao's scalp balance area can effectively improve the balance of stroke patients, increase the ability of lower limbs to improve walking function, reduce the risk of falls.

Objective To know about current statusof ICU nurses about knowledge and practice on venous thromboembolism(VTE) in Guizhou province.Methods A total of 321 ICU nurses were interviewed by self-designed questionnaires to analyses the related factors of the score of the related knowledge and practice on VTE.Results The score of the VTE related knowledge was (17.070±4.340)point and the score of the practice was (62.410±14.640)point respectively.The score of the practice on VTE was positively related to that of ICU nurses knowledge (P＜0.05).The result of multiple linear stepwise regression analysis showed that "departments" and "had the VTE related knowledge in school" were the significant factors on knowledge (P＜0.05)."Active learning the VTE related knowledge" " the levels of hospitals" and "had the VTE related knowledge in school" were the significant factors on the scores of the practice on VTE (P＜0.05).Conclusion The ICU nurses had better knowledge about VTE,and the current status of practice on VTE was ideal in Guizhou province,but further research is needed to make unified and normative processes of VTE preventive interventions.

Objective To investigate the MRI features of peliosis hepatis (PH).Methods Nine patients with pathologically proven PH were retrospectively included.Plain scan and contrast-enhanced MRI of the abdomen were performed on all patients before operation.All clinical,pathological and MR imaging data of patients were collected.The MR image analysis of the lesion included the number,location,size,shape,lesion margins,signal intensity,and enhancement pattern.Results Eleven lesions were detected in 9 patients,with 10 lesions in the right lobe of the liver and 1 lesion in the left lobe.The maximum diameter of the 11 lesions was 0.7 cm to 8.8 cm (mean 3.7 cm).All 11 lesions were round or oval in the shape.Seven lesions had clear boundaries and 4 lesions had blurred boundaries.Signal intensity of 2 lesions were homogeneous,while 9 lesions had heterogenous signal intensity on plain san.Ten lesions showed slightly hypointense on T1WI,slightly hyperintense on T2WI and mildly progressive enhancement.These lesions were weakly enhanced and showed slight cluster-like mild enhancement in the arterial phase.The enhancement scope of the lesions gradually filled into the interior in the portal vein phase and the signal intensity was slightly higher than liver in delay phase.One lesion showed hypointense on T1WI and hyperintensity on T2WI.After the enhancement,the lesion was evenly enhanced and showed continuous enhancement.On DWI,11 lesions were slightly hyperintense.The signal intensity of 9 lesions were equal to that of the liver,and the signal intensity of the 2 lesions was slightly higher than that of the liver on the ADC map.Conclusion MRI signs of PH have certain characteristics,which can help diagnosis and differential diagnosis.