Objective To investigate the predictive value of derived neutrophil lymphocyte ratio(dNLR)and non-high-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio(NHHR)for in-hospital outcomes of acute myocardial infarction(AMI)patients after PCI.Methods A total of 206 AMI patients undergoing PCI in our department from January 2021 to December 2023 were recruited,and according to their outcomes after PCI,they were divided into a good prognosis group(174 cases)and a poor prognosis group(32 cases).The clinical data were collected,and the dNLR and NHHR values were calculated.ROC curve was plotted to evaluate the predictive value of dNLR,NHHR and their combination for in-hospital outcomes of AMI pa-tients after PCI.Multivariate logistic regression analysis was applied to identify the influencing factors for in-hospital outcomes of AMI patients after PCI.Results The poor prognosis group had significantly higher Gensini score,larger proportions of NYHA Classes Ⅲ+Ⅳ and multi-vessel lesions,and elevated dNLR and NHHR,and lower LVEF value than the good prognosis group(P＜0.05,P＜0.01).The AUC value of dNLR,NHHR and their combination in predicting in-hospital outcomes of AMI patients after PCI was 0.758(95％CI:0.713-0.808),0.812(95％CI:0.767-0.857)and 0.914(95％CI:0.869-0.964),respectively.Multivariate logistic regression analysis showed that LVEF(OR=2.519,95％CI:1.249-5.082,P=0.010),multi-vessel lesions(OR=2.323,95％CI:1.358-3.975,P=0.002),dNLR(OR=3.031,95％CI:1.793-5.126,P=0.001),and NHHR(OR=3.480,95％CI:1.873-6.465,P=0.001)were influencing factors for in-hospital outcomes in AMI patients after PCI(P＜0.05).Conclusion High dNLR and NHHR values are closely associated with poor outcomes in AMI patients after PCI,and their combination may be an indicator to predict the outcomes after PCI.

Environmental Microbiology, as a compulsory foundational course for the major of environmental and ecological engineering. Its knowledge system not only lays a profound theoretical foundation but also evinces a close-knit nexus to practical applications in environmental protection and ecological restoration. This course thus serves as an outstanding platform facilitating both teaching reforms and practical innovations of professional courses. With Environmental Microbiology as a paradigmatic illustration, this paper concentrates on addressing issues like archaic course contents and enervating teaching approaches, with the aspiration of augmenting students' professional acuities, practical dexterities, and innovation and entrepreneurial aptitudes. In light of the aforesaid aim, we initiated an all-encompassing probe into the teaching reform and practicable paradigms from the perspective of amalgamating professional education with innovation-steered stratagems. Across multiple fronts, comprehensive reformative undertakings were implemented, subsuming the optimization and reconfiguration of course contents, the exploration of sundry teaching methodologies, and the scientific erection of an evaluation system. Ultimately, a nascent teaching model dubbed "three-dimensional, six-loop and five-collaborative" was formed. This series of comprehensive and innovative reform measures has not only substantially augmented the profundity and extensiveness of professional knowledge, permeating into the core of disciplinary essence, but also remarkably bolstered students' practical operational capabilities and innovative thinking patterns, thereby catalyzing their transformation into well-rounded individuals with a competitive edge. By virtue of these efforts, a solid foundation has been firmly laid for the teaching reform of Environmental Microbiology and the cultivation of high-caliber environmental professionals in the contemporary era, heralding a new chapter in the development of environmental education.
Environmental Microbiology ; Teaching ; Education, Professional/methods* ; Curriculum

Objective The aim of this study was to analyze the incidence and mortality of esophageal cancer and its trend in Lianyungang city from 2008 to 2019.Methods The data of esophageal cancer in all cancer registry areas in Lianyungang city were col-lected and sorted out,and the quality control reached the standards.The incidence,mortality,age-standardized rate of Chinese population(ASRC),age-standardized rate of World population(ASRW),cumulative rate at 0-74 years old,truncation rate of 35-64 years old,and composition ranking were calculated.The Joinpoint4.7.0.0software was used to analyze the average annual percentage change(AAPC)of the age-standardized incidence and mortality of esophageal cancer by the standard population(ASIRC and ASMRC).Results From 2008 to 2019,the incidence of esophageal cancer in Lianyungang city was 25.90/100,000,ASIRC was 17.95/100,000,ASIRW was 17.91/100,000,ranking the third in the incidence spectrum of malignant tumors.The mortality was 20.55/100,000,ASMRC was 13.86/100,000,and ASMRW was 13.71/100,000,ranking the third in the malignant tumor mortality spectrum.The incidence,mortali-ty,ASIRC and ASMRC of esophageal cancer were higher in men than those in women,and higher in rural areas than those in urban are-as.From 2008 to 2019,the change trend of incidence and mortality of esophageal cancer in Lianyungang city was the same,showing a downward trend.The AAPC of the ASIRC was-6.19%(95%CI:-7.08%-5.30%,P<0.001),and the AAPC of the ASMRC was-4.03%(95%CI:-5.81%-2.22%,P<0.001).Among them,the ASIRC and ASMRC of esophageal cancer in urban and rural areas showed a downward trend(P<0.05).Among them,the ASIRC and ASMRC of esophageal cancer in urban women decreased the most,with an average annual decline of-7.99%(95%CI:-10.86%-5.03%,P<0.001)and-9.19%(95%CI:-12.35%-5.93%,P<0.001).Conclusion The incidence and mortality of esophageal cancer in Lianyungang city have shown a downward trend,a rural areas and male populations are the key prevention and control populations for esophageal cancer.

Objective To investigate the predictive value of derived neutrophil lymphocyte ratio(dNLR)and non-high-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio(NHHR)for in-hospital outcomes of acute myocardial infarction(AMI)patients after PCI.Methods A total of 206 AMI patients undergoing PCI in our department from January 2021 to December 2023 were recruited,and according to their outcomes after PCI,they were divided into a good prognosis group(174 cases)and a poor prognosis group(32 cases).The clinical data were collected,and the dNLR and NHHR values were calculated.ROC curve was plotted to evaluate the predictive value of dNLR,NHHR and their combination for in-hospital outcomes of AMI pa-tients after PCI.Multivariate logistic regression analysis was applied to identify the influencing factors for in-hospital outcomes of AMI patients after PCI.Results The poor prognosis group had significantly higher Gensini score,larger proportions of NYHA Classes Ⅲ+Ⅳ and multi-vessel lesions,and elevated dNLR and NHHR,and lower LVEF value than the good prognosis group(P＜0.05,P＜0.01).The AUC value of dNLR,NHHR and their combination in predicting in-hospital outcomes of AMI patients after PCI was 0.758(95％CI:0.713-0.808),0.812(95％CI:0.767-0.857)and 0.914(95％CI:0.869-0.964),respectively.Multivariate logistic regression analysis showed that LVEF(OR=2.519,95％CI:1.249-5.082,P=0.010),multi-vessel lesions(OR=2.323,95％CI:1.358-3.975,P=0.002),dNLR(OR=3.031,95％CI:1.793-5.126,P=0.001),and NHHR(OR=3.480,95％CI:1.873-6.465,P=0.001)were influencing factors for in-hospital outcomes in AMI patients after PCI(P＜0.05).Conclusion High dNLR and NHHR values are closely associated with poor outcomes in AMI patients after PCI,and their combination may be an indicator to predict the outcomes after PCI.

Objective The aim of this study was to analyze the incidence and mortality of esophageal cancer and its trend in Lianyungang city from 2008 to 2019.Methods The data of esophageal cancer in all cancer registry areas in Lianyungang city were col-lected and sorted out,and the quality control reached the standards.The incidence,mortality,age-standardized rate of Chinese population(ASRC),age-standardized rate of World population(ASRW),cumulative rate at 0-74 years old,truncation rate of 35-64 years old,and composition ranking were calculated.The Joinpoint4.7.0.0software was used to analyze the average annual percentage change(AAPC)of the age-standardized incidence and mortality of esophageal cancer by the standard population(ASIRC and ASMRC).Results From 2008 to 2019,the incidence of esophageal cancer in Lianyungang city was 25.90/100,000,ASIRC was 17.95/100,000,ASIRW was 17.91/100,000,ranking the third in the incidence spectrum of malignant tumors.The mortality was 20.55/100,000,ASMRC was 13.86/100,000,and ASMRW was 13.71/100,000,ranking the third in the malignant tumor mortality spectrum.The incidence,mortali-ty,ASIRC and ASMRC of esophageal cancer were higher in men than those in women,and higher in rural areas than those in urban are-as.From 2008 to 2019,the change trend of incidence and mortality of esophageal cancer in Lianyungang city was the same,showing a downward trend.The AAPC of the ASIRC was-6.19%(95%CI:-7.08%-5.30%,P<0.001),and the AAPC of the ASMRC was-4.03%(95%CI:-5.81%-2.22%,P<0.001).Among them,the ASIRC and ASMRC of esophageal cancer in urban and rural areas showed a downward trend(P<0.05).Among them,the ASIRC and ASMRC of esophageal cancer in urban women decreased the most,with an average annual decline of-7.99%(95%CI:-10.86%-5.03%,P<0.001)and-9.19%(95%CI:-12.35%-5.93%,P<0.001).Conclusion The incidence and mortality of esophageal cancer in Lianyungang city have shown a downward trend,a rural areas and male populations are the key prevention and control populations for esophageal cancer.

Diabetes mellitus(DM)is a common metabolic disease,and its hyperglycemia can induce many complications and even threaten human health and life.Ferritinophagy,currently a research focus,has been proven to be related to the occurrence and development of DM and its complications.Ferritinophagy,which is cell-selective,is mediated by nuclear receptor coactivator 4(NCOA4),which degrades ferritin in autophagosomes and releases excessive iron ions so that irons are overloaded and ROS are accumulated.This process contributes to the upstream ferroptosis.This article reviews the mechanism of ferritinophagy and its pathogenesis in DM and its complications,and further analyzes the effects of regulated ferritinophagy on DM and its complications,pro-viding new insight into the prevention and treatment of DM and its complications.

Objective:To investigate the present situation of unintended pregnancy within two years postpartum and its influencing factors in China.Methods:Participants who delivered a live birth at 60 hospitals in 15 provinces in the eastern, central and western regions of China during July 2015 to June 2016 were interviewed by using structured questionnaire. Information on occurrence of unintended pregnancy within 2 years after delivery, postpartum contraceptive use, sexual resumption, breastfeeding, and women′s socio-demographic characteristics, and so on, were collected. Life-table analysis, cluster log-rank tests and a 2-level Cox regression model were used for data analysis.Results:A total of 18 045 postpartum women were investigated. The cumulative 1- and 2-year unintended pregnancy rates after delivery were 5.3% (95% CI: 4.5%－6.1%) and 13.1% (95% CI: 11.3%－14.8%), respectively. Cox regression model analysis showed that the risk of unintended pregnancy within 2 years postpartum were increased in younger women, ethnic minorities, women with abortion history, and those who had a vaginal delivery with short lactation time and late postpartum contraceptive initiation (all P<0.01). The risk of postpartum unintended pregnancy was not associated with geographic regions and hospitals where women gave a birth (all P>0.05). Conclusions:In China, the risk of unintended pregnancy within 2 years after delivery is relatively high. Service institutions and service providers should improve the quality of postpartum family planning services, promote the use of high effect contraceptive methods, and educate women to use a method at the time of their sexual resumption or even before.

Objective To identify the effect of both high glucose and high insulin on miR-145 level.Methods The human vascular smooth muscle cells ( VSMCs) were cultured and the proliferation of VSMCs was induced by high glucose and high insulin medium.The samples were divided into 4 groups: normal group, high glu-cose group (25 mmol/L), high insulin group (300 mU/L), high glucose and high insulin group.The ex-pression of miR-145 in VSMCs was assayed by real-time PCR.Proliferation of VSMCs was determined by MTT method After 72 h cultivation.The migration of VSMCs was analyzed by cell scratch test .VSMCs in each group was transfected by miR-145 virus ( lentiviral vector ) .Proliferation and migration were assayed after 48 h transfection.Results The expression of miR-145 in VSMCs of other three groups was decreased ( P<0.05 ) , especially the expression in the high glucose and insulin group was the lowest ( P<0.01 ) .Prolifera-tion and migration of VSMCs was promoted by high glucose and/or high insulin medium.Under fluorescent, transfection rate of VSMCs was about 80%after 48 h transfection.Proliferation and migration of VSMCs in each group after transfection were significantly lower than before ( P<0.05 ) .Conclusions High glucose and high in-sulin could decrease the expression of miR-145 in VSMCs, The overexpression of miR-145 may inhibit the prolif-eration and migration of VSMCs .

Objective To investigate antimicrobial resistance of Escherichia coli (E.coli)and Klebsiella pneumoniae (K.pneumoniae),antimicrobial use density(AUD),as well as relation between antimicrobial resistance and AUD in a ter-tiary first-class hospital.Methods Antimicrobial resistance rates of clinically-isolated E.coli and K.pneumoniae,AUD of carbapenems and quinolones,as well as relation between resistance and AUD in 2013-2015 were statistically analyzed. Results Correlation analysis of antimicrobial resistance of bacteria and AUD showed that the decrease in resistance rate of E.coli to levofloxacin was related to the decrease in the use density of quinolones(r=0.61,P=0.03);increase in resist-ance rate of K.pneumoniae to imipenem was related to the increase in the use density of carbapenems(r=0.78,P<0.01). Conclusion Antimicrobial use is one of the causes of bacterial resistance,management on antimicrobial use needs to be strengthened to reduce the threat of bacterial resistance to human health.

Objective To evaluate the effect of fine management in perioperative micturition management in patients with hip or knee replacement. Methods By convenient sampling method, 95 patients with hip or knee replacement from September 2015 to March 2016 were selected as the research object. There were 53 cases in the intervention group and 42 cases in the control group. Patients in the intervention group received perioperative micturition management according to the process of fine management, while patients in the control group received routine micturition management mode. The preoperative micturition training compliance rate and the incidence of postoperative urinary retention in two groups were analyzed and compared. Results The preoperative micturition training compliance of patients in the intervention group was 84.9%, and it was 40.5% in the control group;the incidence of postoperative urinary retention in the intervention group was 22.6%, and it was 47. 6% in the control group (χ2 =20. 403, 6. 544;P<0. 05 ) . Conclusions With fine management concept as the guidance, perioperative micturition management process in hip or knee replacement can effectively improve the preoperative micturition training compliance and reduce the incidence of postoperative urinary retention.