Objective To analyze the epidemiological characteristics and disease burden of malignant tumors in Shijiazhuang in 2021. Methods Based on data from the Shijiazhuang City Cancer Registry, incidence and mortality indicators for malignant tumors were calculated, including crude rates, age-standardized rates (using Chinese and world standard populations), and the cumulative rate (0−74 years old), to describe the epidemiological profile. The disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) were calculated to estimate the disease burden of malignant tumors. Results In 2021, a total of 13250 new cancer cases were recorded. The crude incidence rate was 275.50/10⁵, the ASR China was 177.17/10⁵, the ASR world was 172.11/10⁵, and the cumulative rate (0–74 years old) was17.77%. The age-specific incidence of malignant tumors reached its peak in the age group of 80–84 years old. A total of 7165 deaths were noted, and the crude mortality rate was 148.98/10⁵. The ASR China was 85.13/10⁵, the ASR world was 84.52/10⁵, and the cumulative rate (0–74 years old) was 9.49%. The age-specific mortality of malignant tumors reached its peak in the age group of above 85 years old. Lung cancer and breast cancer were the most common malignant tumors in males and females. The DALYs of malignant tumors were 87725.29 person-years, and the DALY rate was 18.24‰. YLL was 85392.09 person-years (97.34%), and YLD was 2333.19 person-years (2.66%). Lung cancer had the heaviest disease burden with DALY of 22687.12 person-years, accounting for 25.86% of all malignant tumors, followed by gastric, liver, colorectal and esophageal cancers. Conclusion Cancers of the lung, liver, female breast, stomach, and colorectum are the major health threats in Shijiazhuang. Malignant tumor brings heavy burden to residents of Shijiazhuang city. To decrease the disease burden of cancer, scholars should pay more attention, and implement preventive measures early.

BackgroundObstructive sleep apnea （OSA） represents a prevalent sleep disordered breathing condition characterized by complex pathophysiology. The arousal threshold （ArTH）， a core non-anatomical contributor to OSA pathogenesis， is intimately tied to the disease severity and clinical phenotypes. To date， research regarding factors associated with ArTH has yielded inconsistent findings， and ArTH profiles and disparities across populations with different genetic backgrounds are not fully elucidated. ObjectiveTo explore the differences of ArTH in OSA patients with different genetic backgrounds and analyze the key factors affecting ArTH， thereby providing evidence for understanding OSA pathophysiology and formulating targeted treatment regimens. MethodsA total of 285 patients who met the diagnostic criteria for OSA， as defined by the Multidisciplinary Diagnosis and Treatment Guidelines for Adult Obstructive Sleep Apnea， were retrospectively enrolled in this study. All participants underwent overnight polysomnography （PSG） at the Sleep Medicine Center of Inner Mongolia Mental Health Center from December 2022 to May 2024. Based on the study design， the cohort was stratified into two distinct genetic background subgroups （group A and group B）. Demographic and clinical characteristics， the Epworth Sleepiness Scale （ESS） score， and overnight PSG data were collected. The apnea hypopnea index （AHI）， the lowest pulse oxygen saturation （LSpO₂）， and fraction of hypopneas （F_Hypopneas） were utilized as surrogate indicators to estimate ArTH in OSA patients. The influencing factors of low ArTH were tested by binary Logistic regression analysis. ResultsAmong the 285 OSA patients， there were 227 cases （79.65%） in group A and 58 cases （20.35%） in group B. Comparisons between the two genetic background subgroups revealed no statistically significant differences in the proportion of low ArTH， ESS score， PSG parameters， and the three markers for low ArTH （AHI<30 events/h， LSpO₂>82.5%， F_Hypopneas>58.3%） （P>0.05）. Binary Logistic regression analysis identified sex （OR=2.421， 95% CI： 1.070–5.478）， BMI （OR=0.847， 95% CI： 0.770–0.932）， N1 sleep duration （OR=0.974， 95% CI： 0.963–0.985）， and hypertension （OR=0.348， 95% CI： 0.143–0.848） as independent factors associated with low ArTH in the total cohort. Stratified analysis by genetic backgrounds revealed that sex（OR=3.799， 95% CI： 1.389–10.392）， BMI（OR=0.819， 95% CI：0.723–0.929）， and N1 sleep duration（OR=0.973， 95% CI： 0.961–0.986） were independent factors of low ArTH in group A. In contrast， only N1 sleep duration （OR=0.951， 95% CI： 0.911–0.993） remained a significant factor in group B. ConclusionArthur may have conservative characteristics in patients with OSA with different genetic backgrounds， but the pathophysiological mechanism of OSA may have population heterogeneity. ［Funded by Inner Mongolia Autonomous Region Natural Science Fundation Project （number， 2024QN08050）； Intra-institutional Scientific Research Project of Inner Mongolia Mental Health Center （number， 2022QNWN0010）］

Objective:To evaluate the application value of the Supply-Processing-Distribution(SPD)supply chain mode in the refined management for medical consumables in hospital on the basis of SPD supply chain mode.Methods:An integrated efficiency index system was constructed based on SPD,and the Analytic Hierarchy Process(AHP)and Entropy Method were used to determine index weights by combined weighting.Medical consumables were classified and managed according to the index weight values.A total of 63,461 types of medical consumables(included low-value medical consumables and high-value medical consumables)that was used in clinical practice at Beijing Anzhen Hospital,Capital Medical University from January to June 2021 and January to June 2023 were selected.In them,the 54,632 types of medical consumables that were used between January and June 2021 were managed by adopting conventional supply chain mode,while 56,471 types of medical consumables that were used(included 47,642 types of medical consumables that were managed by conventional supply chain made at the first stage,and 8,829 types of new medical consumables)between January and June 2023 were managed by adopting the SPD supply chain mode.The inventory amount,inventory quantity,loss rate,and return or change rate of medical consumables of the two management modes were compared.A self-designed satisfaction questionnaire was used to evaluate the satisfaction of medical staffs,who used these medical consumables,for the two kinds of management modes.Results:The inventory amount of low-value medical consumables that were managed by the SPD supply chain mode was(1,424.09±75.68)million CNY,which was lower than(2,290.79±215.93)million CNY of adopting conventional supply chain mode,with a statistically significant difference(t=8.85,P<0.05).The inventory amount of high-value medical consumables that were managed by the SPD supply chain mode was 0,which was lower than(7,692.32±360.53)million CNY of adopting conventional supply chain mode,with a statistically significant difference(Z=-2.201,P<0.05).The inventory quantities of both low-value and high-value medical consumables of adopting SPD supply chain mode were significantly lower than those of adopting conventional supply chain mode,with statistically significant differences(t=10.443,11.225,P<0.05).The average loss rates of both low-value and high-value medical consumables of adopting SPD supply chain mode were significantly lower than those of adopting conventional supply chain mode,with statistically significant differences(Z=-2.207,-2.201,P<0.05).The average return or change rates of both low-value and high-value medical consumables of adopting SPD supply chain mode were significantly lower than those of adopting conventional supply chain mode,with statistically significant differences(t=14.685,8.716,P<0.01).The satisfaction scores of medical staffs from different departments for medical consumables of adopting the SPD supply chain mode were higher than those of adopting conventional supply chain mode,with a statistically significant difference(t=7.674,P<0.05).Conclusion:The application of the SPD supply chain mode for medical consumables in hospital can reduce the inventory amount,inventory quantity,loss rate,and return or change rate of medical consumables,and improve the satisfaction of medical staffs.

Objective To analyze the relationship between humoral immune characteristics and lymph node metastasis status in non-small cell lung cancer(NSCLC)patients,and its predictive value for prognosis.Meth-ods A total of 203 NSCLC patients who were admitted to the hospital from February 2022 to December 2023 were selected.They were divided into two groups,N0+N1 group(n=103)and N2+N3 group(n=100)based on their lymph node metastasis status.Another 100 healthy individuals who underwent physical examinations during the same period were selected as the control group.Clinical data from patients were collected and the propensity score matching method was utilized to match them in a 1∶1 ratio,with 64 cases in each group.A stratified regression model was used to analyze the relationship between humoral immune characteristics and different lymph node metastasis statuses in NSCLC patients.Univariate regression analysis and a multivariate Cox regression model were used to adjust for confounding variables and to explore the independent risk factors of humoral immune characteristics on the prognosis of NSCLC patients.The LOWESS method was used to analyze the two-dimensional curve relationship of continuous variables.The predictive efficacy of humoral im-mune characteristics was evaluated on the prognosis of NSCLC using the area under the receiver operating characteristic and under the curve(AUC).Results Compared with patients in the N0+N1 group,patients in the N2+N3 group had a higher proportion of tumor infiltration depth(T3+T4),high tumor differentiation,and clinical stage(Ⅲ+Ⅳ stage),as well as higher levels of IgA,IgM,IgG,C3,and C4(P＜0.05).Hierarchi-cal regression analysis revealed that IgA,IgM,IgG,C3,and C4 had a significant positive effect on different lymph node metastasis statuses in NSCLC patients(P＜0.05).Univariate and multivariate regression analy-ses revealed that elevated levels of IgA,IgM,IgG,C3 and C4 were independent risk factors for the prognosis of NSCLC(P＜0.05).LOWESS analysis revealed a non-linear relationship between the median overall survival(OS)of NSCLC patients and IgA,IgM,IgG,C3,and C4 levels.The humoral immune characteristics of IgA,IgM,IgG,C3 and C4 showed good predictive performance for the prognosis of NSCLC patients.Conclusion IgA,IgM,IgG,C3 and C4 are independent risk factors for the prognosis of NSCLC patients and demonstrate good predictive performance for the prognosis of NSCLC patients.

Objective:To investigate the epidemiological characteristics of hemorrhagic fever with renal syndrome (HFRS) in Weinan City, Shaanxi Province, and study the predictive effect of the seasonal autoregressive integrated moving average (SARIMA) model.Methods:Relevant information on HFRS cases reported by the China Disease Prevention and Control Information System from January 2010 to August 2024 in Weinan City, as well as the epidemiological investigation data on clinical diagnosis and confirmed HFRS cases in Weinan City were collected. Epidemiological characteristics of HFRS were analyzed by descriptive epidemiological methods. At the same time, a SARIMA model was constructed based on the monthly incidence of HFRS from 2010 to 2023, the incidence of HFRS from January to August 2024 was used to test the simulation prediction effect, and the optimal model was used to predict the incidence of HFRS from September to December 2024.Results:A total of 4 373 HFRS cases were reported in Weinan City from 2010 to 2023, with an average annual incidence of 6.39/100 000. The incidence rate showed a cyclical fluctuation trend, reaching two peaks in 2012 (10.25/100 000) and 2021 (12.26/100 000), respectively. The incidence of HFRS presented a seasonal bimodal distribution, with the peak predominantly in autumn and winter (from October to January of the following year), accounting for 67.83% (2 966/4 373), and the peak in spring and summer (form May to July) accounting for 17.27% (755/4 373). HFRS cases were reported in all counties (cities and districts) of Weinan City, and the top 3 annual incidence rates were Huazhou District (17.84/100 000), Linwei District (16.10/100 000) and Huayin City (9.15/100 000). The age of onset was mainly concentrated in the age group of 15 - 59 years old, accounting for 68.31% (2 987/4 373). The male to female ratio was 2.96∶1.00 (3 268∶1 105). The main occupation was farmers, accounting for 82.07% (3 589/4 373). SARIMA (1, 0, 1) (2, 1, 1) 12 model was the optimal model for short-term prediction of HFRS incidence rate in Weinan City, and the residual difference was listed as white noise ( Q = 7.45, P = 0.878), the model could be used for disease prediction. The model was used to predict the incidence of HFRS from September to December 2024, and the predicted values of each month were 0.17/100 000, 0.59/100 000, 1.85/100 000 and 1.61/100 000, respectively. Conclusions:The epidemic range of HFRS in Weinan City is wide, and the incidence has obvious seasonality. The population are mainly males, young and middle-aged adults and farmers. The SARIMA (1, 0, 1) (2, 1, 1) 12 model constructed can be used for predicting the short-term incidence trend of HFRS in Weinan City.

Objective This study aimed to explore the clinical and etiological characteristics of bloodstream infections in diabetic patients with different levels of glycosylated hemoglobin(HbA1c)for improving empirical diagnosis and treatment in clinical practice.Methods A retrospective study was conducted for diabetic patients with bloodstream infections who were admitted to Sichuan Mental Health Center from 2017 to 2023.Patients were assigned to one of the three groups based on HbA1c levels:low level(HbA1c＜7.0％),medium level(7.0％≤HbA1c＜9.0％),high level(HbA1c≥9.0％).The clinical data,pathogen distribution,and antimicrobial resistance were analyzed and compared between groups.Results A total of 426 diabetic patients with bloodstream infection were included.The proportion of community-acquired bloodstream infection,acidosis,and liver abscess in the high level HbA1c group were significantly higher than those in the medium and low level HbA1c groups.Overall,452 strains of nonduplicate pathogenic bacteria were isolated,the most common of which were Escherichia coli(47.1％),Klebsiella pneumoniae(23.0％),and Staphylococcus aureus(5.8％).The pathogens of bloodstream infections varied with different HbA1c levels.The proportion of K.pneumoniae in the high-level HbA1c group(30.7％)was significantly higher than that in the low-level HbA1c group(15.1％)and medium level HbA1c group(16.0％).More than 50％of E.coli isolates were resistant to piperacillin,cefazolin,and ampicillin,while lower than 10％of the isolates were resistant to cefoxitin and minocycline,and lower than 1％of the isolates were resistant to piperacillin-tazobactam,meropenem,imipenem,and amikacin.The E.coli strains isolated from hospital-acquired infections showed slightly higher resistance rates to penicillin,cephalosporins,aminoglycosides,and fluoroquinolones than the strains isolated from community-acquired infections.K.pneumoniae strains showed low resistance rates(＜30％)to the commonly used antibiotics.However,the strains isolated from hospital-acquired infections were significantly more resistant to cephalosporins,carbapenems,and aminoglycosides than the strains isolated from community-acquired infections.Conclusions E.coli,K.pneumoniae and S.aureus were the common pathogens of bloodstream infections in diabetic patients.Poor HbA1c control was associated with K.pneumoniae bloodstream infection,especially those originated from liver abscess.The antibiotic-resistant E.coli and K.pneumoniae strains were prevalent in hospital-acquired bloodstream infections in diabetic patients.Antimicrobial resistance surveillance should be strengthened for this patient population.

Objective:To investigate the epidemiological characteristics of hemorrhagic fever with renal syndrome (HFRS) in Weinan City, Shaanxi Province, and study the predictive effect of the seasonal autoregressive integrated moving average (SARIMA) model.Methods:Relevant information on HFRS cases reported by the China Disease Prevention and Control Information System from January 2010 to August 2024 in Weinan City, as well as the epidemiological investigation data on clinical diagnosis and confirmed HFRS cases in Weinan City were collected. Epidemiological characteristics of HFRS were analyzed by descriptive epidemiological methods. At the same time, a SARIMA model was constructed based on the monthly incidence of HFRS from 2010 to 2023, the incidence of HFRS from January to August 2024 was used to test the simulation prediction effect, and the optimal model was used to predict the incidence of HFRS from September to December 2024.Results:A total of 4 373 HFRS cases were reported in Weinan City from 2010 to 2023, with an average annual incidence of 6.39/100 000. The incidence rate showed a cyclical fluctuation trend, reaching two peaks in 2012 (10.25/100 000) and 2021 (12.26/100 000), respectively. The incidence of HFRS presented a seasonal bimodal distribution, with the peak predominantly in autumn and winter (from October to January of the following year), accounting for 67.83% (2 966/4 373), and the peak in spring and summer (form May to July) accounting for 17.27% (755/4 373). HFRS cases were reported in all counties (cities and districts) of Weinan City, and the top 3 annual incidence rates were Huazhou District (17.84/100 000), Linwei District (16.10/100 000) and Huayin City (9.15/100 000). The age of onset was mainly concentrated in the age group of 15 - 59 years old, accounting for 68.31% (2 987/4 373). The male to female ratio was 2.96∶1.00 (3 268∶1 105). The main occupation was farmers, accounting for 82.07% (3 589/4 373). SARIMA (1, 0, 1) (2, 1, 1) 12 model was the optimal model for short-term prediction of HFRS incidence rate in Weinan City, and the residual difference was listed as white noise ( Q = 7.45, P = 0.878), the model could be used for disease prediction. The model was used to predict the incidence of HFRS from September to December 2024, and the predicted values of each month were 0.17/100 000, 0.59/100 000, 1.85/100 000 and 1.61/100 000, respectively. Conclusions:The epidemic range of HFRS in Weinan City is wide, and the incidence has obvious seasonality. The population are mainly males, young and middle-aged adults and farmers. The SARIMA (1, 0, 1) (2, 1, 1) 12 model constructed can be used for predicting the short-term incidence trend of HFRS in Weinan City.

Objective:To evaluate the application value of the Supply-Processing-Distribution(SPD)supply chain mode in the refined management for medical consumables in hospital on the basis of SPD supply chain mode.Methods:An integrated efficiency index system was constructed based on SPD,and the Analytic Hierarchy Process(AHP)and Entropy Method were used to determine index weights by combined weighting.Medical consumables were classified and managed according to the index weight values.A total of 63,461 types of medical consumables(included low-value medical consumables and high-value medical consumables)that was used in clinical practice at Beijing Anzhen Hospital,Capital Medical University from January to June 2021 and January to June 2023 were selected.In them,the 54,632 types of medical consumables that were used between January and June 2021 were managed by adopting conventional supply chain mode,while 56,471 types of medical consumables that were used(included 47,642 types of medical consumables that were managed by conventional supply chain made at the first stage,and 8,829 types of new medical consumables)between January and June 2023 were managed by adopting the SPD supply chain mode.The inventory amount,inventory quantity,loss rate,and return or change rate of medical consumables of the two management modes were compared.A self-designed satisfaction questionnaire was used to evaluate the satisfaction of medical staffs,who used these medical consumables,for the two kinds of management modes.Results:The inventory amount of low-value medical consumables that were managed by the SPD supply chain mode was(1,424.09±75.68)million CNY,which was lower than(2,290.79±215.93)million CNY of adopting conventional supply chain mode,with a statistically significant difference(t=8.85,P<0.05).The inventory amount of high-value medical consumables that were managed by the SPD supply chain mode was 0,which was lower than(7,692.32±360.53)million CNY of adopting conventional supply chain mode,with a statistically significant difference(Z=-2.201,P<0.05).The inventory quantities of both low-value and high-value medical consumables of adopting SPD supply chain mode were significantly lower than those of adopting conventional supply chain mode,with statistically significant differences(t=10.443,11.225,P<0.05).The average loss rates of both low-value and high-value medical consumables of adopting SPD supply chain mode were significantly lower than those of adopting conventional supply chain mode,with statistically significant differences(Z=-2.207,-2.201,P<0.05).The average return or change rates of both low-value and high-value medical consumables of adopting SPD supply chain mode were significantly lower than those of adopting conventional supply chain mode,with statistically significant differences(t=14.685,8.716,P<0.01).The satisfaction scores of medical staffs from different departments for medical consumables of adopting the SPD supply chain mode were higher than those of adopting conventional supply chain mode,with a statistically significant difference(t=7.674,P<0.05).Conclusion:The application of the SPD supply chain mode for medical consumables in hospital can reduce the inventory amount,inventory quantity,loss rate,and return or change rate of medical consumables,and improve the satisfaction of medical staffs.

Objective:To explore the prognostic value of assessing plasma thrombin-antithrombin complex (TAT) and D-dimer (D-D) in patients with acute ischemic stroke (AIS).Methods:This prospective cohort study enrolled 538 AIS patients admitted to the General Hospital of Tianjin Medical University from July 2021 to May 2024, including 306 males and 232 females, with an average age of (69.5±11.5) years. Among them, there were 147 cases of lacunar infarction, 166 cases of large artery atherosclerosis type, 122 cases of cardioembolic type, and 103 cases of cancer-related type. Follow-up observations were conducted on enrolled patients, data within 30 days after the initiation of acute phase treatment for one week were collected, thrombus-related cerebral ischemic events recurrence served as the endpoint event, starting from August 5, 2021, to June 19, 2024. During the follow-up period, 68 patients experienced endpoint events, including 14 cases of large artery atherosclerosis type, 23 cases of cardioembolic type, and 31 cases of cancer-related type. The plasma levels of TAT and D-D were determined by chemiluminescence method and enzyme-linked immunofluorescence assay respectively. The receiver operating characteristic (ROC) curve was used to analyze the prediction performance of TAT and D-dimer for recurrent ischemic events in AIS patients during the 30-day follow-up period, and the Kaplan-Meier curve was used for survival analysis.Results:Statistically differences were observed in the plasma TAT and D-D levels among patients with different types of AIS ( P<0.05), with cancer-related type had higher levels than cardioembolic type ( P<0.05), and cardioembolic type had higher levels than large artery atherosclerosis type ( P<0.05). In the non-recurrent ischemic event group, the plasma TAT and D-D levels of patients with large artery atherosclerosis type, cardioembolic type and cancer-related type were lower in post-treatment than pre-treatment ( P<0.05). In the recurrent ischemic event group, the plasma D-D levels were higher in post-treatment than pre-treatment in the patients with large artery atherosclerosis type ( P<0.05); there was no statistically difference between the post-treatment and pre-treatment in plasma TAT and D-D levels in patients with cardioembolic type ( P>0.05); in patients with cancer-related type, the TAT and D-D levels were lower in post-treatment than pre-treatment ( P<0.05), but higher than those in the non-recurrence group ( P<0.05). The ROC curve showed that the area under the curve for predicting the risk of ischemic event recurrence within 30 days in AIS patients by plasma TAT combined with D-D on day 7 after treatment was all >0.9 (0.950 for large artery atherosclerosis type, 0.965 for cardioembolic type, and 0.907 for cancer-related types). Survival analysis indicated that various patients with both indicators above the critical value had an increased cumulative risk probability of adverse events (log-rank χ 2=93.667, 109.266, and 58.433, respectively, with all P<0.001). Conclusion:The changes of plasma TAT and D-D levels in AIS patients are associated with stroke type and coagulation activation, and dynamic monitoring of these two indicators could help evaluate the treatment effect and predict the risk of recurrent ischemic events.

Recurrent spontaneous abortion （RSA） is a common gynecological disease during pregnancy， clinically characterized by repeated spontaneous abortions， yet its pathological mechanism remains incompletely understood. Traditional Chinese medicine attributes the pathogenesis of RSA to the deficiency of Chong Ren and the lack of fetal solidity. It has amassed experience in treating RSA， with Shoutaiwan being widely utilized for addressing miscarriage symptoms such as habitual abortion due to kidney deficiency， bleeding during pregnancy， and fetal movement. In recent years， there has been a gradual increase in experimental studies on the application of Shoutaiwan in treating RSA and on related experiments. These studies have demonstrated that Shoutaiwan preserves the fetus mainly by modulating hormone balance， alleviating immune inflammation， and enhancing blood coagulation equilibrium during pregnancy. Besides， through the modulation of key signaling pathways such as nuclear factor， erythroid 2 like 2 （Nrf2）/heme oxygenase-1 （HO-1） and Janus kinase 1 （JAK1）/signal transducer and activator of transcription （STAT）， as well as mitogen-activated protein kinase （MAPK）， Shoutaiwan has improved cellular antioxidant capacity， adjusted the phenotype of trophoblast and metaphase cells， and inhibited immune rejection， thus improving the pregnancy success rate. These findings not only elucidate the diverse biological foundations underlying Shoutaiwan's efficacy in treating RSA but also offer a scientific rationale for its clinical application and further mechanism research. Nonetheless， there remains a dearth of systematic reviews on RSA treatment with Shoutaiwan. Therefore， this review summarizes and synthesizes existing research findings to systematically analyze existing literature and studies， delving deeply into the principal pharmacological effects and associated signaling pathways of Shoutaiwan in regulating RSA. It aims to establish crucial reference points for its clinical application in RSA treatment and future experiments and research.