Objective To explore the effect of the ratio of high-density lipoprotein cholesterol(HDL-C)/total cholesterol(TC)on no-reflow after percutaneous coronary intervention(PCI)in elderly patients with acute coronary syndrome(ACS)complicated with diabetes mellitus(DM).Methods A retrospective analysis was conducted on 206 elderly ACS patients complicated with DM undergoing PCI in our hospital from January 2018 to August 2024.The HDL-C and TC levels were detected by cholesterol oxidase test,and the HDL-C/TC ratio was calculated.Coronary angi-ography(CAG)was applied to evaluate no-reflow phenomenon after PCI,and according to the re-sults,the patients were divided into a non-reflow group(41 cases)and a normal reflow group(165 cases).ROC curve was plotted to evaluate the predictive performance of HDL-C/TC ratio for no-reflow after PCI in patients with ACS complicated DM.Results The no-reflow group had signifi-cantly higher TC and glycated hemoglobin A1c(HbA1c)levels and more balloon dilatations,but lower HDL-C level and HDL-C/TC ratio than the normal flow group(P＜0.01).Multivariate lo-gistic regression analysis showed that HbA1c(OR=3.196,95％CI:1.619-6.310,P=0.001),number of balloon dilatations(OR=3.504,95％CI:1.807-6.797,P=0.000),and HDL-C/TC ra-tio(OR=3.927,95％CI:2.0 73-7.441,P=0.000)were influencing factors of no-reflow after PCI in patients with ACS and DM.The AUC value of HDLC,TC,and HDL-C/TC ratio in predicting no-reflow after PCI was 0.842,0.726,and 0.922,respectively.Conclusion HDL-C/TC ratio is an influencing factor for no-reflow in patients with ACS and DM after PCI.The ratio at a cut-off val-ue of ≤0.21 has a certain predictive value for no-reflow after PCI in these elderly patients.

Objective:To explore the coordinated development status of the medical service supply-economy-society trinity systems in Zhejiang Common Prosperity Demonstration Zone,and to offer references for formulating policies conducive to the efficient and coordinated development of these three systems.Methods:Based on the panel data from 2013 to 2022,this research was conducted on the 11 prefectural-level cities in Zhejiang Province.Firstly,an evaluation index system for the three systems was established,and the entropy method was employed to determine the weights of each index and calculate the comprehensive evaluation index.Secondly,a triangular model was introduced to delineate the relative relationships among the three systems,and the coupling coordination degree model was utilized to disclose the coordination degree of the three systems.Finally,the spatial autocorrelation analysis method was applied to investigate the spatial autocorrelation of the coupling coordination degree of the three systems.Results:(1)On the whole,the development status of the three systems has improved over time,yet the comprehensive development level remains to be improved.(2)Overall,each prefectural-level city has transited from a medical service supply-society-dominated development to a balanced and coordinated development of the medical service supply-economy-society trinity systems.The coupling coordination degree of the three systems has risen from 0.468(on the verge of imbalance)in 2013 to 0.609(primary coordination)in 2022,presenting an upward trend in general.However,the coordination level remains to be improved and there exist imbalances among regions.(3)The coupling coordination degree of the three systems in Zhejiang Province exhibits a significant positive spatial correlation,and the spatial distribution characteristics are relatively stable. Conclusion:The coupling coordination degree of the medical service supply-economy-society trinity systems in Zhejiang Province awaits further enhancement. At the level of Zhejiang Province,favorable policy support should be provided,the layout of medical resources should be rationally planned,and high-quality economic and social development should be promoted. Each prefectural-level city should formulate strategies for medical service supply,economic,and social development in accordance with its own development level and local conditions,strengthen inter-city linkage and cooperation,and thereby elevate the coordinated development level of the three systems.

Objective To use AI-assisted motor dysfunction assessment for quantitative evaluation of motor function in Parkinson's disease(PD)and multiple system atrophy-Parkinsonian type(MSA-P)in order to achieve accurate differential diagnosis.Methods A total of 105 participants aged ≥60 years were consecutively enrolled from the First and Third Medical Centers of Chinese PLA General Hospital between January and September 2024.Based on diagnostic criteria,they were divided into a PD group(48 cases),a MSA-P group(31 cases),and a control group(26 cases).The general information was collected,and the motor function was evaluated with Move-ment Dysfunction Assessment Software in order to assess the diagnostic value of the AI-assisted assessment in differentiating between PD and MSA-P.Results Significantly differences were observed among the three groups in terms of facial expression indicators,bilateral finger tapping frequency,bilateral hand movement frequency,right hand movement amplitude change rate,bilat-eral palm flipping frequency,bilateral toe tapping frequency,freezing load of bilateral toe tapping,bilateral leg flexibility frequency,right leg flexibility amplitude change rate,freezing load of bilat-eral leg flexibility,upright extension angular velocity,turnaround time,forward step frequency,backward step frequency,forward average stride length,backward average stride length,forward average walking speed,backward average walking speed,forward average step width,backward average step width,bilateral postural tremor frequency,bilateral postural tremor maximum am-plitude,bilateral action tremor frequency,bilateral action tremor maximum amplitude,and com-parison of bilateral resting tremor frequency(P＜0.05,P＜0.01).The MSA-P group exhibited significantly lower blink frequency,maximum amplitude and frequency of facial tremors,upright extension angular velocity,and step frequency,while higher ratio of mouth opening duration and longer turnaround time when compared with the PD group(P＜0.05,P＜0.01).The AUC value of the combined nine motor function indicators and the five facial expression indicators in differ-entiating PD from MSA-P was 0.943(95％CI:0.895-0.991,P=0.000)and 0.925(95％CI:0.870-0.981,P=0.000),respectively,both better than that of individual indicators.Conclusion Combi-nation assessment of facial expression,posture,gait with AI assistance can contribute to the dif-ferential diagnosis of PD and MSA-P.

AIM To sequence the chloroplast genome of Artemisia vestita Wall.ex Bess.METHODS Based on ethnobotanical surveys,sample collection and original plant identification were carried out.The chloroplast genome was sequenced using the Illumina platform,followed by assembly and annotation.A comprehensive comparative analysis was conducted with six Artemisia species.The maximum likelihood(ML)phylogenetic tree was constructed based on the chloroplast genome sequences of A.vestita and 32 other Asteraceae species,with Leptocodon hirsutus D.Y.Hong of Campanulaceae as outgroup.RESULTS The chloroplast genome of A.vestita was 151 204 bp in length,including a small single-copy region of 18 331 bp,a large single-copy region of 82 949 bp,and inverted repeat regions of 24 962 bp,with a total GC content of 37.45％.134 genes were annotated,including 89 protein-coding genes,8 ribosomal RNA genes,and 37 transfer RNA genes.A total of 67 SSRs and 44 LSRs were detected in the chloroplast genome.Comparative analysis with closely related species of Artemisia revealed 3 highly variable genes(clpP,rpl36,ycf1)and 6 highly variable intergenic regions(trnK-UUU-matK,rps18-rpl20,rpl36-infA,rpl14-rpl16,rpl16-rpl3 and trnL-UAG-ccsA),which could serve as candidate DNA barcodes for Artemisia identification.Phylogenetic analysis showed that Artemisia formed a highly supportive monophyletic group,with A.vestita and A.gmelinii Web.ex Stechm.being closely related.CONCLUSION This study may provide fundamental data for phylogenetic analysis of Artemisia,taxonomic identification and DNA barcoding construction of Tibetan herb.

Objective To observe the origin and course of the obturator artery(OA),so as to provide anatomical reference for reducing hemorrhage during pelvic surgery and pubic fracture fixation.Methods A total of 65 human hemi-pelvises specimens with intact structure were dissected to observe the origin,course and other variations of OA.Measure the length of the inner section of OA basin and the outer diameter at the origin,etc.Results OA originated from the internal iliac artery in 57 cases(87.7%),including 3 cases(4.6%)of the superior gluteal artery,5 cases(7.7%)of the inferior gluteal artery,3 cases(4.6%)of the external iliac artery and 5 cases(7.7%)of the inferior epigastric artery.OA participated in the formation of the arterial trunk in 3 cases(4.6%).The length of the pelvic segment of the OA in male and female was(50.87±15.41)mm and(51.71±14.19)mm,respectively,with no statistically significant difference between them(P>0.05).The outer diameters at the origin of the OA in male and female were(2.79±1.05)mm and(2.35±0.86)mm,and there was no statistically significant difference between them(P>0.05).Conclusion OA mainly originated from the anterior trunk of the internal iliac artery,with a few OA originated from the branches of the posterior trunk or the inferior epigastric artery,or participated in the formation of the arterial trunk.In pelvic surgery involving OA area,attention should be paid to the length of its pelvic segment and the outer diameter at the origin of OA,so as to better locate and protect blood vessels during surgery.

Objective The aim of this study was to analyze the incidence and mortality of lymphoma and their changing trends in cancer registration areas of Liaoning Province from 2016 to 2020,and to provide data support for lymphoma prevention and treatment.Methods The data of tumor registration areas in Liaoning province from 2016 to 2020 were collected and sorted out,and the crude incidence,mortality,China standardized incidence and mortality,world standardized incidence and mortality,and cumulative rate of lymphoma were calculated;Joinpoint 5.0.2 software was used to analyze the changing trends of the above indicators from 2016 to 2020.Results From 2016 to 2020,the crude incidence of lymphoma in tumor registration areas of Liaoning Province was 7.43/100,000,age-standardized incidence by Chinese standard population(ASIRC)was 4.07/100,000,and age-standardized incidence by world standard population(ASIRW)was 3.95/100,000;the crude mortality was 4.29/100,000,age-standardized mortality by Chi-nese standard population(ASMRC)was 2.07/100,000,and age-standardized mortality by world standard population(ASMRW)was 2.02/100,000.The ASIRC and ASMRC were higher in males(4.62/100,000 and 2.53/100,000,respectively)than in females(3.56/100,000 and 1.61/100,000,respectively),also higher in urban areas(4.65/100,000 and 2.32/100,000,respectively)than in rural areas(2.46/100,000 and 1.65/100,000,respectively).The incidence and mortality of lymphoma increased with age.The in-cidence reached its peak in the 70-79 age group,and the mortality reached its peak in the 80+age group.From 2016 to 2020,the crude incidence of lymphoma increased from 6.86/100,000 to 8.22/100,000,with a statistically significant trend(APC=5.06％,95％CI;1.13％-9.14％,P=0.026).ASIRC increased from 4.01/100,000 to 4.45/100,000,with no statistical significance(P＞0.05).The crude mortality increased from 3.85/100,000 to 4.53/100,000,while ASMRC decreased from 2.02/100,000 to 2.01/100,000,with no statistically significant trend in the two changes(P＞0.05).Conclusions The incidence and mortality of lymphoma in cancer registration areas of Liaoning Province are higher in men than those of women,and higher in cities than those in rural areas,and reach the peak in the elderly group.The prevention and control of key populations and health management should be strength-ened,especially pay attention to the health needs of the elderly population,and explore possible directions for multidisciplinary collab-orative diagnosis and treatment to reduce the disease burden.

Objective:To investigate the impacts of 1,25-dihydroxyvitamin D 3 (VD) and Lactobacillus plantarum (LP) on intestinal flora in animals with metabolic dysfunction-associated fatty liver disease (MAFLD) and their possible mechanisms. Methods:A methionine- choline-deficient (MCD) diet-induced rat model of MAFLD was created. Forty 10-week-old male Sprague-Dawley rats were randomized into methionine-choline-sufficient (MCS) group, MCD group, VD group, LP group, and VD-LP group, with 8 rats in each group. The intervention groups (VD group, LP group, and VD-LP group) were gastrically fed with VD peanut oil solution (6 ng/100 g daily), Lactobacillus plantarum solution (2×10 9CFU/100 g daily), and a combination of these two solutions, respectively. MCS group, MCD group, and LP group were given the same volume of peanut oil on a daily basis. Fecal samples from rats were collected at week 4 and analyzed using 16S rRNA gene sequencing for fecal flora structure. Portal vein blood samples were collected to detect liver biochemistry and lipopolysaccharide (LPS) levels. Pathological changes in liver and terminal ileum tissues were observed using hematoxylin and eosin (H&E) staining. Results:Compared with the MCS group, the MCD group exhibited massive steatosis and lipid infiltration in liver tissues, markedly thinned ileum mucosa, severely damaged villi structure, excessive necrotic and shedding of epithelial cells, and infiltration of inflammatory cells. Compared with the histopathological changes in the MCD group, the steatosis and lipid infiltration of liver tissue, the damage to the ileal mucosa structure and epithelial cells, and the infiltration of inflammatory cells were alleviated in the VD group, LP group, and VD-LP group. Compared with MCS group, the MCD group had significantly higher serum alanine aminotransferase (ALT) (158.50±14.03 U/L vs. 20.38±7.39 U/L), aspartate aminotransferase (AST) (43.88±11.36 U/L vs. 25.75±5.90 U/L), total bile acid (TBA) (140.60±11.77 μmol/L vs. 19.96±4.31 μmol/L), and LPS (16.57±1.19 pg/ml vs. 7.43±0.95 pg/ml) (All P<0.001),which confirmed the successful establishment of rat models of MAFLD. Serum ALT, AST, TBA, and LPS levels in all the three intervention groups were significantly lower than those in MCD group, and the most significant reductions in ALT (51.38±9.05 U/L vs. 158.50±14.03 U/L), AST (55.88±12.19 U/L vs. 143.88±11.36 U/L), TBA (21.00±8.17 μmol/L vs. 140.60±11.77 μmol/L), and LPS (9.72±0.71 pg/ml vs. 16.57±1.19 pg/ml) were seen in the VD-LP group. The microbiota in the MCD group predominantly featured Muribaculaceae, while the MCS group and other intervention groups primarily harbored Lactobacillus. Firmicutes and Lactobacillus were significantly decreased in the MCD group ,while Bacteroidete, Proteobacteria, Verrucomicrobiota, Prevotellaceae UCG-003, Escherichia coli, Bacteroides, and Enterococcus increased significantly. The opposite was true for each intervention group. There were significant differences in Lactobacillus between MCD group and the other four groups. Conclusion:VD and LP can remarkably improve lipid deposition in MAFLD by regulating intestinal flora.

Objective To investigate the diagnostic value of 4 novel inflammatory markers related to routine blood tests,namely neutrophil-to-lymphocyte ratio(NLR),red blood cell distribution width(RDW),hemoglobin-to-RDW ratio(HRR)and systemic immune-inflammation index(SII),in elderly patients with chronic cardiovascular disease(CVD)complicated with frailty.Methods Retrospectively analyze 110 patients with chronic stable CVD who were hospitalized in the cadre ward of cardiovascular medicine at the Air Force Characteristic Medical Center from January 2022 to June 2023.According to the assessment results of the Fried scale,they were divided into three groups:non-frailty group(Fried score=0,n=30),the pre-frailty group(Fried score 1 or 2,n=40)and frailty group(Fried score≥3,n=40).The differences in general information,the impairment rate of daily living activities,miniature nutritional assessment-short form(MNA-SF)scores,mini-mental state examination(MMSE)scores,and the indicators such as NLR,RDW,HRR,and SII among the three groups were compared.Spearman rank correlation was used to analyze the correlation between NLR,RDW,HRR,SII and frailty scores as well as each frailty indicator.Multivariate logistic regression analysis was performed to identify the independent risk factors for frailty in elderly patients with chronic CVD,and the receiver operating characteristic(ROC)curve was used to assess the clinical diagnostic value of NLR and HRR in elderly patients with chronic CVD complicated with frailty.Results Compared with non-frailty group and pre-frailty group,patients in frailty group were older,with higher impaired rates of daily living activities,NLR,RDW,and SII,and lower MNA-SF scores,MMSE scores,and HRR,and differences were statistically significant(P<0.05).Spearman rank correlation analysis showed that the frailty score was positively correlated with NLR(rs=0.354,P<0.001),and RDW(rs=0.448,P<0.001),negatively correlated with HRR(rs=-0.232,P=0.024),and had no significant correlation with SII(rs=0.144,P=0.167).Further analysis of the correlation between the above novel inflammatory markers and the 5 components of frailty showed that NLR was positively correlated with fatigue(rs=0.228,P=0.017),slowed walking speed(rs=0.299,P<0.001),and low physical function(rs=0.319,P<0.001);RDW was positively correlated with decreased grip strength(rs=0.321,P<0.001),slowed walking speed(rs=0.422,P<0.001),and low physical function(rs=0.246,P=0.001);and HRR was negatively correlated with slowed walking speed(rs=-0.230,P=0.025),and low physical function(rs=-0.299,P=0.003).Multivariate logistic regression analysis showed that MNA-SF score(OR=0.577,95%CI 0.342-0.973)was an independent protective factor for pre-frailty in elderly patients with chronic CVD(P<0.05);NLR(OR=7.866,95%CI 1.101-56.185)was an independent risk factor for frailty,while HRR(OR=0.344,95%CI 0.120-0.983)and MNA-SF score(OR=0.292,95%CI 0.146-0.580)were independent protective factors for frailty in elderly CVD patients(P<0.05).The area under the ROC curve of NLR and HRR for diagnosing frailty in elderly patients with chronic CVD were 0.778 and 0.749,respectively.Conclusion NLR and HRR have high clinical diagnostic value for frailty in elderly patients with chronic CVD,and are expected to become effective inflammatory markers for screening elderly patients with chronic CVD complicated with frailty.

Objective To explore the application effect of blood pressure management based on the health belief model in patients with moyamoya disease after cerebral vascular reconstruction sur-gery.Methods From February to July 2024,210 patients with moyamoya disease who underwent cerebral vascular reconstruction surgery in our hospital were selected as study subjects.They were randomly divided into control group and intervention group,with 105 cases in each group.The control group received routine nursing care,while the intervention group applied blood pressure management based on the health belief model on the basis of routine nursing care.The postoperative cerebral hy-perperfusion syndrome and blood pressure control status of the two groups were compared,and the Health Belief Scale and the Mishel Uncertainty in Illness Scale were used to evaluate the effects before and after intervention.Results A total of 203 patients completed the study,including 100 cases in the control group and 103 cases in the intervention group.There were statistically significant differ-ences in the incidence of cerebral hyperperfusion syndrome and the proportion of patients with blood pressure higher than baseline data between the two groups(P＜0.05).After the intervention,there were statistically significant differences in the postoperative cerebral hyperperfusion syndrome status and blood pressure control status between the two groups(P＜0.05).After intervention,there were statistically significant differences in the scores of susceptibility and health motivation dimensions as well as the total score in the Health Belief Scale between the intervention group and the control group(P＜0.05).After the intervention,there were statistically significant differences in the scores of ambiguity and unpredictability dimensions as well as the total score in the Mishel Uncertainty in Ill-ness Scale between the intervention group and the control group(P＜0.05).Conclusion Blood pressure management based on the health belief model can effectively control blood pressure,reduce the incidence of cerebral hyperperfusion,improve health beliefs,and reduce the sense of uncertainty about the disease.

Objective The aim of this study was to analyze the incidence and mortality of lymphoma and their changing trends in cancer registration areas of Liaoning Province from 2016 to 2020,and to provide data support for lymphoma prevention and treatment.Methods The data of tumor registration areas in Liaoning province from 2016 to 2020 were collected and sorted out,and the crude incidence,mortality,China standardized incidence and mortality,world standardized incidence and mortality,and cumulative rate of lymphoma were calculated;Joinpoint 5.0.2 software was used to analyze the changing trends of the above indicators from 2016 to 2020.Results From 2016 to 2020,the crude incidence of lymphoma in tumor registration areas of Liaoning Province was 7.43/100,000,age-standardized incidence by Chinese standard population(ASIRC)was 4.07/100,000,and age-standardized incidence by world standard population(ASIRW)was 3.95/100,000;the crude mortality was 4.29/100,000,age-standardized mortality by Chi-nese standard population(ASMRC)was 2.07/100,000,and age-standardized mortality by world standard population(ASMRW)was 2.02/100,000.The ASIRC and ASMRC were higher in males(4.62/100,000 and 2.53/100,000,respectively)than in females(3.56/100,000 and 1.61/100,000,respectively),also higher in urban areas(4.65/100,000 and 2.32/100,000,respectively)than in rural areas(2.46/100,000 and 1.65/100,000,respectively).The incidence and mortality of lymphoma increased with age.The in-cidence reached its peak in the 70-79 age group,and the mortality reached its peak in the 80+age group.From 2016 to 2020,the crude incidence of lymphoma increased from 6.86/100,000 to 8.22/100,000,with a statistically significant trend(APC=5.06％,95％CI;1.13％-9.14％,P=0.026).ASIRC increased from 4.01/100,000 to 4.45/100,000,with no statistical significance(P＞0.05).The crude mortality increased from 3.85/100,000 to 4.53/100,000,while ASMRC decreased from 2.02/100,000 to 2.01/100,000,with no statistically significant trend in the two changes(P＞0.05).Conclusions The incidence and mortality of lymphoma in cancer registration areas of Liaoning Province are higher in men than those of women,and higher in cities than those in rural areas,and reach the peak in the elderly group.The prevention and control of key populations and health management should be strength-ened,especially pay attention to the health needs of the elderly population,and explore possible directions for multidisciplinary collab-orative diagnosis and treatment to reduce the disease burden.