Objective To quantitatively evaluate the structure and content of the long-term care insurance(LTCI)policy in China's deeply aging areas.Methods Using the Policy Modeling Consistency(PMC)index model indicator design method,a LTCI policy evalua-tion index system was constructed,consisting of nine primary indicators and 34 secondary indicators.A total of 123 provincial-level LTCI policies issued in deeply aging regions of China between June 1,2014,and October 1,2024 were analyzed.High-frequency word extraction was performed using ROSTCM 6.0,and a social network diagram of LTCI policies was created.The policy structure and content were quantitatively evaluated and ana-lyzed based on the established policy evaluation index system.Results The main content of LTCI policies in deeply aging areas of China covered services,institutions and assessment.The highest policy score was 7.28,and the lowest was 2.20,with an average score of 5.00.There were 25 perfect policies,63 excellent policies,28 good policies and seven qualified policies.In the dimension of policy content,the indexes of five primary indicators of policy evaluation,policy target groups,policy nature,policy perspective and policy tools were 0.60 or more;while the indexes of four primary indicators of policy content,incentives and constraints,policy timeliness,and policy level were 0.50 or less.Conclusion LTCI policies issued in China's deeply aging areas provide comprehensive coverage in aspects such as poli-cy evaluation,policy target groups and policy nature,and need to be improved in policy tool selection and the construction of incentive and constraint mechanisms.

Objective To investigate the association of cerebral white matter lesions(WMLs)with systolic and diastolic blood pressure.Methods Patients admitted to our department from January 2023 to December 2023 were prospectively recruited for this study.The Fazekas method was used to grade the severity of the periventricular WMLs(P-WMLs)and deep WMLs(D-WMLs).Multivariate logistic regression analyses were performed to examine the association of systolic and diastolic blood pressure with WMLs.Results A total of 966 eligible participants were enrolled in this study.The mean age was 65.96±11.35 years and 487 participants(50.41%)were male.The results indicated that the more severe the P-WMLs and D-WMLs,the higher the systolic blood pressure was[P-WMLs:0:(134.41±19.86)mmHg,1:(136.82±20.47)mmHg,2:(144.52±21.64)mmHg,3:(147.80±20.7)mmHg;D-WMLs:0:(137.49±20.58)mmHg,1:(139.17±21.33)mmHg,2:(144.39±21.20)mmHg,3:(147.50±21.73)mmHg],but not diastolic blood pressure.Multivariate logistic regression analysis showed that an elevated systolic level(P-WMLs:OR=1.02,95%CI:0.009-0.021;D-WMLs:OR=1.01,95%CI:0.005-0.016)was associated with an increased risk of more severe of P-WMLs and deep D-WMLs.No significant association was observed between diastolic blood pressure and WMLs,whether for P-WMLs or D-WMLs.Conclusion The more severe P-WMLs and D-WMLs were,the higher the systolic blood pressure was.Elevated systolic blood pressure was an independent risk factors for more severe of P-WMLs and D-WMLs,but not diastolic blood pressure.

Retinal vein occlusion(RVO)is the second most common blinding retinal vascular disease, and its secondary macular edema(ME)is an important cause of visual function impairment in patients. Intravitreal injection of anti-vascular endothelial growth factor(VEGF)drugs serves as the first-line treatment, yet it is confronted with such issues as the need for repeated injections and non-response in some patients. Imaging and laboratory biomarkers play a crucial role in the early accurate diagnosis, prediction of disease progression, and evaluation of visual prognosis of RVO-ME. This study systematically reviews the research progress of imaging and laboratory biomarkers related to the prognosis of RVO-ME after anti-VEGF treatment in recent years, covering imaging biomarkers like central retinal thickness and ellipsoid zone integrity, as well as laboratory biomarkers such as serum APLN and aqueous humor IL-6. It summarizes the associations between different biomarkers and the prognosis of anti-VEGF therapy, aiming to provide a basis for the early accurate assessment and optimization of individualized treatment for RVO-ME patients, which holds significant clinical reference value.

OBJECTIVE: To observe the effects of thumbtack-needle embedding therapy of auricular acupuncture on gastrointestinal function and intestinal microflora in the patients with gastric cancer after operation, and to explore its mechanism. METHODS: A total of 80 patients with gastric cancer after radical operation were randomly divided into an observation group (40 cases, 3 cases discontinued) and a control group (40 cases, 3 cases discontinued). The patients of both groups received the perioperative care for accelerating recovery. Additionally, in the observation group, the thumbtack-needle embedding therapy of auricular acupuncture was delivered at the auricular points of unilateral side, including Wei (CO₄), Pi (CO₁₃), Dachang (CO₇), Xiaochang (CO₆), Yuanzhong (AT_2,3,4i), Erzhong (HX₁), Sanjiao (CO₁₇) and Jiaowozhong (TF₃), and the needles were embedded and retained for 72 h. The postoperative recovery time of gastrointestinal function (the postoperative bowel sound recovery time, the first exhaust time, the first defecation time), the postoperative hospital stay and pain visual analogue scale (VAS) score were observed in the two groups. Before operation and on day 5 after operation, the serum gastrin level was detected in the two groups. The third-generation 16S rRNA sequencing technology was used to detect the composition and relative abundance of intestinal flora in the two groups before and after operation. RESULTS: Compared with the control group, the postoperative bowel sound recovery time, the first exhaust time and the first defecation time were shortened in the observation group (P<0.05). In the observation group, the VAS scores at 24 h, 48 h, and 72 h after surgery were lower than those of the control group, respectively (P<0.05). There was no significant differences in postoperative hospital stay and serum gastrin level between the two groups (P>0.05). The alpha diversity analysis showed that the differences in Shannon index, Simpson index, Pielou_J index and Pd_fath index were not significant statistically after intervention between the two groups (P>0.05). After intervention, the community structure of the fecal sample was similar at each taxonomic level between the two groups, and although the proportion between species was various, the difference was not significant (P>0.05). After intervention, there were 55 species with the differences between the two groups, 17 species of them presented significant difference in relative abundance in the observation group and 38 species in the control group. Regarding the level of genus, the levels of Klebsiell and Enterobacter increased (P<0.05) and the level of Streptococcus decreased (P<0.05) in the observation group. The main microbial groups that played an important role were Coprobacillaceae, Sutterellaceae and Yersiniaceae in the observation group. KEGG function prediction indicated that the function of intestinal microflora was mainly associated with the cofactor and vitamin metabolism, carbohydrate metabolism, and amino acid metabolism. CONCLUSION The thumbtack-needle embedding therapy of auricular acupuncture improves the postoperative gastrointestinal function of the patients with gastric cancer probably through regulating the structure and relative abundance of intestinal microflora and affecting the energy metabolism.
Humans ; Male ; Female ; Middle Aged ; Acupuncture, Ear/instrumentation* ; Gastrointestinal Microbiome ; Aged ; Stomach Neoplasms/therapy* ; Adult ; Acupuncture Points ; Gastrointestinal Tract/microbiology* ; Intestines/physiopathology* ; Postoperative Period ; Acupuncture Therapy

Objective To quantitatively evaluate the structure and content of the long-term care insurance(LTCI)policy in China's deeply aging areas.Methods Using the Policy Modeling Consistency(PMC)index model indicator design method,a LTCI policy evalua-tion index system was constructed,consisting of nine primary indicators and 34 secondary indicators.A total of 123 provincial-level LTCI policies issued in deeply aging regions of China between June 1,2014,and October 1,2024 were analyzed.High-frequency word extraction was performed using ROSTCM 6.0,and a social network diagram of LTCI policies was created.The policy structure and content were quantitatively evaluated and ana-lyzed based on the established policy evaluation index system.Results The main content of LTCI policies in deeply aging areas of China covered services,institutions and assessment.The highest policy score was 7.28,and the lowest was 2.20,with an average score of 5.00.There were 25 perfect policies,63 excellent policies,28 good policies and seven qualified policies.In the dimension of policy content,the indexes of five primary indicators of policy evaluation,policy target groups,policy nature,policy perspective and policy tools were 0.60 or more;while the indexes of four primary indicators of policy content,incentives and constraints,policy timeliness,and policy level were 0.50 or less.Conclusion LTCI policies issued in China's deeply aging areas provide comprehensive coverage in aspects such as poli-cy evaluation,policy target groups and policy nature,and need to be improved in policy tool selection and the construction of incentive and constraint mechanisms.

Objective To investigate the association of cerebral white matter lesions(WMLs)with systolic and diastolic blood pressure.Methods Patients admitted to our department from January 2023 to December 2023 were prospectively recruited for this study.The Fazekas method was used to grade the severity of the periventricular WMLs(P-WMLs)and deep WMLs(D-WMLs).Multivariate logistic regression analyses were performed to examine the association of systolic and diastolic blood pressure with WMLs.Results A total of 966 eligible participants were enrolled in this study.The mean age was 65.96±11.35 years and 487 participants(50.41%)were male.The results indicated that the more severe the P-WMLs and D-WMLs,the higher the systolic blood pressure was[P-WMLs:0:(134.41±19.86)mmHg,1:(136.82±20.47)mmHg,2:(144.52±21.64)mmHg,3:(147.80±20.7)mmHg;D-WMLs:0:(137.49±20.58)mmHg,1:(139.17±21.33)mmHg,2:(144.39±21.20)mmHg,3:(147.50±21.73)mmHg],but not diastolic blood pressure.Multivariate logistic regression analysis showed that an elevated systolic level(P-WMLs:OR=1.02,95%CI:0.009-0.021;D-WMLs:OR=1.01,95%CI:0.005-0.016)was associated with an increased risk of more severe of P-WMLs and deep D-WMLs.No significant association was observed between diastolic blood pressure and WMLs,whether for P-WMLs or D-WMLs.Conclusion The more severe P-WMLs and D-WMLs were,the higher the systolic blood pressure was.Elevated systolic blood pressure was an independent risk factors for more severe of P-WMLs and D-WMLs,but not diastolic blood pressure.

  Objective  To establish a model that can predict the occurrence of acute kidney disease (AKD) in liver cirrhotic patients and evaluate its performance.  Methods  Liver cirrhotic patients who hospitalized in the department of gastroenterology of the First Hospital of Lanzhou University from January 2017 to January 2022 were retrospectively included. They were divided into AKD and non-AKD groups according to whether they were combined with AKD during hospitalization, and were randomized into training and validation sets in a 7∶3 ratio. The clinical data of patients in the two groups were collected, and LASSO regression and multifactorial Logistic regression were used to screen the influencing factors for the occurrence of AKD in patients with liver cirrhosis and to establish a prediction model. The model was then evaluated by using the receiver operating characteristic curve, the calibration curve and the clinical decision curve.  Results  A total of 796 cases of liver cirrhotic patients who met the inclusion and exclusion criteria were enrolled. Among them, 103 cases were in the AKD group and 693 cases were in the non-AKD group; 561 cases were in the training set and 235 cases were in the validation set. The results of LASSO regression and multifactorial Logistic regression showed that a history of diabetes (OR=2.922, 95% CI: 1.290-6.564, P=0.009), hepatic encephalopathy (OR=6.210, 95% CI: 2.278-17.479, P < 0.001), gastrointestinal bleeding (OR=2.501, 95% CI: 1.236-5.073, P=0.011), ascites (OR=3.219, 95% CI: 1.664-6.539, P < 0.001), male (OR=0.477, 95% CI: 0.254-0.879, P=0.019), hemoglobin (OR=0.987, 95% CI: 0.975-0.999, P=0.044), albumin (OR=0.952, 95% CI: 0.911-0.991, P=0.023), and prothrombin time (OR=0.865, 95% CI: 0.779-0.920, P < 0.001) were the independent influences on the occurrence of AKD in liver cirrhotic patients, and were used to construct a prediction model. The area under the curve of the model in the training set and validation set for predicting the occurrence of AKD in liver cirrhotic patients was 0.895 (95% CI: 0.865-0.925) and 0.869 (95% CI: 0.807-0.930), respectively. The calibration curves showed that the model had good fit and consistency and the clinical decision curves showed that the use of the model for predicting the risk of AKD could benefit liver cirrhotic patients overall.  Conclusions  A prediction model for the occurrence of AKD in liver cirrhotic patients was established based on eight influencing factors, including gender, history of diabetes, and hepatic encephalopathy. It was validated to have good discrimination, calibration, and clinical utility, and is expected to assist in the clinical early screening and identification of liver cirrhosis-associated AKD.

Objective:To investigate the short-term efficacy and safety of three dimensional (3D) brachytherapy with 192Ir under computed tomography (CT)-guidance in patients with locally advanced cervical carcinoma. Methods:A total of 82 patients with locally advanced cervical carcinoma,who admitted to the Department of Tumor Radiotherapy of the First Affiliated Hospital of Xi 'an Jiaotong University from October 2022 to October 2023,were selected,and they were divided into observation group and control group according to random number table method,with 41 cases in each group. The observation group received 3D brachytherapy with 192Ir under computed tomography (CT)-guidance,and control group received routine two-dimensional (2D) brachytherapy. The short-term efficacy,serum tumor markers,treatment safety and quality of life of the two groups were compared. Results:In observation group,the total effective rate was 97.56％,which was significantly higher than 80.49％ in control group (x2=6.116,P<0.05). The levels of glucose chain antigen 125 (CA125) and squamous cell carcinoma (SCC) antigen of serum tumor markers after treatment of observation group were significantly lower than those of control group (t=11.352,5.507,P<0.05),respectively. The incidences of radiation proctitis and radiation cystitis of observation group were respectively 7.32％ and 4.88％,which were significantly lower than 24.39％ and 21.95％ of control group (x2=4.479,5.143,P<0.05),respectively. After treatment,the scores of functional assessment of cancer therapy-cervix (FACT-Cx) scale (physiological status,social/family status,emotional status,functional status and additional concerns) of observation group were significantly higher than those of control group,and the differences of them between two groups were significantly (t=6.150,7426,9.341,10.029,8.623,P<0.05),respectively. Conclusion:3D brachytherapy with 192Ir under CT-guidance can achieve favorable short-term efficacy and higher safety on patients with locally advanced cervical carcinoma,which is helpful to further improve the quality of life of patients.

Objective:To investigate the short-term efficacy and safety of three dimensional (3D) brachytherapy with 192Ir under computed tomography (CT)-guidance in patients with locally advanced cervical carcinoma. Methods:A total of 82 patients with locally advanced cervical carcinoma,who admitted to the Department of Tumor Radiotherapy of the First Affiliated Hospital of Xi 'an Jiaotong University from October 2022 to October 2023,were selected,and they were divided into observation group and control group according to random number table method,with 41 cases in each group. The observation group received 3D brachytherapy with 192Ir under computed tomography (CT)-guidance,and control group received routine two-dimensional (2D) brachytherapy. The short-term efficacy,serum tumor markers,treatment safety and quality of life of the two groups were compared. Results:In observation group,the total effective rate was 97.56％,which was significantly higher than 80.49％ in control group (x2=6.116,P<0.05). The levels of glucose chain antigen 125 (CA125) and squamous cell carcinoma (SCC) antigen of serum tumor markers after treatment of observation group were significantly lower than those of control group (t=11.352,5.507,P<0.05),respectively. The incidences of radiation proctitis and radiation cystitis of observation group were respectively 7.32％ and 4.88％,which were significantly lower than 24.39％ and 21.95％ of control group (x2=4.479,5.143,P<0.05),respectively. After treatment,the scores of functional assessment of cancer therapy-cervix (FACT-Cx) scale (physiological status,social/family status,emotional status,functional status and additional concerns) of observation group were significantly higher than those of control group,and the differences of them between two groups were significantly (t=6.150,7426,9.341,10.029,8.623,P<0.05),respectively. Conclusion:3D brachytherapy with 192Ir under CT-guidance can achieve favorable short-term efficacy and higher safety on patients with locally advanced cervical carcinoma,which is helpful to further improve the quality of life of patients.

Background: and Purpose A systematic review and meta-analysis was performed of the outcome of Coronavirus disease 2019 (COVID-19) infection in patients with multiple sclerosis (MS) who received disease-modifying therapies (DMTs). Methods: Relevant studies published before November 2022 in the PubMed, Cochrane Library, Chinese National Knowledge Infrastructure, and Web of Science databases were retrieved using the following search expression: (“multiple sclerosis” OR “MS”) AND (“DMT” OR “disease modifying therapies”) AND (“COVID-19”). Two authors independently screened the articles and extracted the data. Qualitative analyses and a meta-analysis constituted 22 of the 794 retrieved articles. Differences in the hospitalization and mortality rates were used as the main measures of efficacy, and the meta-analysis was performed using RevMan software. Results: 22 clinical trials were selected. The hospitalization rate was lower in the 3,216 patients who received DMTs than in the 774 patients who did not receive any treatment, with a moderate effect size of 0.43 (p<0.00001). The mortality rate was also lower among patients with MS treated using DMTs than in controls (odds ratio [OR]=0.19, 95% confidence interval [CI]=0.13–0.27, p<0.00001). The hospitalization rates for COVID-19 infection in patients with MS treated with anti-CD20 therapy also increased markedly (OR=3.32, 95% CI=2.63–4.20, p<0.00001). However, there was no significant difference between patients with MS who did and did not receive DMTs. Conclusions In summary, the application of DMTs was found to be valuable for patients with MS infected with COVID-19. However, more clinical studies are needed to determine the use of anti-CD20 drugs in patients with MS during the COVID-19 pandemic.