This paper introduces a real-world cohort research model for community-acquired pneumonia （CAP） based on the Jiangsu Traditional Chinese Medicine （TCM） Dominant Diseases Diagnosis and Treatment Data Platform. Firstly， data cleaning is performed by standardizing diagnosis， symptoms， treatment and imaging， intelligently extracting unstructured information， and cleaning and constructing a standardized database. Secondly， for cohort establishment， CAP patients across the province are screened in accordance with CAP diagnostic criteria to build a high-quality disease-specific cohort. Lastly， in terms of protocol design， the characteristics of TCM research and the CAP disease profile are considered to determine appropriate inclusion and exclusion criteria， estimate sample size， define interventions， outcomes and economic evaluations， providing a reference for real-world TCM research on CAP.

This paper introduces a real-world cohort research model for community-acquired pneumonia （CAP） based on the Jiangsu Traditional Chinese Medicine （TCM） Dominant Diseases Diagnosis and Treatment Data Platform. Firstly， data cleaning is performed by standardizing diagnosis， symptoms， treatment and imaging， intelligently extracting unstructured information， and cleaning and constructing a standardized database. Secondly， for cohort establishment， CAP patients across the province are screened in accordance with CAP diagnostic criteria to build a high-quality disease-specific cohort. Lastly， in terms of protocol design， the characteristics of TCM research and the CAP disease profile are considered to determine appropriate inclusion and exclusion criteria， estimate sample size， define interventions， outcomes and economic evaluations， providing a reference for real-world TCM research on CAP.

Objective To investigate the effect of growth differentiation factor 15(GDF15)on apoptosis and insulin secretion of MIN6 cells under high glucose conditions.Methods The mouse pancreatic islet β cell line(MIN6 cells)were divided into four groups:NG group,NG+rGDF15 group,HG group,and HG+rGDF15 group.The cell morphology among groups were observed,the apoptosis rate,the protein expression levels of Bcl-2 and Bax and the insulin level was detected.Results HG group exhibited significant cellular damage,characterized by upregulated apoptosis-promoting protein Bax and downregulated apoptosis-suppressing protein Bcl-2 expression,accompanied by a marked increase in apoptosis rate and a substantial decrease in insulin secretion(P＜0.01).Administration of recombinant GDF15 protein improved MIN6 cell morphology,significantly reduced Bax protein relative expression,elevated Bcl-2 protein relative expression,markedly decreased apoptosis rate,and enhanced insulin secretion(P＜0.01).Conclusion GDF15 can mitigate high glucose-induced MIN6 cell damage.

Objective: To investigate the characteristics of hospitalized injury cases in Huangpu District, Guangzhou City in 2022, so as to provide evidence for optimizing injury prevention interventions. Methods: Data on hospitalized injury cases admitted between January to December 2022 were collected through the hospitalization registry system from 17 healthcare institutions in Huangpu District. The population distribution characteristics, causes of injury, injury sites, duration of hospital stay, and hospitalization costs were descriptively analyzed. Results: A total of 6 729 hospitalized injury cases were reported in Huangpu District in 2022, including 4 277 males and 2 452 females, with a male-to-female ratio of 1.74∶1. The average age was (49.57±19.82) years, with 2 064 cases (30.67%) aged 45 to <60 years and 1 921 cases (28.55%) aged ≥60 years. The median length of hospitalization was 9.00 (interquartile range, 11.00) days, with median hospitalization costs of 15 968.93 (interquartile range, 25 786.69) yuan. In the months of June to August, there were more cases of injury hospitalization,with 1 904 cases accounting for 28.30%. The top three causes of injury were falls (2 895 cases, 43.02%), transportation accidents (1 247 cases, 18.53%) and exposure to inanimate mechanical forces (1 104 cases, 16.41%). The top three injured sites were lower limb injuries (1 850 cases, 27.49%), upper limb injuries (1 596 cases, 23.72%) and other sites (1 178 cases, 17.51%). The three leading causes of injury with longest hospitalization duration were burns and scalds, transport accidents and falls, with the median duration being 12.00 (interquartile range, 8.00) days, 10.00 (interquartile range, 13.00) days and 10.00 (interquartile range, 11.00) days, respectively. The top three injury sites associated with the longest hospitalization duration were others, lower limb injuries, and head and neck injuries, with the median duration being 11.00 (interquartile range, 13.00) days, 11.00 (interquartile range, 11.00) days, and 10.00 (interquartile range, 12.00) days, respectively. The causes of injury associated with higher hospitalization costs were falls and transportation accidents, with the median hospitalization cost being 23 550.13 (interquartile range, 30 087.76) yuan for falls and 20 301.94 (interquartile range, 30 589.86) yuan for transportation accidents. The injury sites associated with higher hospitalization costs were lower limb injuries and upper limb injuries, with the median hospitalization cost being 24 257.32 (interquartile range, 34 145.54) yuan for lower limb injuries and 16 506.33 (interquartile range, 20 052.27) yuan for upper limb injuries. Conclusions In Huangpu District, hospitalized injury mainly occurred among males and individuals aged ≥45 years, with the higher incidence observed between June and August. Fall was the primary cause of injury, while lower limb injuries was the main injury sites. The injury resulted in substantially higher hospitalization costs.

Objective To investigate the effect of growth differentiation factor 15(GDF15)on apoptosis and insulin secretion of MIN6 cells under high glucose conditions.Methods The mouse pancreatic islet β cell line(MIN6 cells)were divided into four groups:NG group,NG+rGDF15 group,HG group,and HG+rGDF15 group.The cell morphology among groups were observed,the apoptosis rate,the protein expression levels of Bcl-2 and Bax and the insulin level was detected.Results HG group exhibited significant cellular damage,characterized by upregulated apoptosis-promoting protein Bax and downregulated apoptosis-suppressing protein Bcl-2 expression,accompanied by a marked increase in apoptosis rate and a substantial decrease in insulin secretion(P＜0.01).Administration of recombinant GDF15 protein improved MIN6 cell morphology,significantly reduced Bax protein relative expression,elevated Bcl-2 protein relative expression,markedly decreased apoptosis rate,and enhanced insulin secretion(P＜0.01).Conclusion GDF15 can mitigate high glucose-induced MIN6 cell damage.

Objective To explore the effect of evidence-based thinking oriented micro-course and case-based learning(CBL)on cultivation of clinical thinking ability of nurses who are taking the standardised nursing training in intensive care unit(ICU)so as to provide a new teaching method in the training of nurses.Methods A total of 72 nurses taking standardised nursing training in ICU of our hospital from November 2021 to October 2023 were selected as the research objects.Thirty-six of nurses who took rotation in the ICU from November 2021 to October 2022 were assigned in the control group,and other 36 nurses who took rotation in the ICU from November 2022 to October 2023 were assigned in the trial group.In the control group,CBL teaching method was adopted in the standardised nursing training,while both of evidence-based thinking oriented micro-course and CBL teaching mothed were adopted in the trial group for the standardised nursing training.The two groups were compared in terms of scores of clinical thinking ability,assessment of theory and clinical skills,as well as nurses'satisfaction with the teaching.Results After the training,nurses in the trial group exhibited significant superiority to the control group in total scores of clinical thinking ability and its three dimensions,critical thinking ability,systematic thinking ability and evidence-based thinking ability(P<0.05 for all).Furthermore,nurses in the trial group achieved significantly higher scores in theoretical assessment and assessment of clinical skills in comparison with those in the control group(P<0.05).Moreover,the trial group reported significantly higher satisfaction with both of the teaching method and learning atmosphere than those of the control group(P<0.05 for both).Conclusion Evidence-based thinking oriented micro-course and CBL teaching method can effectively improve the clinical thinking ability,theoretical knowledge and operational skills among the nurses taking standardised nursing training in ICU.

Background: Dust generated during the processing of building materials enterprises can pose a serious health risk. The study aimed to compare and analyze the results of ART and the Monte Carlo model for the dust exposure assessment in building materials enterprises, to derive the application scope of the two models. Methods: First, ART and the Monte Carlo model were used to assess the exposure to dust in each of the 15 building materials enterprises. Then, a comparative analysis of the exposure assessment results was conducted. Finally, the model factors were analyzed using correlation analysis and the scope of application of the models was determined. Results: The results show that ART is mainly influenced by four factors, namely, localized controls, segregation, dispersion, surface contamination, and fugitive emissions, and applies to scenarios where the workplace information of the building materials enterprises is specific and the average dust concentration is greater than or equal to 1.5 mg/m3. The Monte Carlo model is mainly influenced by the dust concentration in the workplace of building materials enterprises and is suitable for scenarios where the dust concentration in the workplace of the building materials enterprises is relatively uniform and the average dust concentration is less than or equal to 6mg/m3. Conclusion ART is most accurate when workplace information is specific and average dust concentration is > 1.5 mg/m3; whereas, The Monte Carlo model is the best when dust concentration is homogeneous and average dust concentration is < 6 mg/m3.

Objective To explore the morphological characteristics of overlapping bloodstains and judge the deposition sequence of bloodstain patterns.Methods The overlapping bloodstains formed by drip stains and bloody shoe prints were simulated on ceramic tiles,and the morphological characteristic differences of 6 group overlapping bloodstain patterns were analyzed to screen effective indicative characteristics.A survey was held to measure the accuracy of the participants in judging the blood deposition sequence without and with information about the morphological characteristic guidance.Results After participants mastered morphological characteristics,the accuracy of judging deposition sequence increased from 59.5%to 89.0%,and the accuracy of judging dry and wet conditions of the primary bloodstains increased from 45.6%to 65.3%.Conclusion According to the morphological characteristics of bloodstains,not only the deposition sequence of bloodstains can be effectively judged,but also the dry and wet conditions of bloodstains can be judged,so as to infer the time interval of bloodstains deposition,which can provide technical support for the analysis and reconstruction of crime scene.

Objective:To investigate predictive value of ultrasound imageomics of carotid artery plaque on the progression of transient ischemic attack (TIA) with high risk. Methods:We enrolled 120 patients with high-risk TIA who admitted to The Central Hospital of Enshi Tujia And Miao Autonomous Prefecture from October 1,2022 to May 1,2024,and they were divided into seizure group (42 cases) and non-seizure group (78 cases) according to whether occurred ischemic stroke. The differences of the characteristics of ultrasonic images,which included the maximum length,the area,the maximum flow velocity and resistance index of the stenosis of plaque,were compared between two groups. The region of interest (ROI) of imaging characteristics of all patients were analyzed as ratio of 7∶3,and they were divided into train set and verification set,and the diagnostic sensitivities of verification set and train set were further analyzed. Results:The maximum length (21.86±1.31)mm,the maximum height (6.92±1.27)mm,the area (72.58±1.37) mm2,the maximum flow velocity (4.14±1.17) cm/s and resistance index (0.77±0.32) of the narrow area of plaque in seizure group were significantly higher than those[(15.04±1.32)mm,(2.81±0.29)mm,(65.78±1.4) mm2,(2.81±0.15)cm/s and (0.34±0.42)]in non-seizure group,and the differences of them between two groups were significant (t=27.129,20.685,25.735,7.335,6.272,P<0.05),respectively. Higher values of the maximum length,the maximum height and the area of plaque,and the maximum flow velocity at stenosis,and the resistance index were risk factors of causing ischemic stroke in patients (OR=3.323,2.846,2.963,2.915,2.974,P<0.05),respectively. The area under curve (AUC) values of receiver operating characteristic (ROC) curve of the comprehensive diagnostic model of the imageomics in both train set and verification set were above 0.700. Correlation:The analysis method of ultrasound imageomics for plaque can more comprehensively assess the situation of carotid artery plaque of patients,which can provide importantly auxiliary information for clinical doctors. It will contribute to formulate the scheme of medical diagnosis and treatment in ischemic stroke.

Objective:To investigate predictive value of ultrasound imageomics of carotid artery plaque on the progression of transient ischemic attack (TIA) with high risk. Methods:We enrolled 120 patients with high-risk TIA who admitted to The Central Hospital of Enshi Tujia And Miao Autonomous Prefecture from October 1,2022 to May 1,2024,and they were divided into seizure group (42 cases) and non-seizure group (78 cases) according to whether occurred ischemic stroke. The differences of the characteristics of ultrasonic images,which included the maximum length,the area,the maximum flow velocity and resistance index of the stenosis of plaque,were compared between two groups. The region of interest (ROI) of imaging characteristics of all patients were analyzed as ratio of 7∶3,and they were divided into train set and verification set,and the diagnostic sensitivities of verification set and train set were further analyzed. Results:The maximum length (21.86±1.31)mm,the maximum height (6.92±1.27)mm,the area (72.58±1.37) mm2,the maximum flow velocity (4.14±1.17) cm/s and resistance index (0.77±0.32) of the narrow area of plaque in seizure group were significantly higher than those[(15.04±1.32)mm,(2.81±0.29)mm,(65.78±1.4) mm2,(2.81±0.15)cm/s and (0.34±0.42)]in non-seizure group,and the differences of them between two groups were significant (t=27.129,20.685,25.735,7.335,6.272,P<0.05),respectively. Higher values of the maximum length,the maximum height and the area of plaque,and the maximum flow velocity at stenosis,and the resistance index were risk factors of causing ischemic stroke in patients (OR=3.323,2.846,2.963,2.915,2.974,P<0.05),respectively. The area under curve (AUC) values of receiver operating characteristic (ROC) curve of the comprehensive diagnostic model of the imageomics in both train set and verification set were above 0.700. Correlation:The analysis method of ultrasound imageomics for plaque can more comprehensively assess the situation of carotid artery plaque of patients,which can provide importantly auxiliary information for clinical doctors. It will contribute to formulate the scheme of medical diagnosis and treatment in ischemic stroke.