In order to meet the accuracy requirements of hospitals for abnormal detection of fetal monitor data,a hospital fetal monitor data anomaly detection method based on Euclidean distance was proposed.In this method,according to the abnormal detection method of fetal monitor data in hospitals,the ultrasound Doppler detector was used to collect fetal heart rate signal data,and the fetal heart rate signal denoising method based on adaptive filtering was used to remove the noise components of the collected fetal heart rate signal.The denoised fetal heart rate signal was used as the identification sample of the abnormal fetal heart rate signal identification method based on Euclidean distance method.The Euclidean distance Euclidean distance between the denoised fetal heart rate signal and the normal fetal heart rate signal was analyzed by combining the Euclidean distance method and the strong classifier to analyze whether the virtual sinusoidal distance between the denoised fetal heart rate signal and the normal fetal heart rate signal was greater than the tuned Euclidean distance threshold.Fetal heart rate signal samples greater than the threshold were classified and diagnosed as abnormal monitoring data.The fetal heart rate information collected by the fetal monitor in the hospital was accurate,and the abnormal detection results were valid and reliable.

Objective To investigate the effects of nicorandil combined with rosuvastatin calcium on monocyte-to-high density lipoprotein cholesterol ratio (MHR), systemic immune-inflammation index (SII), and cardiac function in patients with coronary slow flow (CSF). Methods A group case-control study was used to select 240 patients with CSF confirmed by coronary angiography, and they were randomly divided into observation group and control group, with 120 patients in each group. On the basis of conventional drug treatment, the control group was treated with rosuvastatin calcium, while the observation group was treated with nicorandil combined with rosuvastatin calcium for 6 months. Clinical efficacy, inflammatory markers[high-sensitivity C-reactive protein (hs-CRP), MHR, SII], corrected TIMI frame count (CTFC) of major coronary branches [left anterior descending branch (LAD), left circumflex branch (LCX), right coronary artery (RCA)], cardiac function indicators[left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), global longitudinal strain (GLS)], and the occurrence of major adverse cardiovascular events (MACE) were compared between the two groups. Results The total effective rate in the observation groupwas significantly higher than that in the control group (95.00% versus 80.00%, P < 0.05). After treatment, the duration, severity, andfrequency of angina pectoris attacks were reduced or shortened in both groups, with more changes observed in the observation group (P < 0.05). Serum levels of hs-CRP, MHR, and SII were lower in both groups after 6 months of treatment, and the observation group with significantly was lower compared to the control group (P < 0.05). CTFC values of LAD, LCX, and RCA were also lower in both groups after 6 months, with the observation group showing significantly lower values (P < 0.05). The absolute values of LVEF and GLS increased in both groups after 6 months of treatment, and the observation group was higher than the control group (P < 0.05). However, no significant difference was observed in LVEDD and occurrence of MACE between the two groups (P>0.05). Conclusion The application of nicorandil combined with rosuvastatin calcium in the treatment of CSF patients can significantly improve the overall treatment efficacy, reduce hs-CRP, MHR, and SII levels, enhance cardiac function indicators such as LVEF, LVEDD, and GLS, and effectively alleviate the severity of angina pectoris attacks.

Objective:To compare the characteristics of MSM with different types of primary sexual partners and to analyze the factors associated with MSM not being tested for HIV in the last six months.Methods:MSM were recruited in nine cities of Shandong Province from April to July 2021, and face-to-face questionnaires were conducted to collect information on sociodemographic characteristics, high-risk behaviors, and HIV testing of MSM. Blood samples were taken for serological tests of HIV and syphilis antibodies.Results:A total of 3 008 men who had anal sex with men in the last six months were divided into three groups according to the type of primary sexual partner in the last six months: the fixed sexual partner group (36.83%, 1 108/3 008), the commercial sexual partner group (3.06%, 92/3 008), and casual sexual partner group (60.11%, 1 808/3 008). There were statistically significant differences in the distribution of age, local residence time, education level, the primary place to find male sexual partners, use of new-type drugs in the last six months, consistent condom use every time during same-sex anal sex in the last six months, group sex in the last six months, no HIV testing in the last six months, having had a sexually transmitted disease in the last year, receiving peer education in the last year, and frequency of syphilis testing in the last year among different groups ( P<0.05). Multivariable logistic regression analysis showed that related factors of not being tested for HIV in the last six months in MSM were those aged less than 30 years old (a OR=1.39, 95% CI: 1.06-1.83), married/cohabiting (a OR=1.74, 95% CI: 1.39-2.16), high school education or less (a OR=1.39, 95% CI: 1.15-1.67), had not used new-type drugs in the last six months (a OR=2.27, 95% CI: 1.89-2.71), had not received peer education in the last year (a OR=1.59, 95% CI: 1.28-1.98), had never been tested for syphilis (a OR=11.30, 95% CI: 8.15-15.66), had not been tested in the last year but had been previously tested for syphilis (a OR=5.65, 95% CI: 4.19-7.62), the type of primary sexual partner in the last six months being a commercial sexual partner (a OR=1.80, 95% CI: 1.01-3.20), and the type of primary sexual partner in the last six months being a casual sexual partner (a OR=1.50, 95% CI: 1.26-1.80). Conclusions:The characteristics of MSM with different types of primary sexual partners are different, and the proportion of HIV testing still needs to be improved. In the future, we should make full use of the Internet and peer education to expand the coverage of HIV testing for MSM, targeting the characteristics of MSM with different types of primary sexual partners.

Objective:To explore the influencing factors of AIDS-related deaths among HIV-infected patients in Shandong Province, to help reduce the risk of death and prolong survival time.Methods:The study population was HIV-infected patients in Shandong Province from 2017-2021, and Cox proportional hazards regression model was used to analyze the influencing factors of AIDS-related deaths and deaths within one year of confirmation.Results:Among 14 700 HIV- infected patients reported in Shandong Province in 2017-2021, 351 AIDS-related deaths occurred, accounting for 2.4% (351/14 700). The results of multifactorial Cox proportional hazards regression model analysis showed that the risk factors for AIDS-related deaths among HIV-infected patients included education level of junior high school, high school, and secondary school (a HR=1.37, 95% CI:1.01-1.84), sample source from healthcare institutions (a HR=1.61, 95% CI:1.22-2.12), duration of disease in AIDS stage (a HR=9.86,95% CI:6.86-14.19), baseline CD4 +T lymphocytes (CD4) undetected (a HR=3.93, 95% CI:2.69-5.75), duration of antiviral treatment (ART) <6 months (a HR=3.46, 95% CI:2.42-4.93) and no ART (a HR=1.45, 95% CI:1.02-2.07), final CD4 <200 cells/μl (a HR=3.51, 95% CI:2.18-5.65) and final CD4 undetected (a HR=10.58, 95% CI:6.15-18.19), and final viral load (VL) values of 50-999 copies/ml,≥1 000 copies/ml and undetected (a HR=2.59, 95% CI:1.07-6.26; a HR=9.50, 95% CI:5.60-16.12; a HR=15.33, 95% CI:8.91-26.36). Factors with higher risk of AIDS-related deaths within one year of confirmation of HIV-infected patients included samples originating from healthcare facilities (a HR=1.68, 95% CI: 1.19-2.36), AIDS stage of disease (a HR=10.60, 95% CI:7.13-15.75), baseline CD4 undetected (a HR=3.71, 95% CI:2.34-5.90), duration of ART <6 months (a HR=4.30, 95% CI:2.85-6.49) and no ART (a HR=2.05, 95% CI:1.35-3.13), final CD4 <200 cells/μl (a HR=5.45,95% CI:2.04-14.60) and final CD4 undetected (a HR=20.95, 95% CI: 7.69- 57.04), and final VL values of 50-999 copies/ml, ≥1 000 copies/ml and undetected (a HR=15.21, 95% CI: 2.54-91.21; a HR=42.93, 95% CI:9.64-191.20; a HR=61.35, 95% CI:13.85-271.77). Conclusions:Expanding the coverage of testing, promoting early detection and treatment, strengthening regular follow-up and the test of HIV-infected patients, grasping the progress of the disease to provide accurate management and treatment are important for reducing the disease mortality rate and prolonging the survival time of HIV-infected patients.

Objective:To analyze the awareness status and influencing factors of hepatitis C among patients presented to hospitals in Shandong province, to provide reference for the prevention and control of viral hepatitis C.Methods:A total of 22, 139 questionnaires were collected from local residents aged 15-65 who visited general hospitals in 16 cities in Shandong province from May to December 2021. The survey was conducted in the form of face-to-face questionnaires, including general demographic information and questions and answers on hepatitis C prevention, treatment. and related behavioral characteristics. There are a total of 8 questions on the prevention and treatment of hepatitis C, and if 6 questions are correct, it is judged as knowing.Results:The overall awareness rate of hepatitis C-related knowledge among those who visited hospitals in Shandong province was 57.75%. The awareness rate of hepatitis C knowledge among respondents aged less than or equal to 20, 21-40, and 41-59 was higher than that of the age group over 60 years old. The OR values were 1.49, 2.30 and 1.88, respectively; the awareness rate of respondents with education level of high school or junior college and above was higher than that of people with education level of junior high school and below, the OR values were 1.14 and 1.21, respectively; The awareness rate of physical examination population and invasive diagnosis and treatment population was higher than that of family planning clinic visits, with OR values of 1.20 and 1.28, respectively. The awareness rate of respondents with a history of visiting a doctor in an informal medical service was lower than that of the population without such behavior. Conclusions:The awareness rate of hepatitis C knowledge among hospital patients in Shandong province needs to be further improved. Carrying out different forms of publicity and education for different groups of people is an effective means and method to reduce the hepatitis C infection rate.

Objective:To evaluate the safety of ensartinib in the treatment of anaplastic lymphoma kinase (ALK) -positive non-small cell lung cancer (NSCLC) in the real-world clinical setting.Methods:Clinical data of 2 221 patients with ALK-positive locally advanced or metastatic NSCLC who received ensartinib treatment (225 mg/d) from December 16, 2020 to December 16, 2021 were collected and analyzed to assess drug adverse reactions in all population including elderly patients (≥ 65 years old) .Results:Among the total 2 221 patients, 511 patients (23.01%) experienced adverse events, including 8 patients (0.36%) who experienced serious adverse events. Adverse events led to dose modification in 67 patients (3.02%) and discontinuation in 18 patients (0.81%). The common adverse events were rash (407/2 221, 18.33%), pruritus (41/2 221, 1.85%), constipation (41/2 221, 1.85%), and facial edema (31/2 221, 1.40%). Thirty-six patients (1.62%) experienced ≥grade 3 adverse events. After symptomatic treatment of 511 patients with adverse reactions, 50 patients (9.78%) were healed, 271 patients (53.03%) were improved, 120 patients (23.48%) were persisted, and 70 patients (13.71%) were unknown due to loss of follow-up or other reasons. Forty-three patients (1.94%) reported 57 unintended adverse reactions. Among the 599 elderly patients, 116 patients (19.37%) experienced adverse events, including 1 patient (0.17%) who experienced serious adverse events. Adverse events led to dose modification in 25 patients (4.17%) and discontinuation in 5 patients (0.83%). The common adverse events of elderly patients were rash (88/599, 14.69%), constipation (14/599, 2.34%), facial edema (12/599, 2.00%), and pruritus (10/599, 1.67%). Twelve patients (2.00%) experienced ≥grade 3 adverse events. Among the 116 elderly patients with adverse reactions following the symptomatic treatment, 11 patients (9.48%) were healed, 58 patients (50.00%) were improved, 28 patients (24.13%) were persisted, and 19 patients (16.39%) were unknown due to loss of follow-up or other reasons. During the treatment, 1 patient (0.05%) experienced grade 2 interstitial lung disease, and no patient died due to adverse events.Conclusion:Ensartinib has a favorable safety profile in the real-world populations, with the most frequent adverse events being rash, mostly mild, and low incidence of ≥grade 3 adverse events. Overall, adverse reactions were tolerable and manageable.

Objective:To analyze the status of first viral load (VL) suppression for newly diagnosed HIV/AIDS on antiretroviral therapy (ART) from 2014 to 2016 in Shandong province, to provide theoretical evidence for improvement of ART effectiveness.Methods:Based on a retrospective cohort study, logistic regression model was used to identify influencing factors about VL suppression.Results:There were 4 833 newly diagnosed HIV/AIDS cases who received ART from 2014 to 2016 in Shandong province, and 3 449 cases achieved VL suppression at the first VL testing. The rate of first VL suppression was 71.36%. The possibilities of first VL suppression among patients on ART with education at junior high school, junior college and above were higher than those with education at primary school and below, with OR values at 1.75 and 2.00, separately. The possibilities of first VL suppression for patients treated at medical institutions was higher than those by CDC, with OR value 1.29. The possibilities of first VL suppression among patients whose CD4 count level at 201-350, 351-500 and ≥501 cells/μl were higher than that of the patients whose CD4 count level at ≤200 cells/μl, with OR values at 2.36, 2.11 and 2.66, respectively. The possibilities of first VL suppression among patients who missed doses was lower than those who did not miss doses, with OR value at 0.55. All the Pvalues for the above comparisons was <0.05. Conclusions:The suppression of viral load for HIV/AIDS on ART was influenced by culture level, CD4 count level at the entry of ART, treatment institutions and adherence to the therapy. Earlier diagnosis, treatment services provided by medical institutions and improvement of drug adherence can enhance ART effectiveness.

The diagnosis of food allergy in children is one hotspot attracting people′s attention in recent years.The incidence of it shows an increasing trend which exposes problems in the understanding of children′s food allergy in China, especially in the misdiagnosis and missed diagnosis.To further standardize the diagnosis and treatment of food allergy in children, based on the current domestic, foreign guidelines and relevant research evidence, the guideline recommends 16 clinical hot-button issues in the 4 aspects of diagnosis, treatment, prognosis, and prevention.Finally, a diagnosis flowchart has been formulated.The guideline aims to improve the standard diagnosis and treatment of food allergies in children in China.

Objective:To study the single purse-string parachute suturing technique for pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy, and to determine its feasibility and safety.Methods:The clinical data of 71 patients who underwent laparoscopic pancreaticoduodenectomy using the single purse-string parachute suturing technique for pancreaticojejunostomy from October 2018 to October 2021 at the Second Hospital of Hebei Medical University were retrospectively analyzed. There were 41 males and 30 females, with age (59.1±9.7) years old. The operative time, intraoperative blood loss, complication rate and other data were analyzed.Results:All 71 patients successfully underwent total laparoscopic pancreaticoduodenectomy, with 5 patients who underwent 2D laparoscopic surgery and 66 patients 3D laparoscopic surgery. There were additional vascular resection and reconstruction in 2 patients. The operative time was (388.9±92.9) min, the intraoperative blood loss was (411.3±176.9) ml, and the postoperative hospital stay was (14.1±5.8) d. The operation time of 71 patients who underwent the single purse-string parachute technique of pancreaticojejunostomy was (26.9±6.8) min. Postoperative complications occurred in 18 patients (25.4%). Grade B pancreatic fistula occurred in 2 patients (2.8%), and the longest time for removal of abdominal drain was 17 days after operation. Among the 71 patients, complications including biliary fistula occurred in 6 patients (8.5%), delayed gastric emptying in 5 patients (7.0%), pulmonary infection in 4 patients (5.6%), non-pancreatic fistula-related abdominal infection in 4 patients (5.6%), non-pancreatic fistula-related abdominal bleeding in 1 patient (1.4%), biliary tract bleeding in 1 patient (1.4%), and chylous leakage in 2 patients (2.8%).Conclusion:The single purse-string parachute technique of pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy had the advantages of being safe and reliable. The procedure is worthy of furthers promotion.

Objective:To analyze the timeliness and influencing factors of antiretroviral treatment (ART) among HIV/AIDS patients from 2017 to 2019 in Shandong province.Methods:Data were collected from the Chinese HIV/AIDS Comprehensive Response Information Management System, HIV/AIDS cases enrolled in antiretroviral therapy, from January 1, 2017 to December 31, 2019, ≥15 years of age and from the mainland of China were the subjects of the study. The general demographic characteristics (gender, age, ethnicity, education level, marital status, etc), infection routes, sample sources, date of diagnosis, baseline CD4+ T cell level, and clinical stage and other information were collected from the database. Univariate analysis was conducted for the timeliness of ART of the subjects by Chi square test, and the influencing factors associated with timeliness of ART were analyzed by binary non-conditional Logistic regression.Results:Among the 7 425 cases of HIV/AIDS, 6 813(91.8%) were male, 5 236(70.5%) had homosexual transmission, the age at the ART initiation was(36.05±12.51)years. The proportion of timeliness of ART within 30 d increased from 55.9% (1145/2050) in 2017 to 65.3% (1821/2789) in 2019. The possibility of timeliness of ART among HIV/AIDS who were married or cohabiting, education of high school and above were higher, with OR values at 1.136, 1.299. The possibility of timeliness of ART among HIV/AIDS cases whose domicile place is outside Shandong province were lower, with OR values at 0.664. The possibility of timeliness of ART in group of HIV/AIDS aging≥55, 45~54 and 35~44 years old were higher than that in 15~24 years old, with OR values at 1.530, 1.505 and 1.394. The possibility of timeliness of ART among the heterosexuals were lower than that of homosexuals, with OR values at 0.803. The possibility of timeliness of ART is lower for cases in places of detention centers than cases from volunteer testing and counseling, with OR values at 0.204. The possibility of timeliness of ART among HIV/AIDS cases whose CD4+ T lymphocyte at >500 cells/μL were lower than that of the cases whose CD4+ T lymphocyte at≤500 cells/μl, with OR values at 0.545. Patients without symptoms at baseline were less likely to receive prompt treatment than those with clinical symptoms, with OR values at 0.727. Patients with baseline clinical staging of stage Ⅳ, period of HIV/AIDS treatment with timeliness was longer than the cases with baseline clinical stages ofⅠ, Ⅱ, Ⅲ, with OR values at 1.307. Conclusions:The proportion of timeliness of ART increased from 2017 to 2019. Marital status, educational level, age, sample source, infection routes, baseline clinical stage, and CD4+ T lymphocyte levels were associated with the timeliness of ART.