Objective To evaluate the relationship between the QRS duration(QRSd)of the first medical contact(FMC)and the 30-day clinical endpoint of acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 547 STEMI patients were selected and divided into the QRSd＜100 ms group(306 cases)and the QRSd≥100 ms group(241 cases).Clinical data of the patients were collected,and electrocardiography(ECG)and cardiac ultrasound were evaluated according to the FMC examination results of patients.The starting point of the study was the postoperative day.Outpatient or telephone follow-up was performed after discharge until 30 days or death,the primary endpoint was major adverse cardiovascular events(MACE),which was defined as the composite endpoint of all-cause mortality,acute heart failure(AHF)and revascularization again,and the secondary endpoint was AHF.Kaplan-Meier curves were drawn to evaluate the incidence rates of MACE and AHF.QRSd was included in Cox regression with continuous variables and categorical variables to analyze influence factors of 30-day MACE and AHF in STEMI patients.The receiver operating characteristic(ROC)curve was used to evaluate the efficacy of QRSd in predicting 30 d MACE occurrence in STEMI patients.Results Compared with the QRSd＜100 ms group,HR was faster and the proportion of smoking history was lower in the QRSd≥100 ms group(P＜0.05).MACE occurred in 44 patients,including 11 in the QRSd＜100 ms group and 33 in the QRSd≥100 ms group.AHF occurred in 17 patients,including 2 patients in the QRSd＜100 ms group and 15 patients in the QRSd≥100 ms group.Kaplan-Meier survival analysis showed that the incidence of MACE and AHF were higher in the QRSd≥100 ms group than those in the QRSd＜100 ms group(P＜0.01).Multivariate Cox regression analysis showed that prolonged QRSd and QRSd≥100 ms were risk factors for MACE and AHF(P＜0.05).ROC curve results showed that the best cutoff value of QRSd for predicting MACE was 111 ms,the area under the curve(AUC)was 0.796(95%CI:0.710-0.881),the sensitivity was 0.75,and the specificity was 0.84.Conclusion Compared with QRSd＜100 ms,QRSd≥100 ms of the FMC can increase the risk of 30-day MACE and heart failure in patients with STEMI,and this risk increases with prolonged QRSd.

Objective To evaluate the relationship between the QRS duration(QRSd)of the first medical contact(FMC)and the 30-day clinical endpoint of acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 547 STEMI patients were selected and divided into the QRSd＜100 ms group(306 cases)and the QRSd≥100 ms group(241 cases).Clinical data of the patients were collected,and electrocardiography(ECG)and cardiac ultrasound were evaluated according to the FMC examination results of patients.The starting point of the study was the postoperative day.Outpatient or telephone follow-up was performed after discharge until 30 days or death,the primary endpoint was major adverse cardiovascular events(MACE),which was defined as the composite endpoint of all-cause mortality,acute heart failure(AHF)and revascularization again,and the secondary endpoint was AHF.Kaplan-Meier curves were drawn to evaluate the incidence rates of MACE and AHF.QRSd was included in Cox regression with continuous variables and categorical variables to analyze influence factors of 30-day MACE and AHF in STEMI patients.The receiver operating characteristic(ROC)curve was used to evaluate the efficacy of QRSd in predicting 30 d MACE occurrence in STEMI patients.Results Compared with the QRSd＜100 ms group,HR was faster and the proportion of smoking history was lower in the QRSd≥100 ms group(P＜0.05).MACE occurred in 44 patients,including 11 in the QRSd＜100 ms group and 33 in the QRSd≥100 ms group.AHF occurred in 17 patients,including 2 patients in the QRSd＜100 ms group and 15 patients in the QRSd≥100 ms group.Kaplan-Meier survival analysis showed that the incidence of MACE and AHF were higher in the QRSd≥100 ms group than those in the QRSd＜100 ms group(P＜0.01).Multivariate Cox regression analysis showed that prolonged QRSd and QRSd≥100 ms were risk factors for MACE and AHF(P＜0.05).ROC curve results showed that the best cutoff value of QRSd for predicting MACE was 111 ms,the area under the curve(AUC)was 0.796(95%CI:0.710-0.881),the sensitivity was 0.75,and the specificity was 0.84.Conclusion Compared with QRSd＜100 ms,QRSd≥100 ms of the FMC can increase the risk of 30-day MACE and heart failure in patients with STEMI,and this risk increases with prolonged QRSd.

Objective:To analyze the cognitive changes and alterations in the topological properties of functional and structural brain networks in elderly women with mild cognitive impairment (MCI), and explore the relationship between brain network and cognitive function, and find the neuroimaging mechanism of cognitive decline in female patients with MCI.Methods:A cross-sectional study was conducted, collecting clinical data from 38 elderly women with MCI, aged 60-79, recruited between October 1, 2019 and May 31, 2021, through community visits, online advertisements, free consultations by experts at the First Hospital of China Medical University and outpatient promotions. A matched control group of 37 healthy women of similar age was also recruited. Both groups underwent comprehensive neuropsychological assessments and MRI data collection, Brain functional and structural networks were constructed, and the corresponding global and nodal topological metrics were calculated. Differences in general demographic data, cognitive function scores, and network topology attribute indexes were compared. Pearson correlation analysis was used to explore the relationship between the altered topological properties of brain networks and cognitive function differences.Results:Cognitive function assessments showed that compared to the healthy control group, elderly women with MCI scored lower on the Rey Auditory Verbal Learning Test-N5 (AVLT-N5), Digit Span Test (DST), Clock Drawing Test (CDT), and Verbal Fluency Test (VFT) (1.95±1.02 vs 6.42±1.63, t=14.85; 7.14±1.58 vs 8.08±1.29, t=2.93; 3.30±1.12 vs 3.73±0.55, t=2.20; 15.49±3.87 vs 18.53±3.80, t=3.60; all P<0.05). The results of brain functional and structural network nodal topological properties indicated that the left inferior parietal angular gyri, left supramarginal gyrus, right orbital inferior frontal gyrus, and right insula showed incomplete white matter network structure or reduced efficiency in brain network functional transmission ( P<0.05). Conversely, regions such as the left cuneus, left superior frontal gyrus orbital part, left middle occipital gyrus, left precuneus, right superior parietal gyrus, and left paracentral lobule showed enhanced structural integrity of white matter network or increased efficiency in brain network functional transmission ( P<0.05). Correlation analysis suggested that abnormal nodal topological attributes were associated with language function (VFT), short-term memory (AVLT-N5), and visuospatial ability (CDT) in patients with MCI(All P<0.05). Conclusion:Elderly women with MCI exhibit declines in short-term memory, linguistic function, attention, and visuospatial abilities. Changes in the topological properties of brain function and structural networks occur in regions such as the orbital superior frontal gyrus, middle occipital gyrus, and cuneus in the elderly women.

Objective:To investigate the role of clinical pharmacists in the management of pharmacological treatment for pancreatic cancer pain.Methods:A retrospective analysis was conducted on the clinical data of 58 inpatients diagnosed with pancreatic cancer associated pain at the Pancreas Center of Nanjing BenQ Hospital Affiliated to Nanjing Medical University from January 2023 to March 2023. The outcomes of pain control, quality of life (QOL), medication adherence, patient satisfaction with pain management, and trust in clinical pharmacists were compared before and after pharmacist intervention. Adverse drug reactions (ADRs) were also monitored.Results:The involvement of clinical pharmacists in pain medication management significantly reduced pain scores in 58 patients at 12, 24, and 48 hours after intervention compared to pre-intervention levels [(2.64±1.04), (2.72±1.12), and (2.17±0.96) vs (5.88±1.11)]. Pain scores at 48 hours after intervention were significantly lower than those at 12 and 24 hours. QOL scores significantly improved after the intervention [(38.53±7.03), (38.84±7.11), and (39.77±6.71) vs (32.48 ± 7.32)], with scores at 48 hours significantly higher than those at 12 and 24 hours. All the differences were statistically significant (all P value <0.05). After intervention, pain scores were negatively correlated with QOL scores, indicating that a significant reduction in pain was associated with a substantial improvement in quality of life. The proportion of patients with good medication adherence increased from 41.4% before the intervention to 86.2% after the intervention. Trust in clinical pharmacists rose from 70.7% to 100%, with a satisfaction rate of 98.2%. Among the 58 patients, 21 experienced ADRs, including constipation (29.0%), nausea (23.7%), vomiting (13.1%), somnolence (10.5%), dizziness (7.9%), diarrhea (7.9%), fatigue (5.3%), and delirium (2.6%). Conclusions:The involvement of clinical pharmacists in the pharmacological management of pain in pancreatic cancer could significantly reduce pain scores, improve patients' QOL, enhance medication adherence, and monitor ADRs, which may comprehensively promote rational and standardized pain management for pancreatic cancer patients.

Objective:To investigate the role of clinical pharmacists in the management of pharmacological treatment for pancreatic cancer pain.Methods:A retrospective analysis was conducted on the clinical data of 58 inpatients diagnosed with pancreatic cancer associated pain at the Pancreas Center of Nanjing BenQ Hospital Affiliated to Nanjing Medical University from January 2023 to March 2023. The outcomes of pain control, quality of life (QOL), medication adherence, patient satisfaction with pain management, and trust in clinical pharmacists were compared before and after pharmacist intervention. Adverse drug reactions (ADRs) were also monitored.Results:The involvement of clinical pharmacists in pain medication management significantly reduced pain scores in 58 patients at 12, 24, and 48 hours after intervention compared to pre-intervention levels [(2.64±1.04), (2.72±1.12), and (2.17±0.96) vs (5.88±1.11)]. Pain scores at 48 hours after intervention were significantly lower than those at 12 and 24 hours. QOL scores significantly improved after the intervention [(38.53±7.03), (38.84±7.11), and (39.77±6.71) vs (32.48 ± 7.32)], with scores at 48 hours significantly higher than those at 12 and 24 hours. All the differences were statistically significant (all P value <0.05). After intervention, pain scores were negatively correlated with QOL scores, indicating that a significant reduction in pain was associated with a substantial improvement in quality of life. The proportion of patients with good medication adherence increased from 41.4% before the intervention to 86.2% after the intervention. Trust in clinical pharmacists rose from 70.7% to 100%, with a satisfaction rate of 98.2%. Among the 58 patients, 21 experienced ADRs, including constipation (29.0%), nausea (23.7%), vomiting (13.1%), somnolence (10.5%), dizziness (7.9%), diarrhea (7.9%), fatigue (5.3%), and delirium (2.6%). Conclusions:The involvement of clinical pharmacists in the pharmacological management of pain in pancreatic cancer could significantly reduce pain scores, improve patients' QOL, enhance medication adherence, and monitor ADRs, which may comprehensively promote rational and standardized pain management for pancreatic cancer patients.

Objective:To analyze the cognitive changes and alterations in the topological properties of functional and structural brain networks in elderly women with mild cognitive impairment (MCI), and explore the relationship between brain network and cognitive function, and find the neuroimaging mechanism of cognitive decline in female patients with MCI.Methods:A cross-sectional study was conducted, collecting clinical data from 38 elderly women with MCI, aged 60-79, recruited between October 1, 2019 and May 31, 2021, through community visits, online advertisements, free consultations by experts at the First Hospital of China Medical University and outpatient promotions. A matched control group of 37 healthy women of similar age was also recruited. Both groups underwent comprehensive neuropsychological assessments and MRI data collection, Brain functional and structural networks were constructed, and the corresponding global and nodal topological metrics were calculated. Differences in general demographic data, cognitive function scores, and network topology attribute indexes were compared. Pearson correlation analysis was used to explore the relationship between the altered topological properties of brain networks and cognitive function differences.Results:Cognitive function assessments showed that compared to the healthy control group, elderly women with MCI scored lower on the Rey Auditory Verbal Learning Test-N5 (AVLT-N5), Digit Span Test (DST), Clock Drawing Test (CDT), and Verbal Fluency Test (VFT) (1.95±1.02 vs 6.42±1.63, t=14.85; 7.14±1.58 vs 8.08±1.29, t=2.93; 3.30±1.12 vs 3.73±0.55, t=2.20; 15.49±3.87 vs 18.53±3.80, t=3.60; all P<0.05). The results of brain functional and structural network nodal topological properties indicated that the left inferior parietal angular gyri, left supramarginal gyrus, right orbital inferior frontal gyrus, and right insula showed incomplete white matter network structure or reduced efficiency in brain network functional transmission ( P<0.05). Conversely, regions such as the left cuneus, left superior frontal gyrus orbital part, left middle occipital gyrus, left precuneus, right superior parietal gyrus, and left paracentral lobule showed enhanced structural integrity of white matter network or increased efficiency in brain network functional transmission ( P<0.05). Correlation analysis suggested that abnormal nodal topological attributes were associated with language function (VFT), short-term memory (AVLT-N5), and visuospatial ability (CDT) in patients with MCI(All P<0.05). Conclusion:Elderly women with MCI exhibit declines in short-term memory, linguistic function, attention, and visuospatial abilities. Changes in the topological properties of brain function and structural networks occur in regions such as the orbital superior frontal gyrus, middle occipital gyrus, and cuneus in the elderly women.

Objective The present study is to investigate the distribution of endogenous sulfur dioxide (SO2) in severe acute pancreatitis (SAP) rats.Methods Thirty-two SPF male Sprague-Dawley rats were randomized (random number) into sham operation group,SAP rat 3 h group (SAP 3 h),SAP rat 6 hgroup (SAP6h),SAP rat 12 hgroup (SAP 12 h),n=8 in each group.The SAPmodel rats were induced by retrograde cholangiopancreatic infusion of 5％ sodium taurocholate.Rats were sacrified 3 h,6 h or 12 h after treatment.,then we collected pancrease,liver,lung,kidney and serum.The SO2 concentration in each tissue or serum was detected by enzyme-linked immune sorbentassay.Results The concentration of SO2 in tissues of pancreas (1.72 ± 0.14) μmol/g,liver (1.62 ± 0.11) μmol/g,lung (1.65 ± 0.11) μ.mol/g,kidney (1.12 ± 0.06) μmol/g or serum (16.80 ± 1.27) μmol/g in SAP 3 h rats was not significant compared with the sham operation group (P ＞ 0.05 in each group).The SO2 content in the pancreas (1.89 ± 0.17) μmol/g,liver (1.92 ± 0.16) μmol/g,lung (1.91 ± 0.15) μmol/g,kidney (1.30 ± 0.10) μmol /g and serum (14.93 ± 1.00) μmol /g of SAP 6 h was significantly increased compared with sham operation group (P ＜ 0.05 each group).The content SO2 in the pancreas (2.31 ± 0.23) μmol /g,liver (2.22 ± 0.15) μmol /g,lung (2.17 ± 0.07)μmol /g,kidney (1.55 ± 0.15) μmol /gand serum (18.88 ± 1.56) μmol /g of SAP rats reached the peak 12Hafter treatment and was significantly higher compared with the sham operation group (P ＜ 0.05).Conclusions The increase of SO2 concentration in SAP might be,at least in our present opinion,involved into the pathogenesis of SAP rats.

Guided by the spirit of the 4th Plenum of the 16th Party Central Committee, the authors have done some exploratory reflection on promoting Party building in a large general hospital under the new circumstances. It is pointed out that Party building in the hospital should focus on the "three integrations , the "three roles", the "one guarantee", and the "three submissions"; that it is imperative to update ideas, keep abreast of the times in Party building, and manage the Party as well as development, service, and supervision; that the Party Committee should strive for the "six musts", and bolster the executive ability of the Party in the hospital; that it is necessary to stick to and advance the principle of cadre and talent management by the Party, innovate the mechanism for the use of cadres and talents, create a sound environment for starting new undertakings, and build a quality contingent of cadres and talents; that it is essential to construct a people-oriented hospital culture, strengthen ideological work, and enhance the managerial level of the hospital.