Objective To analyze the characteristics of birth defects in seven hospitals in Suzhou from 2020 to 2022,and to provide a basis for the formulation of birth defect prevention strategies.Methods Information on 74,515 perinatal infants delivered in the participating hospitals was collected through birth defect monitoring,and the characteristics of birth defect incidence and changes in the ranking of occurrences were analyzed.Results From 2020 to 2022,the incidence of birth defects in perinatal infants was 173.12 per 10,000,with the incidence in male infants being 197.22 per 10,000 and in female infants 147.17 per 10,000,showing a statistically significant difference(χ2=27.383,P<0.05).The incidence of birth defects in male infants was significantly higher than in female infants,with a statistically significant difference(all P<0.05).In 2020 and 2021,the incidence of birth defects was higher in mothers under 20 years of age,with statistically significant differences(all P<0.05).From 2020 to 2022,the incidence of congenital heart disease in perinatal infants fluctuated between 49.49 and 75.35 per 10,000,ranking first each year.Conclusion Strengthening the management of high-risk populations,especially young pregnant women,and leveraging the multidisciplinary diagnosis and treatment capabilities of prenatal diagnosis centers and nationally recognized clinical key specialties are essential for the prevention and control of birth defects.

Objective:This study implemented a pulmonary rehabilitation integrated care management model based on an Internet of things platform for patients with chronic obstructive pulmonary disease (COPD) and evaluated its effectiveness to provide evidence for clinical respiratory rehabilitation practices.Methods:A quasi-experimental design was adopted. Patients from the Department of Respiratory and Critical Care Medicine at Changsha Central Hospital Affiliated to University of South China between May and December 2023 were selected via purposive sampling. Sixty COPD patients from May to August 2023 were assigned to the control group, while 60 patients from September to December 2023 were assigned to the comprehensive management group. The control group adopted routine respiratory rehabilitation management, the comprehensive management group adopted a pulmonary rehabilitation integarted care management mode based on Internet of things platform respiratory rehabilitation. Before and after 6 months of intervention, patients were assessed for respiratory rehabilitation compliance, lung function (including the percentage of forced expiratory volume in the first second to the expected value (FEV 1% pred) and the ratio of forced expiratory volume in the first second to forced vital capacity (FEV 1/FVC), 6-minute walk test (6MWT) and COPD Assessment Test (CAT). Results:Finally, 55 cases were included in the control group and 59 cases were included in the comprehensive management group. The control group included 32 males and 23 females, aged (67.31 ± 7.14) years. The comprehensive management group included 39 males and 20 females, aged (68.15 ± 6.34) years. The respiratory rehabilitation compliance score, FEV 1% pred, FEV 1/FVC, 6MWT, and CAT score of the full management group after intervention were as follows: (26.45 ± 1.51) points, (59.21 ± 6.68)%, (78.35 ± 8.01)%, (479.63 ± 54.70) m, and (12.35 ± 4.01) points, which were all better than the control group′s (15.68 ± 1.56) points, (44.09 ± 6.31)%, (68.38 ± 6.43)%, (429.82 ± 60.50) m, and (17.03 ± 4.23) points. The difference between two groups were significant ( t values were 1.83-5.24, all P<0.05). Conclusions:The pulmonary rehabilitation integarted care management model based on Internet of things platform improves patient compliance, enhances pulmonary function, enhance their activity endurance, and improve their quality of life. It is worth promoting and using in clinical practice.

Objective:To analyze the current situation and influencing factors of information need for cardiac rehabilitation of urban and rural patients with coronary heart disease, and explore the inequality of information need for cardiac rehabilitation among urban and rural patients with coronary heart disease and its influencing factors, so as to provide a scientific reference for formulating targeted cardiac rehabilitation programs.Methods:From June to July 2024, hospitalized patients with coronary heart disease from a Class A tertiary hospital in Suzhou City were selected by convenience sampling as the study subjects. A General Information Questionnaire, Information Need in Cardiac Rehabilitation Hospital Anxiety and Depression Scale, Health Literacy Management Scale, and Coronary Artery Disease Self-Management Scale were used to conduct a questionnaire survey. Multiple linear regression was used to analyze the influencing factors of the cardiac rehabilitation information needs and the oaxaca-blinder model was used to analyze the causes of unequal information needs in urban and rural patients.Results:A total of 254 hospitalized patients with coronary heart disease who met the inclusion and exclusion criteria were surveyed, included 127 males and 127 females, 182 of them were aged 60 years or older. The total cardiac rehabilitation information needs score of rural and urban patients with coronary heart disease were 168.00 (115.50, 255.00) and 213.00 (132.00, 255.00), respectively, the difference was significant ( U = 5 389.50, P<0.05). Multiple regression analysis showed that health literacy ( β = 0.871, P<0.05) was the influencing factor of cardiac rehabilitation information needs of rural coronary heart disease patients, and depression ( β = 0.719, P<0.05) and living status ( β = -0.186, P<0.05) was the influencing factor of cardiac rehabilitation information needs of urban coronary heart disease patients. Average monthly household income per capita (C = 14.50%) and health literacy (C = 88.30%) were the main causes of the difference in cardiac rehabilitation information needs between urban and rural patients with coronary heart disease. Conclusions:The information demand for cardiac rehabilitation of patients with coronary heart disease in rural area is lower than that in urban areas in Suzhou, mainly due to health literacy and monthly income. It is recommended to narrow the urban-rural gap by improving rural health literacy, optimizing medical insurance policies, and promoting a multi-level rehabilitation service network.

Objective To analyze the characteristics of birth defects in seven hospitals in Suzhou from 2020 to 2022,and to provide a basis for the formulation of birth defect prevention strategies.Methods Information on 74,515 perinatal infants delivered in the participating hospitals was collected through birth defect monitoring,and the characteristics of birth defect incidence and changes in the ranking of occurrences were analyzed.Results From 2020 to 2022,the incidence of birth defects in perinatal infants was 173.12 per 10,000,with the incidence in male infants being 197.22 per 10,000 and in female infants 147.17 per 10,000,showing a statistically significant difference(χ2=27.383,P<0.05).The incidence of birth defects in male infants was significantly higher than in female infants,with a statistically significant difference(all P<0.05).In 2020 and 2021,the incidence of birth defects was higher in mothers under 20 years of age,with statistically significant differences(all P<0.05).From 2020 to 2022,the incidence of congenital heart disease in perinatal infants fluctuated between 49.49 and 75.35 per 10,000,ranking first each year.Conclusion Strengthening the management of high-risk populations,especially young pregnant women,and leveraging the multidisciplinary diagnosis and treatment capabilities of prenatal diagnosis centers and nationally recognized clinical key specialties are essential for the prevention and control of birth defects.

Objective:This study implemented a pulmonary rehabilitation integrated care management model based on an Internet of things platform for patients with chronic obstructive pulmonary disease (COPD) and evaluated its effectiveness to provide evidence for clinical respiratory rehabilitation practices.Methods:A quasi-experimental design was adopted. Patients from the Department of Respiratory and Critical Care Medicine at Changsha Central Hospital Affiliated to University of South China between May and December 2023 were selected via purposive sampling. Sixty COPD patients from May to August 2023 were assigned to the control group, while 60 patients from September to December 2023 were assigned to the comprehensive management group. The control group adopted routine respiratory rehabilitation management, the comprehensive management group adopted a pulmonary rehabilitation integarted care management mode based on Internet of things platform respiratory rehabilitation. Before and after 6 months of intervention, patients were assessed for respiratory rehabilitation compliance, lung function (including the percentage of forced expiratory volume in the first second to the expected value (FEV 1% pred) and the ratio of forced expiratory volume in the first second to forced vital capacity (FEV 1/FVC), 6-minute walk test (6MWT) and COPD Assessment Test (CAT). Results:Finally, 55 cases were included in the control group and 59 cases were included in the comprehensive management group. The control group included 32 males and 23 females, aged (67.31 ± 7.14) years. The comprehensive management group included 39 males and 20 females, aged (68.15 ± 6.34) years. The respiratory rehabilitation compliance score, FEV 1% pred, FEV 1/FVC, 6MWT, and CAT score of the full management group after intervention were as follows: (26.45 ± 1.51) points, (59.21 ± 6.68)%, (78.35 ± 8.01)%, (479.63 ± 54.70) m, and (12.35 ± 4.01) points, which were all better than the control group′s (15.68 ± 1.56) points, (44.09 ± 6.31)%, (68.38 ± 6.43)%, (429.82 ± 60.50) m, and (17.03 ± 4.23) points. The difference between two groups were significant ( t values were 1.83-5.24, all P<0.05). Conclusions:The pulmonary rehabilitation integarted care management model based on Internet of things platform improves patient compliance, enhances pulmonary function, enhance their activity endurance, and improve their quality of life. It is worth promoting and using in clinical practice.

Objective:To analyze the current situation and influencing factors of information need for cardiac rehabilitation of urban and rural patients with coronary heart disease, and explore the inequality of information need for cardiac rehabilitation among urban and rural patients with coronary heart disease and its influencing factors, so as to provide a scientific reference for formulating targeted cardiac rehabilitation programs.Methods:From June to July 2024, hospitalized patients with coronary heart disease from a Class A tertiary hospital in Suzhou City were selected by convenience sampling as the study subjects. A General Information Questionnaire, Information Need in Cardiac Rehabilitation Hospital Anxiety and Depression Scale, Health Literacy Management Scale, and Coronary Artery Disease Self-Management Scale were used to conduct a questionnaire survey. Multiple linear regression was used to analyze the influencing factors of the cardiac rehabilitation information needs and the oaxaca-blinder model was used to analyze the causes of unequal information needs in urban and rural patients.Results:A total of 254 hospitalized patients with coronary heart disease who met the inclusion and exclusion criteria were surveyed, included 127 males and 127 females, 182 of them were aged 60 years or older. The total cardiac rehabilitation information needs score of rural and urban patients with coronary heart disease were 168.00 (115.50, 255.00) and 213.00 (132.00, 255.00), respectively, the difference was significant ( U = 5 389.50, P<0.05). Multiple regression analysis showed that health literacy ( β = 0.871, P<0.05) was the influencing factor of cardiac rehabilitation information needs of rural coronary heart disease patients, and depression ( β = 0.719, P<0.05) and living status ( β = -0.186, P<0.05) was the influencing factor of cardiac rehabilitation information needs of urban coronary heart disease patients. Average monthly household income per capita (C = 14.50%) and health literacy (C = 88.30%) were the main causes of the difference in cardiac rehabilitation information needs between urban and rural patients with coronary heart disease. Conclusions:The information demand for cardiac rehabilitation of patients with coronary heart disease in rural area is lower than that in urban areas in Suzhou, mainly due to health literacy and monthly income. It is recommended to narrow the urban-rural gap by improving rural health literacy, optimizing medical insurance policies, and promoting a multi-level rehabilitation service network.

Objectives:To investigate the long-term efficacy of balloon assisted endplate reduction with vertebral augmentation combined with pedicle screw fixation in the treatment of thoracolumbar burst fractures, and to compare the clinical efficacy of calcium sulfate cement (CSC) and calcium phosphate cement(CPC).Methods:This study is a retrospective cohort study.The clinical data of 39 patients with thoracolumbar burst fractures admitted to Hefei Hospital Affiliated to Anhui Medical University from November 2013 to December 2017 were retrospectively analyzed.All patients were treated with pedicle screw reduction and fixation of the injured vertebra,balloon-assisted reduction of the collapsed endplate of the injured vertebra,and artificial bone vertebral body augmentation,and the follow-up time was >5 years.There were 24 males and 15 females,aged (42.9±13.3) years (range: 29 to 56 years).According to the Frankel spinal nerve dysfunction grading standard, there were 4 cases of grade C, 7 cases of grade D and 28 cases of grade E. There were 21 cases of CSC augmentation(CSC group) and 18 cases of CPC augmentation (CPC group). X-ray and CT were performed at 1 week, 1-, 2-, 5-year after surgery and at the last follow-up, and the imaging indicators were measured, including the injured vertebra anterior edge height ratio,the injured vertebra middle height ratio,the injured vertebra wedge angle,and the sagittal plane Cobb angle. The pain visual analogue scale (VAS) and the Oswestry disability index (ODI) was used for functional evaluation, nervous function was evaluated according to the Frankel spinal nerve dysfunction grading standard.Independent sample t test was used for inter-group comparison, and paired sample t test and repeated measure ANOVA were used for intra-group comparison. Results:All operative procedures were successfully completed, no spinal nerve function damage occurred. The postoperative imaging indexes of the patients were significantly improved compared with those before surgery (all P<0.01). The follow-up time of patients was (6.7±2.8)years (range: 5 to 9 years). Among the 11 patients with symptoms of neurological impairment before surgery, 9 patients completely recovered at the last follow-up, and 2 patients recovered from Frankel grade C to D. There were no significant differences in imaging indexes between the first week after surgery and the last follow-up in the CPC group (all P>0.05), while there were significant differences in imaging indexes between the CSC group and the last follow-up (all P<0.05). CPC group was superior to CSC group in frontal height ratio, middle height ratio, wedge angle variation and sagittal Cobb angle correction loss at 2 year, 5 year after surgery and the last follow-up, with statistical significance (all P<0.05). At the last follow-up, there were no differences in VAS and ODI between the two groups (all P>0.05). After absorption of CSC in the filling area, a hardened zone was formed around the area, and the central cavity remained without bone tissue filling. CPC absorption was very slow, and the CPC group was still filled satisfactorily at the last follow-up. Conclusions:Balloon assisted endplate reduction and vertebral augmentation combined with pedicle screw fixation through the injured vertebra have good long-term efficacy in the treatment of thoracolumbar burst fractures. Compared with CSC, CPC vertebral augmentation can better maintain the shape and spinal sequence of the injured vertebra in the long term, and can effectively reduce the collapse of the space above the injured vertebra.

ObjectiveTo understand the mortality trends among residents of Fuling District， Chongqing， before and after theCOVID-19 outbreak， and to provide references for the government to formulate disease prevention and control policies and measures. MethodsData on mortality and population in Fuling District from 2017 to 2022 were collected to analyze population mortality and standardized mortality rates， and to compare the changes in the causes of death by year and before and after the pandemic. ResultsFrom 2017 to 2022， the crude mortality rate in Fuling District showed an upward trend （APC=3.04%， P<0.05）， while the standardized mortality rate showed a downward trend （APC=-6.47%， P<0.01）. The mortality rate of males was higher than that of females （P<0.05）， with different age groups having different causes of death composition. The highest proportion of deaths in 0-year-old group was from infectious diseases， maternal and neonatal diseases， and nutritional deficiencies， the highest proportion of deaths in the 1‒24 age group， with the exception of those aged 5‒9， was from injuries， and the main cause of death for residents aged 25 and above was chronic diseases. The mortality rate of mental and behavioral disorders rose from the 13th to the 9th place. According to the epidemic situation of COVID-19， there were no changes in the top five causes of death among the entire population. The motility rate of endocrine， nutritional and metabolic diseases rose from the sixth to the fifth place in male population， and the motility rate of malignant tumor rose from the 3rd to the 2nd place in female population. ConclusionThere are no changes in the top five causes of death among the entire population of Fuling District before and after the COVID-19 outbreak. Chronic diseases remain the main cause of death. It is necessary to control the risk factors for cardiovascular and cerebrovascular diseases such as hypertension， diabetes， and dyslipidemia， and to curb the rising trend of mortality rates from strokes and acute myocardial infarction. For deaths caused by accidental injuries， targeted health education should be conducted for different populations.

Objective:To investigate the association between plasma anti-Müllerian hormone(AMH) levels and ischemic stroke.Methods:In this case-control study, 93 ischemic stroke patients were randomly selected as the case group from a study on the prevention and treatment of metabolic syndrome, which was conducted in 2018-2019 in Changshu, Jiangsu Province, while 372 nonischemic stroke patients were selected as the control group according to the principle of 1∶4 matching.An enzyme-linked immunosorbent assay was used to measure plasma AMH levels.The conditional logistic regression model and restricted cubic spline were used to analyze the relationship between AMH levels and ischemic stroke.Results:A total of 465 subjects with an average age of (68.7±7.4)years were included in this study, of whom 215(46.2%)were men and 250(53.8%)were women.According to our conditional Logistic regression analysis, the risk of ischemic stroke was reduced by 44% for every unit increase in the log-AMH level( OR=0.56, 95% CI: 0.37-0.85)in the overall population after multivariate adjustment.Compared with the tertile with the lowest AMH level, the risk of ischemic stroke in the tertile with the highest AMH level decreased significantly( OR=0.37, 95% CI: 0.19-0.69). When subgrouped by sex, the tertiles with the highest AMH levels were associated with a 66% lower risk of ischemic stroke in men( OR=0.34, 95% CI: 0.13-0.88)and a 64% lower risk of ischemic stroke in women( OR=0.36, 95% CI: 0.15-0.87), compared with the tertiles with the lowest AMH levels.The results of restricted cubic spline analysis showed that there was a linear dose-response relationship between plasma AMH levels and ischemic stroke both in the general population and in male or female population( Pvalues for linear trends were 0.0002, 0.008 and 0.007, respectively). Conclusions:Higher plasma AMH levels decrease the risk of ischemic stroke with a dose-response pattern.

Objectives:To investigate the long-term efficacy of balloon assisted endplate reduction with vertebral augmentation combined with pedicle screw fixation in the treatment of thoracolumbar burst fractures, and to compare the clinical efficacy of calcium sulfate cement (CSC) and calcium phosphate cement(CPC).Methods:This study is a retrospective cohort study.The clinical data of 39 patients with thoracolumbar burst fractures admitted to Hefei Hospital Affiliated to Anhui Medical University from November 2013 to December 2017 were retrospectively analyzed.All patients were treated with pedicle screw reduction and fixation of the injured vertebra,balloon-assisted reduction of the collapsed endplate of the injured vertebra,and artificial bone vertebral body augmentation,and the follow-up time was >5 years.There were 24 males and 15 females,aged (42.9±13.3) years (range: 29 to 56 years).According to the Frankel spinal nerve dysfunction grading standard, there were 4 cases of grade C, 7 cases of grade D and 28 cases of grade E. There were 21 cases of CSC augmentation(CSC group) and 18 cases of CPC augmentation (CPC group). X-ray and CT were performed at 1 week, 1-, 2-, 5-year after surgery and at the last follow-up, and the imaging indicators were measured, including the injured vertebra anterior edge height ratio,the injured vertebra middle height ratio,the injured vertebra wedge angle,and the sagittal plane Cobb angle. The pain visual analogue scale (VAS) and the Oswestry disability index (ODI) was used for functional evaluation, nervous function was evaluated according to the Frankel spinal nerve dysfunction grading standard.Independent sample t test was used for inter-group comparison, and paired sample t test and repeated measure ANOVA were used for intra-group comparison. Results:All operative procedures were successfully completed, no spinal nerve function damage occurred. The postoperative imaging indexes of the patients were significantly improved compared with those before surgery (all P<0.01). The follow-up time of patients was (6.7±2.8)years (range: 5 to 9 years). Among the 11 patients with symptoms of neurological impairment before surgery, 9 patients completely recovered at the last follow-up, and 2 patients recovered from Frankel grade C to D. There were no significant differences in imaging indexes between the first week after surgery and the last follow-up in the CPC group (all P>0.05), while there were significant differences in imaging indexes between the CSC group and the last follow-up (all P<0.05). CPC group was superior to CSC group in frontal height ratio, middle height ratio, wedge angle variation and sagittal Cobb angle correction loss at 2 year, 5 year after surgery and the last follow-up, with statistical significance (all P<0.05). At the last follow-up, there were no differences in VAS and ODI between the two groups (all P>0.05). After absorption of CSC in the filling area, a hardened zone was formed around the area, and the central cavity remained without bone tissue filling. CPC absorption was very slow, and the CPC group was still filled satisfactorily at the last follow-up. Conclusions:Balloon assisted endplate reduction and vertebral augmentation combined with pedicle screw fixation through the injured vertebra have good long-term efficacy in the treatment of thoracolumbar burst fractures. Compared with CSC, CPC vertebral augmentation can better maintain the shape and spinal sequence of the injured vertebra in the long term, and can effectively reduce the collapse of the space above the injured vertebra.