Heart failure(HF)is the final stage of various cardiovascular diseases.The period of high incidence of death and readmission in patients with HF within 2 to 3 months after discharge is defined as the"vulnerable period".The management of vulnerable period focuses on how to identify high-risk groups with the need of close follow-up and more active intervention.Despite the application of various effective medical treatment and nursing strategies,readmissions in HF patients remain high,which not only poses a significant financial burden on the healthcare system but also carries the prognostic impact of worsening survival associated with repeated hospitalizations.Remote monitoring is a promising approach for early detection of worsening HF and intervention before apparent decompensation.Remote monitoring includes patient reporting of remote vital signs monitoring,wearable devices,information from cardiac implantable electronic devices and invasive remote hemodynamic monitoring.Remote cardiac monitoring devices have developed rapidly.A wide variety of monitoring devices have been developed,and trials have been conducted to explore the availability and safety of remote monitoring devices and their effectiveness in reducing the risk of HF re-hospitalization.Wearable devices are easy to be accepted by patients because of their non-invasive,portable,cost and other factors.

BACKGROUND:Polyether ether ketone has the advantages of elastic modulus close to human cortical bone,good ray transmission,chemical stability,and biocompatibility.Polyether ether ketone is expected to be applied in the field of oral implants.However,polyether ether ketone is bioinert and is difficult to integrate with surrounding bone tissue.Therefore,how to improve the surface bioactivity of polyether ether ketone remains a major issue.OBJECTIVE:To analyze the osteogenic and vasogenic effects of polyether ether ketone surface bone forming peptide 1 and polydopamine composite coating.METHODS:Polyether ether ketone titanium sheets were immersed in dopamine solution for 24 hours to prepare polyether ether ketone-polydopamine materials.Polyether ether ketone-polydopamine material was immersed in the bone forming peptide 1 solution for 24 hours to prepare polyether ether ketone-polydopamine-bone forming peptide 1 material.The micromorphology,hydrophilicity,and elemental composition of the material were characterized.Bone marrow mesenchymal stem cells were injected on the surface of polyether ether ketone,polyether ether ketone-polydopamine,and polyether ether ketone-polydopamine-bone forming peptide-1 materials.Cell viability and adhesion status were evaluated by live/dead cell staining and cytoskeleton staining.Cellular osteogenic differentiation ability was detected by alizarin red and osteocalcin immunofluorescence staining.Human umbilical vein endothelial cells were inoculated on the surface of three groups of materials.Cell viability and angiogenesis level were assessed by live/dead cell staining and immunofluorescence staining of cytoskeleton/vascular endothelial growth factor.RESULTS AND CONCLUSION:(1)Under scanning electron microscope,the surface of polyether ether ketone material was smooth;the surface of polyether ether ketone-polydopamine material had uneven deposits,and the surface of polyether ether ketone-polydopamine-bone forming peptide 1 material had small particles protruding.The results of contact angle test showed that the hydrophilicity of polyether ether ketone-polydopamine-bone forming peptide-1 material was better than the other two materials.X-ray photoelectron spectroscopy results showed that bone forming peptide 1 had been successfully modified on the surface of polyether ether ketone material.(2)Live/dead cell staining and cytoskeleton staining exhibited that compared with the other two materials,polyether ether ketone-polydopamine-bone-forming peptide 1 material could improve the viability and adhesion of bone marrow mesenchymal stem cells.Alizarin red and osteocalcin immunofluorescence staining showed that compared with the other two materials,polyether ether ketone-polydopamine-bone forming peptide-1 materials could promote the osteogenic differentiation of bone marrow mesenchymal stem cells.(3)Live/dead cell staining and immunofluorescence staining showed that compared with the other two materials,polyether ether ketone-polydopamine-bone forming peptide 1 material could improve the viability and adhesion of human umbilical vein endothelial cells and the expression of vascular endothelial growth factor protein.(4)The results show that the modification of bone forming peptide 1 and polydopamine composite coating on polyether ether ketone surface can improve the osteogenesis and angiogenesis.

Ergonomic Principle for the Prevention of Work-Related Musculoskeletal Disorders Part 1: General Principles (T/WSJD 14.1-2020) is the first guideline standard for the prevention of work-related musculoskeletal disorders provided to employers and occupational health technical service institutions in China, which covers ergonomic risk factors and their hazard definition, ergonomic prevention principles, risk assessment process, risk control process and risk evaluation principles. The standard specifically clarify the specific types of adverse ergonomic risk factors and control strategies and the standard process of systematic ergonomic risk assessment, providing implementation paths and practical guidance for eliminating/reducing adverse ergonomic risks and enhance workplace environments to prevent work-related musculoskeletal disorders. This paper interprets and analyzes the background of standard establishment, formulation process, fundamental basis, and main content, etc., to provide scientific and accurate technical support for enterprise managers, labours and technical personnel of occupational health institutions to optimize the use of this standard.

Objective To understand the changing trend of nutritional status of children undergoing liver transplantation within 6 months after discharge,and to explore its influencing factors,in order to provide guidance for the clinical formulation of personalized nutritional intervention programs.Methods By the convenient sampling method,153 children undergoing liver transplantation admitted to the liver transplantation center of a tertiary A hospital in Hangzhou from January 2023 to January 2024 were selected as the research subjects.Their basic and clinical data were collected.The nutritional status at the 1 day before surgery and 1 month,3 months,and 6 months after discharge was evaluated by the standard deviation evaluation method of children's nutritional status.According to the changing trend of their nutritional status,they were grouped.Univariate and multivariate Logistic regression were used to analyze the influencing factors of the changing trend of nutritional status in children undergoing liver transplantation.Results A total of 144 children who underwent liver transplantation were ultimately included in the study.The incidence of malnutrition at 1 month,3 months,and 6 months after discharge was 66.0％,54.9％,and 53.5％,respectively.According to the changing trend of nutritional status of children undergoing liver transplantation,they were divided into 3 groups:54 cases(37.5％)in the good nutritional status group,24 cases(16.7％)in the fluctuating nutritional status group,and 66 cases(45.8％)in the poor nutritional status group.The results of multivariate Logistic regression analysis showed that birth weight,feeding method within 6 months after birth,age of caregivers and learning situation of nutritional knowledge were the influencing factors of the changing trend of nutritional status in children undergoing liver transplantation(P＜0.05).Conclusion The incidence of malnutrition in children undergoing liver transplantation is high within 6 months after discharge;medical staff should closely collaborate with families to formulate and implement staged personalized nutritional intervention measures based on the specific conditions and influencing factors of the children to effectively improve the nutritional status of the children after transplantation.

Objective:To analyze the situation of outpatient patients diagnosed with carpal tunnel syndrome (CTS) due to typical hand symptoms and evaluate the diagnostic factors of CTS patients.Methods:Through an electronic medical record information system, a retrospective analysis was conducted on the data of outpatient patients diagnosed with CTS with "numbness and pain in the hands" as the complaints from January 1, 2018 to December 31, 2022 in eight medical institutions including Peking University Third Hospital, Third People's Hospital of Guizhou Province, Zhejiang Provincial People's Hospital Bijie Hospital, then the demographic characteristics and diagnostic factors such as symptoms, signs, and auxiliary examinations were analyzed. Chi-square test was used to compare the differences in CTS diagnosis rates between different genders and age groups.Results:There were a total of 43105 outpatients with complaints of "numbness and pain in the hands" over the past 5 years, of whom 754 were diagnosed with CTS, with a diagnostic rate of 1.7%. The there were 166 males and 588 females diagnosed with CTS, and the diagnostic rate of female patients was significantly higher than that of male patients ( χ2=158.13, P<0.001). Among the CTS patients, the proportion of patients aged 45 to 60 was the highest (43.8%, 330/754), and there was a statistically significant difference in CTS diagnosis rates among patients of different age groups ( χ2=36.99, P<0.001). All CTS patients had varying degrees of hand symptoms, and some had definite abnormalities in auxiliary examinations such as physical examination, wrist ultrasound, MRI or neuroelectrophysiology. Conclusion:The diagnosis rate of CTS among outpatients presenting with complaints of "numbness and pain in the hands" is relatively low, and there are gender and age distribution differences. In addition to typical clinical symptoms, the diagnosis of CTS also requires objective evidence from physical examination and further auxiliary examinations.

Objective:To explore the value of three-dimensional automatic right ventricular quantitive analysis（3D Auto RVQ）technology in predicting the improvement of left ventricular ejection fraction（LVEF）in patients with heart failure with reduced ejection fraction（HFrEF）.Methods:A retrospective analysis was conducted on 89 HFrEF patients admitted to the Cardiology Department of Central China Fuwai Hospital of Zhengzhou University from April 2022 to June 2024. All patients received medication treatment and were further divided into heart failure with improved ejection fraction（HFimpEF）group and non HFimpEF group based on changes detected by echocardiography in LVEF after treatment. The clinical data，biological indicators，and medication treatment status of patients were collected，routine echocardiographic parameters and right ventricular strain parameters were measured，3D right ventricular ejection fraction（3D-RVEF），3D right ventricular stroke volume index（3D-RVSVI），3D right ventricular end-diastolic volume index（3D-RVEDVI），3D right ventricular end-systolic volume index（3D-RVESVI），3D tricuspid annular plane systolic excursion（3D-TAPSE），and 3D right ventricular fractional area change（3D-RVFAC）were measured using 3D Auto RVQ technology. The differences of the above parameters between the two groups were compared. The ROC curve was used to analyze the predictive efficiency of right ventricular parameters for HFimpEF，and the area under ROC curve（AUC）was calculated and compared. Logistic regression models were used to analyze the predictive value of right ventricular parameters for HFimpEF.Results:Compared with the non HFimpEF group，the HFimpEF group had a younger age，shorter heart failure course，a smaller proportion of males，New York Heart Association（NYHA）functional class ≥Ⅲ，and patients with concomitant coronary heart disease. The baseline LVEF，absolute value of two dimensional right ventricular global longitudinal strain（2D-RVGLS），3D-RVEF，3D-TAPSE，and 3D-RVSVI were higher in the HFimpEF group（all P<0.05）. ROC curve analysis showed that the AUC of 3D-RVEF for predicting HFimpEF was 0.858，and the predictive efficiency was higher than other right ventricular parameters. According to the Yoden index，the optimal cutoff value for predicting HFimpEF based on 3D-RVEF was 36.2%，with a corresponding sensitivity of 84.0% and specificity of 75.0%. After adjusting for clinical and other echocardiographic parameters，the logistic regression model showed that 3D-RVEF was an independent predictor of HFimpEF（ OR=1.435，95% CI=1.145-1.800， P<0.05）. Conclusions:The 3D-RVEF evaluated by 3D Auto RVQ technology has high predictive value for HFimpEF，which can provide a reference for clinical treatment，thereby improving the prognosis of HFrEF patients.

Objective To understand the changing trend of nutritional status of children undergoing liver transplantation within 6 months after discharge,and to explore its influencing factors,in order to provide guidance for the clinical formulation of personalized nutritional intervention programs.Methods By the convenient sampling method,153 children undergoing liver transplantation admitted to the liver transplantation center of a tertiary A hospital in Hangzhou from January 2023 to January 2024 were selected as the research subjects.Their basic and clinical data were collected.The nutritional status at the 1 day before surgery and 1 month,3 months,and 6 months after discharge was evaluated by the standard deviation evaluation method of children's nutritional status.According to the changing trend of their nutritional status,they were grouped.Univariate and multivariate Logistic regression were used to analyze the influencing factors of the changing trend of nutritional status in children undergoing liver transplantation.Results A total of 144 children who underwent liver transplantation were ultimately included in the study.The incidence of malnutrition at 1 month,3 months,and 6 months after discharge was 66.0％,54.9％,and 53.5％,respectively.According to the changing trend of nutritional status of children undergoing liver transplantation,they were divided into 3 groups:54 cases(37.5％)in the good nutritional status group,24 cases(16.7％)in the fluctuating nutritional status group,and 66 cases(45.8％)in the poor nutritional status group.The results of multivariate Logistic regression analysis showed that birth weight,feeding method within 6 months after birth,age of caregivers and learning situation of nutritional knowledge were the influencing factors of the changing trend of nutritional status in children undergoing liver transplantation(P＜0.05).Conclusion The incidence of malnutrition in children undergoing liver transplantation is high within 6 months after discharge;medical staff should closely collaborate with families to formulate and implement staged personalized nutritional intervention measures based on the specific conditions and influencing factors of the children to effectively improve the nutritional status of the children after transplantation.

Objective:To analyze the situation of outpatient patients diagnosed with carpal tunnel syndrome (CTS) due to typical hand symptoms and evaluate the diagnostic factors of CTS patients.Methods:Through an electronic medical record information system, a retrospective analysis was conducted on the data of outpatient patients diagnosed with CTS with "numbness and pain in the hands" as the complaints from January 1, 2018 to December 31, 2022 in eight medical institutions including Peking University Third Hospital, Third People's Hospital of Guizhou Province, Zhejiang Provincial People's Hospital Bijie Hospital, then the demographic characteristics and diagnostic factors such as symptoms, signs, and auxiliary examinations were analyzed. Chi-square test was used to compare the differences in CTS diagnosis rates between different genders and age groups.Results:There were a total of 43105 outpatients with complaints of "numbness and pain in the hands" over the past 5 years, of whom 754 were diagnosed with CTS, with a diagnostic rate of 1.7%. The there were 166 males and 588 females diagnosed with CTS, and the diagnostic rate of female patients was significantly higher than that of male patients ( χ2=158.13, P<0.001). Among the CTS patients, the proportion of patients aged 45 to 60 was the highest (43.8%, 330/754), and there was a statistically significant difference in CTS diagnosis rates among patients of different age groups ( χ2=36.99, P<0.001). All CTS patients had varying degrees of hand symptoms, and some had definite abnormalities in auxiliary examinations such as physical examination, wrist ultrasound, MRI or neuroelectrophysiology. Conclusion:The diagnosis rate of CTS among outpatients presenting with complaints of "numbness and pain in the hands" is relatively low, and there are gender and age distribution differences. In addition to typical clinical symptoms, the diagnosis of CTS also requires objective evidence from physical examination and further auxiliary examinations.

A 15-year-old boy developed abdominal pain and melena two weeks after COVID-19 infection, which was followed by gross hematuria and proteinuria. Laboratory studies revealed significantly elevated inflammatory markers. Endoscopic examinations showed multiple jejunal and ileal ulcers. Renal biopsy suggested mesangial proliferative glomerulonephritis with crescent formation, necrosis of capillary loops, and mesangial IgA deposits. IgA vasculitis without purpura was considered as a possible diagnosis, and the treatment with prednisone led to remission of both gastrointestinal and renal diseases.

Objective:To explore the value of three-dimensional automatic right ventricular quantitive analysis（3D Auto RVQ）technology in predicting the improvement of left ventricular ejection fraction（LVEF）in patients with heart failure with reduced ejection fraction（HFrEF）.Methods:A retrospective analysis was conducted on 89 HFrEF patients admitted to the Cardiology Department of Central China Fuwai Hospital of Zhengzhou University from April 2022 to June 2024. All patients received medication treatment and were further divided into heart failure with improved ejection fraction（HFimpEF）group and non HFimpEF group based on changes detected by echocardiography in LVEF after treatment. The clinical data，biological indicators，and medication treatment status of patients were collected，routine echocardiographic parameters and right ventricular strain parameters were measured，3D right ventricular ejection fraction（3D-RVEF），3D right ventricular stroke volume index（3D-RVSVI），3D right ventricular end-diastolic volume index（3D-RVEDVI），3D right ventricular end-systolic volume index（3D-RVESVI），3D tricuspid annular plane systolic excursion（3D-TAPSE），and 3D right ventricular fractional area change（3D-RVFAC）were measured using 3D Auto RVQ technology. The differences of the above parameters between the two groups were compared. The ROC curve was used to analyze the predictive efficiency of right ventricular parameters for HFimpEF，and the area under ROC curve（AUC）was calculated and compared. Logistic regression models were used to analyze the predictive value of right ventricular parameters for HFimpEF.Results:Compared with the non HFimpEF group，the HFimpEF group had a younger age，shorter heart failure course，a smaller proportion of males，New York Heart Association（NYHA）functional class ≥Ⅲ，and patients with concomitant coronary heart disease. The baseline LVEF，absolute value of two dimensional right ventricular global longitudinal strain（2D-RVGLS），3D-RVEF，3D-TAPSE，and 3D-RVSVI were higher in the HFimpEF group（all P<0.05）. ROC curve analysis showed that the AUC of 3D-RVEF for predicting HFimpEF was 0.858，and the predictive efficiency was higher than other right ventricular parameters. According to the Yoden index，the optimal cutoff value for predicting HFimpEF based on 3D-RVEF was 36.2%，with a corresponding sensitivity of 84.0% and specificity of 75.0%. After adjusting for clinical and other echocardiographic parameters，the logistic regression model showed that 3D-RVEF was an independent predictor of HFimpEF（ OR=1.435，95% CI=1.145-1.800， P<0.05）. Conclusions:The 3D-RVEF evaluated by 3D Auto RVQ technology has high predictive value for HFimpEF，which can provide a reference for clinical treatment，thereby improving the prognosis of HFrEF patients.