OBJECTIVE: Chronic obstructive pulmonary disease (COPD) is a major health concern in northwest China; however, the impact of particulate matter (PM) exposure during sand-dust storms (SDS) remains poorly understood. Therefore, this study aimed to investigate the association between PM exposure on SDS days and COPD hospitalization risk in arid regions. METHODS: Data on daily COPD hospitalizations were collected from 323 hospitals from 2018 to 2022, along with the corresponding air pollutant and meteorological data for each city in Gansu Province. Employing a space-time-stratified case-crossover design and conditional Poisson regression, we analyzed 265,379 COPD hospitalizations. RESULTS: PM exposure during SDS days significantly increased COPD hospitalization risk [relative risk ( RR) for PM _2.5, lag 3:1.028, 95% confidence interval ( CI): 1.021-1.034], particularly among men and the elderly, and during the cold season. The burden of PM exposure on COPD hospitalization was substantially high in Northwest China, especially in the arid and semi-arid regions. CONCLUSION Our findings revealed a positive correlation between PM exposure during SDS episodes and elevated hospitalization rates for COPD in arid and semi-arid zones in China. This highlights the urgency of developing region-specific public health strategies to address adverse respiratory outcomes associated with SDS-related air quality deterioration.
Humans ; China/epidemiology* ; Pulmonary Disease, Chronic Obstructive/chemically induced* ; Particulate Matter/analysis* ; Hospitalization/statistics & numerical data* ; Male ; Female ; Middle Aged ; Aged ; Air Pollutants/analysis* ; Environmental Exposure/adverse effects* ; Spatio-Temporal Analysis ; Adult ; Sand ; Air Pollution

OBJECTIVE: To explore clinical efficacy of different technical combinations in treating ischemic diabetic foot (DF). METHODS: A retrospective analysis was conducted on 35 patients with DF who were treated with vascular interventional opening technique, periosteal distraction technique and bone cement coverage technique from January 2024 to November 2024. They were divided into comprehensive group and periosteal distraction group according to whether the vascular interventional opening technique was used in combination or not. There were 5 patients in comprehensive group, including 4 males and 1 female, aged from 59 to 73 years old with an average of (64.40±5.46) years old;the duration of diabetes ranged from 0.17 to 30.00 years with an average of (14.63±12.02) years;the courses of DF ranged from 30 to 150 days with an average of (84.00±61.48) days;2 patients were grade 2, 2 patients were grade 3, and 1 patient was grade 4 according to Wagner classification;combined vascular interventional opening, periosteal distraction and bone cement coverage surgery for treatment. There were 30 patients in periosteal stretch group, including 22 males and 8 females, aged from 58 to 86 years old with an average of (72.63±7.84) years old;the duration of diabetes was 10.00 (6.75, 16.75) years;the courses of DF was 30.00 (15.00, 37.50) days;14 patients were grade 2, 11 patients were grade 3, and 5 patients were grade 4 according to Wagner classification; combined periosteal distraction and bone cement coverage surgery for treatment. Changes of C-reactive protein (CRP), interleukin-6 (IL-6), and procalcitonin (PCT), toe skin temperature, peripheral capillary oxygen saturation (SpO₂), and visual analogue scale (VAS) for pain were compared between two groups before operation and 1 week after operation. The number of operations, healing period, healing number, toe amputation number, preoperative fever situation and the number of complications were compared between two groups. RESULTS: Both groups were followed up for at least 6 months. There were no statistically significant differences in the number of operations, healing period, toe amputation rate, wound healing rate and complications between two groups (P>0.05). Before operation, the toe skin temperature of comprehensive group (26.98±0.88) ℃ was lower than that of periosteal distraction group (28.17±1.45) ℃, and the difference was statistically significant (P<0.05);while there were no statistically significant difference in CRP, IL-6, PCT, toe SpO2 and VAS between two groups (P>0.05). At 1 week after operation, IL-6, toe skin temperature, toe SpO₂ and VAS in comprehensive group were 12.29(7.92, 22.15) pg·ml-1, (36.02±0.23) ℃, (95.80±0.84) % and(1.40±0.55) respectively, while those in periosteal distraction group were 5.49(4.36, 7.45) pg·ml^-1, (31.36±1.57) ℃, (84.53±6.38) %, (2.20±0.81);and there were statistically significant differences between two groups(P<0.05). CRP, IL-6 and VAS at 1 week after operation in both groups were decreased compared with those before operation, and the differences were statistically significant(P<0.05). The toe skin temperature and SpO₂ were increased compared with those before operation, and the differences were statistically significant(P<0.001). CONCLUSION The multi-technique combination therapy, including vascular interventional opening technique, periostealdistraction technique and bone cement covering technique, could protect each other, enhance efficacy, effectively promote the wound healing of ischemic diabetic foot ulcer, and reduce the toe amputation rate. For moderate to severe ischemic DF, the combined use of periosteal distraction and bone cement coverage techniques has a satisfactory effect. For extremely severe ischemic DF with inflow tract lesions, vascular interventional opening techniques need to be added.
Humans ; Male ; Female ; Middle Aged ; Aged ; Diabetic Foot/surgery* ; Retrospective Studies ; Aged, 80 and over ; Ischemia/surgery* ; Interleukin-6/metabolism*

PURPOSE: To investigate the incidence and influencing factors of bone loss in patients with spinal cord injury (SCI). METHODS: A retrospective case-control study was conducted. Patients with SCI in our hospital from January 2019 to March 2023 were collected. According to the correlation between bone mineral density (BMD) at different sites, the patients were divided into the lumbar spine group and the hip joint group. According to the BMD value, the patients were divided into the normal bone mass group (t > -1.0 standard deviation) and the osteopenia group (t ≤ -1.0 standard deviation). The influencing factors accumulated as follows: gender, age, height, weight, cause of injury, injury segment, injury degree, time after injury, start time of rehabilitation, motor score, sensory score, spasticity, serum value of alkaline phosphatase, calcium, and phosphorus. The trend chart was drawn and the influencing factors were analyzed. SPSS 26.0 was used for statistical analysis. Correlation analysis was used to test the correlation between the BMD values of the lumbar spine and bilateral hips. Binary logistic regression analysis was used to explore the influencing factors of osteoporosis after SCI. p < 0.05 was considered statistically significant. RESULTS: The incidence of bone loss in patients with SCI was 66.3%. There was a low concordance between bone loss in the lumbar spine and the hip, and the hip was particularly susceptible to bone loss after SCI, with an upward trend in incidence (36% - 82%). In this study, patients with SCI were divided into the lumbar spine group (n = 100) and the hip group (n = 185) according to the BMD values of different sites. Then, the lumbar spine group was divided into the normal bone mass group (n = 53) and the osteopenia group (n = 47); the hip joint group was divided into the normal bone mass group (n = 83) and the osteopenia group (n = 102). Of these, lumbar bone loss after SCI is correlated with gender and weight (p = 0.032 and < 0.001, respectively), and hip bone loss is correlated with gender, height, weight, and time since injury (p < 0.001, p = 0.015, 0.009, and 0.012, respectively). CONCLUSIONS The incidence of bone loss after SCI was high, especially in the hip. The incidence and influencing factors of bone loss in the lumbar spine and hip were different. Patients with SCI who are male, low height, lightweight, and long time after injury were more likely to have bone loss.
Humans ; Spinal Cord Injuries/complications* ; Male ; Female ; Retrospective Studies ; Incidence ; Adult ; Bone Density ; Middle Aged ; Case-Control Studies ; Osteoporosis/etiology* ; Lumbar Vertebrae ; Bone Diseases, Metabolic/etiology* ; Aged ; Risk Factors

Objective:To investigate the effect of emergency whole course optimized management model based on first aid effect and blood gas index on the outcome and prognosis of patients with acute myocardial ischemia.Meth-ods:A total of 105 patients with acute myocardial ischemia admitted in People's Hospital of Hai'an City between May 2020 and January 2023 were enrolled in this randomized controlled study.Patients were divided into control group(n=53)and intervention group(n=52).Patients in the control group received routine emergency nursing mode,while those in the intervention group received whole course optimized management mode of emergency nurs-ing.Patients in both groups received a one-week nursing intervention.The indexes of emergency time,cardiac function,psychological condition,blood gas indexes and incidence of adverse events during nursing were compared between the two groups.Results:Compared to those in the control group,participants in the intervention group had significant lower triage assessment time[(0.59±0.22)min vs.(3.57±0.38)min,P＜0.001],time of the first ECG[(5.30±0.84)min vs.(9.58±1.02)min,P＜0.001],venous passage time[(6.22±1.27)min vs.(15.20±2.29)min,P＜0.001],anticoagulant administration time[(9.56±1.46)min vs.(16.23±2.17)min,P＜0.001],total emergency time[(52.50±2.99)min vs.(70.34±5.32)min,P＜0.001],significant higher partial pressure of oxygen in arterial blood(PaO2)[(78.24±3.25)mmHg vs.(70.20±3.02)mmHg,P＜0.001],and sig-nificant lower left ventricular end-diastolic diameter(LVEDd)[(52.27±4.37)mm vs.(57.86±5.59)mm,P＜0.001],left ventricular end-systolic diameter(LVESd)[(35.25±3.77)mm vs.(42.51±4.29)mm,P＜0.001],scores of self-rating anxiety scale(SAS)[(31.17±5.06)points vs.(48.62±5.60)points,P＜0.001],self-rating depression scale(SDS)[(32.19±4.78)points vs.(44.93±5.91)points,P＜0.001]and partial pres-sure of carbon dioxide in arterial blood(PaCO2)[(33.00±2.70)mmHg vs.(40.72±3.15)mmHg,P＜0.001].We detected lower adverse event occurrence(12.00％vs.28.00％)in the intervention group(P=0.046).Conclu-sion:The emergency whole course optimized management may reduce the time consuming of all aspects of emergen-cy,alleviate the anxiety and depression,improve blood gas indexes,and reduce the occurrence of adverse events in patients with acute myocardial ischemia.

Widespread utilization of glyphosate has led to environmental residues,posing potential threats to ecological systems and human health.Traditional methods for detection of glyphosate are limited by specialized equipment and operational techniques,resulting in inefficient responses.Therefore,it is urgent to develop a convenient,sensitive and accurate detection method for detection of glyphosate.Herein,a new naphthalenesulfonamide-based"Turn-on"fluorescent probe was synthesized using 2-chloroaniline and dansyl chloride as raw materials through a one-step process,which showed a good linear relationship between the glyphosate concentration in concentration range of 0.003-70 μmol/L and the fluorescence intensity(R2=0.995),with a detection limit of 2.73 nmol/L(S/N=3).Analytical techniques such as nuclear magnetic resonance(NMR)spectroscopy and high-resolution mass spectrometry(HRMS)were used to investigate the interaction mechanism between the fluorescent probe and glyphosate.The results indicated that a nucleophilic substitution reaction occurred between the probe and the secondary amine(—NH—)of glyphosate,inducing a photoinduced electron transfer(PET)effect which enhanced the fluorescence intensity by 11.2 times.The probe showed good anti-interference ability towards coexisting metal ions,anions and pesticides in water.When applied to determination of glyphosate in the samples such as tap water,river water(Xiangxi River Reservoir),soil,soybeans,and corn,the spiking recoveries ranged from 94.7％to 109.9％,demonstrating the high accuracy and broad applicability of this detection method.A portable test strip based on this fluorescent probe was developed for rapid semi-quantitative analysis of glyphosate.The developed method was rapid,sensitive,and portable,providing theoretical and technical support for on-site measurement of environmental contaminants.

Objective To explore the intervention effect of the"5E"rehabilitation nursing model(Education,Encouragement,Evaluation,Exercise,and Employment)for patients with primary aldo-steronism(PA).Methods A total of 120 patients diagnosed as PA in the Cardiology Department of the Third People's Hospital of Qingdao from January 2022 to June 2024 were randomly divided into control group(n=60)and observation group(n=60).The control group received routine nursing in-tervention,while the observation group received the"5E"rehabilitation nursing intervention.Blood test indicators,clinical manifestations(blood pressure,fatigue level),score of quality of life,and nursing satisfaction rate were compared between the two groups.Results After intervention,blood so-dium,plasma aldosterone,blood creatinine,urea nitrogen,uric acid,systolic blood pressure,dias-tolic blood pressure,and scores of fatigue degree in the observation group were significantly lower than those in the control group,while blood potassium level and score of quality of life were significantly higher than those in the control group(P＜0.05).The nursing satisfaction rate in the observation group was 96.67％,which was significantly higher than 80.00％in the control group(P＜0.05).Conclusion Implementation of the"5E"rehabilitation nursing intervention during hospitalization for PA patients can improve their blood indicators and clinical symptoms,alleviate the severity of the dis-ease,and enhance their qualities of life.

Objective:To investigate the effect of emergency whole course optimized management model based on first aid effect and blood gas index on the outcome and prognosis of patients with acute myocardial ischemia.Meth-ods:A total of 105 patients with acute myocardial ischemia admitted in People's Hospital of Hai'an City between May 2020 and January 2023 were enrolled in this randomized controlled study.Patients were divided into control group(n=53)and intervention group(n=52).Patients in the control group received routine emergency nursing mode,while those in the intervention group received whole course optimized management mode of emergency nurs-ing.Patients in both groups received a one-week nursing intervention.The indexes of emergency time,cardiac function,psychological condition,blood gas indexes and incidence of adverse events during nursing were compared between the two groups.Results:Compared to those in the control group,participants in the intervention group had significant lower triage assessment time[(0.59±0.22)min vs.(3.57±0.38)min,P＜0.001],time of the first ECG[(5.30±0.84)min vs.(9.58±1.02)min,P＜0.001],venous passage time[(6.22±1.27)min vs.(15.20±2.29)min,P＜0.001],anticoagulant administration time[(9.56±1.46)min vs.(16.23±2.17)min,P＜0.001],total emergency time[(52.50±2.99)min vs.(70.34±5.32)min,P＜0.001],significant higher partial pressure of oxygen in arterial blood(PaO2)[(78.24±3.25)mmHg vs.(70.20±3.02)mmHg,P＜0.001],and sig-nificant lower left ventricular end-diastolic diameter(LVEDd)[(52.27±4.37)mm vs.(57.86±5.59)mm,P＜0.001],left ventricular end-systolic diameter(LVESd)[(35.25±3.77)mm vs.(42.51±4.29)mm,P＜0.001],scores of self-rating anxiety scale(SAS)[(31.17±5.06)points vs.(48.62±5.60)points,P＜0.001],self-rating depression scale(SDS)[(32.19±4.78)points vs.(44.93±5.91)points,P＜0.001]and partial pres-sure of carbon dioxide in arterial blood(PaCO2)[(33.00±2.70)mmHg vs.(40.72±3.15)mmHg,P＜0.001].We detected lower adverse event occurrence(12.00％vs.28.00％)in the intervention group(P=0.046).Conclu-sion:The emergency whole course optimized management may reduce the time consuming of all aspects of emergen-cy,alleviate the anxiety and depression,improve blood gas indexes,and reduce the occurrence of adverse events in patients with acute myocardial ischemia.

Objective To mine and analyze the adverse drug reaction(ADR)signals caused by tacrolimus(Tac)combined with mycophenolic acid(MPA)based on Food and Drug Administration(FDA)adverse event reporting system(FAERS)database,so as to provide reference for clinical drug combination.Methods Open Vigil 2.1 platform was used to collect adverse events reports related to Tac and MPA between the first quarter of 2004 and the first quarter of 2023.Disproportionality analysis methods were used to mine the ADR risk signals.Characteristics of the population reporting adverse events were analyzed.ADR that arose from the combination of the two drugs were compared with those specified in the instructions of the two drugs in order to screen out new ADR.Results A total of 32 866 ADR reports of Tac and MPA used in combination were retrieved,in which 17 455 cases(53.11％)were males,11 445 cases(34.82％)were females.Cases were major in age from 40 to 65 years old(13 174 cases,40.08％).ADR with high frequency mainly included pyrexia,infections and renal impairment;ADR with strong signal strength mainly included infections and skin toxicity;new ADR mainly included blood parathyroid hormone increased,heart valve incompetence and acute psychosis.Conclusion When using Tac and MPA in combination,attention and care should be paid to the high frequency,strong signal strength and new signal of ADR.

Objective To investigate the incidence rate,clinical characteristics,and prognosis of neonatal stroke in Shenzhen,China.Methods Led by Shenzhen Children's Hospital,the Shenzhen Neonatal Data Collaboration Network organized 21 institutions to collect 36 cases of neonatal stroke from January 2020 to December 2022.The incidence,clinical characteristics,treatment,and prognosis of neonatal stroke in Shenzhen were analyzed.Results The incidence rate of neonatal stroke in 21 hospitals from 2020 to 2022 was 1/15 137,1/6 060,and 1/7 704,respectively.Ischemic stroke accounted for 75％(27/36);boys accounted for 64％(23/36).Among the 36 neonates,31(86％)had disease onset within 3 days after birth,and 19(53％)had convulsion as the initial presentation.Cerebral MRI showed that 22 neonates(61％)had left cerebral infarction and 13(36％)had basal ganglia infarction.Magnetic resonance angiography was performed for 12 neonates,among whom 9(75％)had involvement of the middle cerebral artery.Electroencephalography was performed for 29 neonates,with sharp waves in 21 neonates(72％)and seizures in 10 neonates(34％).Symptomatic/supportive treatment varied across different hospitals.Neonatal Behavioral Neurological Assessment was performed for 12 neonates(33％,12/36),with a mean score of(32±4)points.The prognosis of 27 neonates was followed up to around 12 months of age,with 44％(12/27)of the neonates having a good prognosis.Conclusions Ischemic stroke is the main type of neonatal stroke,often with convulsions as the initial presentation,involvement of the middle cerebral artery,sharp waves on electroencephalography,and a relatively low neurodevelopment score.Symptomatic/supportive treatment is the main treatment method,and some neonates tend to have a poor prognosis.

Background/Aims: Chronic hepatitis C (CHC) patients who failed antiviral therapy are at increased risk for hepatocellular carcinoma (HCC). This study assessed the potential role of metformin and statins, medications for diabetes mellitus (DM) and hyperlipidemia (HLP), in reducing HCC risk among these patients. Methods: We included CHC patients from the T-COACH study who failed antiviral therapy. We tracked the onset of HCC 1.5 years post-therapy by linking to Taiwan’s cancer registry data from 2003 to 2019. We accounted for death and liver transplantation as competing risks and employed Gray’s cumulative incidence and Cox subdistribution hazards models to analyze HCC development. Results: Out of 2,779 patients, 480 (17.3%) developed HCC post-therapy. DM patients not using metformin had a 51% increased risk of HCC compared to non-DM patients, while HLP patients on statins had a 50% reduced risk compared to those without HLP. The 5-year HCC incidence was significantly higher for metformin non-users (16.5%) versus non-DM patients (11.3%; adjusted sub-distribution hazard ratio [aSHR]=1.51; P=0.007) and metformin users (3.1%; aSHR=1.59; P=0.022). Statin use in HLP patients correlated with a lower HCC risk (3.8%) compared to non-HLP patients (12.5%; aSHR=0.50; P<0.001). Notably, the increased HCC risk associated with non-use of metformin was primarily seen in non-cirrhotic patients, whereas statins decreased HCC risk in both cirrhotic and non-cirrhotic patients. Conclusions Metformin and statins may have a chemopreventive effect against HCC in CHC patients who failed antiviral therapy. These results support the need for personalized preventive strategies in managing HCC risk.