BACKGROUND: Pulmonary arterial hypertension (PAH) presents a significant health burden in Asia and remains a critical challenge. This study aims to delineate the PAH burden in Asia from 1990 to 2021. METHODS: Using the latest data from the Global Burden of Disease 2021, we evaluated and analyzed the distributions and patterns of PAH disease burden among various age groups, sexes, regions, and countries in Asia. Additionally, we examined the associations between PAH disease burden and key health system indicators, including the socio-demographic index (SDI) and the universal health coverage (UHC) index. RESULTS: In 2021, there were 25,989 new PAH cases, 103,382 existing cases, 13,909 PAH-associated deaths, and 385,755 DALYs attributed to PAH in Asia, which accounted for approximately 60% of global PAH cases. The age-standardized rates (ASRs) for prevalence and deaths were 2.05 (95% uncertainty interval [UI]: 1.66-2.52) per 100,000 population and 0.31 (95% UI: 0.23-0.38) per 100,000 population, respectively. From 1990 to 2021, Asia reported the lowest ASRs for PAH prevalence but the highest ASRs for deaths compared to other continents. While the ASRs for prevalence increased slightly, ASRs for mortality and DALYs decreased over time. This increasing burden of PAH was primarily driven by population growth and aging. The burden was especially pronounced among individuals aged ≥60 years and <9 years, who collectively accounted for the majority of deaths and DALYs. Moreover, higher SDI and UHC levels were linked to reduced incidence, but higher prevalence rates. CONCLUSIONS Although progress has been made in reducing PAH-related mortality and DALYs, the disease continues to impose a substantial burden in Asia, particularly among older adults and young children. Region-specific health policies should focus on improving early diagnosis, expanding access to treatment, and effectively addressing the growing PAH burden in the region.
Humans ; Global Burden of Disease ; Male ; Female ; Middle Aged ; Adult ; Asia/epidemiology* ; Prevalence ; Aged ; Pulmonary Arterial Hypertension/mortality* ; Adolescent ; Young Adult ; Child ; Child, Preschool ; Infant ; Hypertension, Pulmonary/epidemiology*

BACKGROUND:The inferior pole of the patella is very important for the integrity and stability of the knee extensor mechanism and maintaining good knee joint function.Currently,there is no unified surgical method for the clinical treatment of inferior pole patella fractures,but effective internal fixation should have the ability to counteract the tensile stress of the quadriceps and patellar ligament,the flexion stress of the femoral condyle,and the separation and displacement of the fracture ends.OBJECTIVE:A three-dimensional model of patellar inferior pole fracture was established by finite element method to compare the fixation effect and biomechanical stability of Kirschner-tension band,Kirschner-tension band combined with encircling,Kirschner-tension band combined with longitudinal binding,so as to provide a reliable surgical choice for clinical treatment of patellar inferior pole fracture.METHODS:A healthy female volunteer was selected to undergo CT scan of the knee joint,and a model of the fracture of the inferior pole of the patella was constructed using finite element software.According to different internal fixation methods,they were divided into three groups:A,B and C.Group A received tension-band wiring;group B received tension-band wiring combined with cerclage wiring,and group C received tension-band wiring combined with separate vertical wiring.Under the same support and constraint conditions,the biomechanical properties of the three internal fixation models were evaluated by finite element analysis software.RESULTS AND CONCLUSION:The results of finite element analysis showed that group C had the smallest displacement of the whole model,the patella and the internal fixator,and the smallest stress of the model and the internal fixator compared with group A and group B when different loads were applied in the direction of 45°.It is indicated that compared with Kirschner-tension band wiring and Kirschner-tension band wiring combined with cerclage wiring,Kirschner-tension band wiring combined with separate vertical wiring exhibits smaller displacement and stress,with superior biomechanical strength,providing a more reliable internal fixation.Theoretically,it is sufficient to meet the needs of patients to perform functional exercises after surgery in the early postoperative period.

BACKGROUND:There is currently still no absolute standard for internal fixation of plates in the treatment of proximal humerus fractures in clinical practice,but reconstruction of the medial humeral distance and effective resistance to inversion displacement of the humeral head are the key points in achieving strong fixation of proximal humerus fractures.OBJECTIVE:Finite element analysis techniques were used to obtain the mechanical differences between these three internal fixation modalities acting on proximal humerus fractures and to compare which internal fixation method provides more stable fixation support.METHODS:A healthy female volunteer was selected to undergo CT scanning of the left shoulder joint,and finite element analysis software was used to construct a model of proximal humerus fracture with medial column support defect.The model was categorized into three groups based on different internal fixation methods.In group A,Philos plate fixation was applied only on the lateral side.In group B,Philos plate fixation was applied on the lateral side combined with miniature straight-locking compression plate fixation on the medial side.In group C,Philos plate fixation was applied on the lateral side combined with miniature straight-locking compression plate fixation on the anterior medial side.The biomechanical stability of these three groups of internal fixation models was evaluated using ANSYS analysis software under the same fixation support and constraint conditions.RESULTS AND CONCLUSION:(1)The stress of the internal fixation in the three groups of internal fixation models did not exceed 450 MPa.(2)The stress of the humerus and internal fixation in group A was higher than that in groups B and C under different loading conditions,whereas the stress of the humerus and internal fixation in group C was the minimum.(3)Under the flexion loading condition,the relative displacement in group C had a smaller value than that in groups A and B.(4)The relative displacement of the fracture end in group B was the smallest under all the loading conditions.The relative displacement of group B was about half of that of group A under the loading conditions of internal retraction,abduction,and axial compression.(5)The relative displacements between group C and group B were not significantly different,and all of the relative displacements in group C were smaller than those in group A as well.(6)It was found that the combination of the lateral Philos plate and the medial miniature in-line locking compression plate,as well as the combination of the lateral Philos plate and the anterior medial miniature in-line locking compression plate,demonstrated significant stability of the internal fixation system compared with the application of the lateral Philos plate alone.However,when comparing the combination of the lateral Philos plate with the medial miniature in-line locking compression plate and the combination of the lateral Philos plate with the anterior medial miniature in-line locking compression plate,no significant difference in internal fixation system stability was observed.Considering the difficulty of operation in clinical practice,the combination of lateral Philos plate and anterior medial miniature in-line locking compression plate may bring better treatment results in the treatment of proximal humerus fractures.

BACKGROUND:The inferior pole of the patella is very important for the integrity and stability of the knee extensor mechanism and maintaining good knee joint function.Currently,there is no unified surgical method for the clinical treatment of inferior pole patella fractures,but effective internal fixation should have the ability to counteract the tensile stress of the quadriceps and patellar ligament,the flexion stress of the femoral condyle,and the separation and displacement of the fracture ends.OBJECTIVE:A three-dimensional model of patellar inferior pole fracture was established by finite element method to compare the fixation effect and biomechanical stability of Kirschner-tension band,Kirschner-tension band combined with encircling,Kirschner-tension band combined with longitudinal binding,so as to provide a reliable surgical choice for clinical treatment of patellar inferior pole fracture.METHODS:A healthy female volunteer was selected to undergo CT scan of the knee joint,and a model of the fracture of the inferior pole of the patella was constructed using finite element software.According to different internal fixation methods,they were divided into three groups:A,B and C.Group A received tension-band wiring;group B received tension-band wiring combined with cerclage wiring,and group C received tension-band wiring combined with separate vertical wiring.Under the same support and constraint conditions,the biomechanical properties of the three internal fixation models were evaluated by finite element analysis software.RESULTS AND CONCLUSION:The results of finite element analysis showed that group C had the smallest displacement of the whole model,the patella and the internal fixator,and the smallest stress of the model and the internal fixator compared with group A and group B when different loads were applied in the direction of 45°.It is indicated that compared with Kirschner-tension band wiring and Kirschner-tension band wiring combined with cerclage wiring,Kirschner-tension band wiring combined with separate vertical wiring exhibits smaller displacement and stress,with superior biomechanical strength,providing a more reliable internal fixation.Theoretically,it is sufficient to meet the needs of patients to perform functional exercises after surgery in the early postoperative period.

BACKGROUND:There is currently still no absolute standard for internal fixation of plates in the treatment of proximal humerus fractures in clinical practice,but reconstruction of the medial humeral distance and effective resistance to inversion displacement of the humeral head are the key points in achieving strong fixation of proximal humerus fractures.OBJECTIVE:Finite element analysis techniques were used to obtain the mechanical differences between these three internal fixation modalities acting on proximal humerus fractures and to compare which internal fixation method provides more stable fixation support.METHODS:A healthy female volunteer was selected to undergo CT scanning of the left shoulder joint,and finite element analysis software was used to construct a model of proximal humerus fracture with medial column support defect.The model was categorized into three groups based on different internal fixation methods.In group A,Philos plate fixation was applied only on the lateral side.In group B,Philos plate fixation was applied on the lateral side combined with miniature straight-locking compression plate fixation on the medial side.In group C,Philos plate fixation was applied on the lateral side combined with miniature straight-locking compression plate fixation on the anterior medial side.The biomechanical stability of these three groups of internal fixation models was evaluated using ANSYS analysis software under the same fixation support and constraint conditions.RESULTS AND CONCLUSION:(1)The stress of the internal fixation in the three groups of internal fixation models did not exceed 450 MPa.(2)The stress of the humerus and internal fixation in group A was higher than that in groups B and C under different loading conditions,whereas the stress of the humerus and internal fixation in group C was the minimum.(3)Under the flexion loading condition,the relative displacement in group C had a smaller value than that in groups A and B.(4)The relative displacement of the fracture end in group B was the smallest under all the loading conditions.The relative displacement of group B was about half of that of group A under the loading conditions of internal retraction,abduction,and axial compression.(5)The relative displacements between group C and group B were not significantly different,and all of the relative displacements in group C were smaller than those in group A as well.(6)It was found that the combination of the lateral Philos plate and the medial miniature in-line locking compression plate,as well as the combination of the lateral Philos plate and the anterior medial miniature in-line locking compression plate,demonstrated significant stability of the internal fixation system compared with the application of the lateral Philos plate alone.However,when comparing the combination of the lateral Philos plate with the medial miniature in-line locking compression plate and the combination of the lateral Philos plate with the anterior medial miniature in-line locking compression plate,no significant difference in internal fixation system stability was observed.Considering the difficulty of operation in clinical practice,the combination of lateral Philos plate and anterior medial miniature in-line locking compression plate may bring better treatment results in the treatment of proximal humerus fractures.

The health effects associated with environmental pollutants remain one of the major public health issues at present. The research method focusing on the population as the research subjects is limited by reliable cohorts, and the research method targeting individual molecules cannot fully reflect the biological health effects under environmental pollutant stress. Using high-throughput multi-omics, machine learning, and epigenetic detection to conduct targeted research and joint analysis on cells, organoids, organs, animals, and humans in different biological dimensions will help provide data support for the study of potential targets and biological effects of environmental pollutants, providing a theoretical basis for the risk assessment and safety evaluation of environmental pollutants.

Objective:To investigate the value of modified early warning score (MEWS) combined with D-dimer test in the establishment of an acute pancreatitis severity evaluation model.Methods:The clinical data of 357 patients with acute pancreatitis who received treatment in the Second Affiliated Hospital of Anhui Medical University, China between January 2017 and December 2018 were collected for this study. The receiver operating characteristic curve was used to determine the optimal cut-off value of MEWS combined with D-dimer test for predicting non-mild acute pancreatitis. The relationship between MEWS and D-dimer level was analyzed using regression analysis. The area under the curve (AUC) was used to evaluate the ability of each factor to predict the severity of acute pancreatitis. The sensitivity and specificity of the new model to predict non-mild acute pancreatitis were calculated.Results:According to the receiver operating characteristic curve, the AUC of D-dimer, MEWS, and new model were 0.702, 0.628 and 0.734 respectively ( P < 0.05). The AUC of the new model in predicting non-mild acute pancreatitis was significantly higher than that of MEWS and D-dimer test (0.734 > 0.702 > 0.628, Z = 3.20, P < 0.01). Conclusion:The ability of the new model established based on MEWS and D-dimer to predict the severity of acute pancreatitis is stronger than that of each of MEWS and D-dimer. The new model is simple, convenient and more suitable for clinical use.

Objective:To explore the clinical efficacy of internal fixation with a reduction plate assisted by our self-designed lower extremity fracture traction reduction device for tibial plateau fractures of Schatzker type Ⅵ.Methods:A retrospective study was conducted of the 32 patients with tibial plateau fracture of Schatzker type Ⅵ who had been treated at Orthopaedic Department, Mindong Hospital Affiliated to Fujian Medical University from April 2018 to July 2021. Depending on their treatments, they were divided into 2 groups. In the control group of 16 cases subjected to open reduction and internal fixation with manual traction, there were 9 males and 7 females with an age of 50.0±11.7 years; in the observation group of 16 cases subjected to internal fixation with a reduction plate assisted by our self-designed lower extremity fracture traction reduction device, there were 8 males and 8 females with an age of 54.6±11.1 years. The operation time, fracture reduction time, total incision length, intraoperative blood loss, Rasmussen knee function score and maximum active range of knee motion were compared between the 2 groups.Results:There was no significant difference in the preoperative general data between the 2 groups, showing comparability between the groups ( P>0.05). The operation time [(158.6±26.0) min], fracture reduction time [(61.6±9.6) min], and total incision length [16.0 (13.3, 17.0) cm] in the observation group were significantly shorter than those in the control group [(199.9±60.9) min, (73.8±17.2) min, and 20.0 (17.0, 21.8) cm]; the intraoperative blood loss [175.0 (100.0, 200.0) mL] in the observation group was significantly less than that in the control group [200.0 (162.5, 387.5) mL]; the maximum active ranges of knee motion at one week and one month in the observation group were 94.9°±12.0° and 113.8°±14.1°, significantly larger than those in the control group (78.3°±14.6° and 96.8°±11.4°) (all P<0.05). Fractures achieved bony union at one year after operation in both groups. At 12 months after operation, there was no significant difference in the maximum active range of knee motion or the Rasmussen knee function score between the 2 groups ( P>0.05). Conclusion:In the treatment of Schatzker type Ⅵ tibial plateau fractures, compared with manual traction and open reduction, internal fixation with a reduction plate assisted by our self-designed lower extremity fracture traction reduction device can shorten operation time and total incision length, reduce intraoperative blood loss, and facilitate postoperative functional recovery of the knee for the patients.

Objective:To investigate the cognitive frailty of inpatients in Department of Geriatrics and analyze its influencing factors.Methods:This study was a cross-sectional study. Using the convenient sampling method, inpatients in Department of Geriatrics who were treated in Xuanwu Hospital of Capital Medical University were selected from June 2019 to June 2020. A total of 486 elderly patients who met the inclusion and exclusion criteria completed the questionnaire survey, physical examination and laboratory examination. The FRAIL Frailty Assessment Scale and Mini-Mental State Examination (MMSE) were used to evaluate cognitive frailty. Single factor analysis and Logistic regression were used to analyze the influencing factors of cognitive frailty in elderly inpatients.Results:The age of the survey subjects was (77.99±10.47) years old and the prevalence of cognitive impairment was 37.45% (182/486) . Logistic regression analysis showed that patients with a history of falls within 1 year, drinking, older age, anemia and ADL decline had a higher risk of cognitive impairment ( P<0.05) . Conclusions:The incidence of cognitive frailty is higher in elderly inpatients. Reducing the risk of falls, abstaining from alcohol, improving anemia and intervening to improve the ability of self-care in daily life may help to improve the cognitive frailty of the elderly.

Cases of 2019-nCoV nucleic acid and antibody (IgM and IgG total antibody) after discharge from a hospital in Chongqing were continuously monitored. It was found that 5 cases of "re-positive" phenomenon, 5 cases of antibody were positive, and there was a trend of increasing with time. "Re-Positive" may be related to the following three factors. Children with asymptomatic infection had a long time of fecal detoxification.There were two consecutive nucleic acid tests "false negative" caused by various reasons.The virus clearance in patients was not complete, and the discharge standard was not conservative enough. The analysis of the causes of "Re-Positive" patients and the discussion of its infection will help us reveal more characteristics of this virus, and to provide a new basis for the discharge standard in the constantly updated diagnosis and treatment programme.