1.The predictive value of stress hyperglycemia ratio on in-hospital mortality and mechan-ical complications in patients with acute ST-segment elevation myocardial infarction
Shiheng ZHOU ; Zhen TAN ; Lei LIU ; Kai TANG ; Xuejun DENG ; Yijun LIU
Chinese Journal of Arteriosclerosis 2025;33(5):427-434
Aim To explore the predictive value of stress hyperglycemia ratio(SHR)for in-hospital mortality and mechanical complications in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods This study constituted a retrospective investigation that collected 995 patients diagnosed with acute STEMI at Suining Central Hospital from June 2019 to July 2023.Comparisons of baseline data were conducted using t-test,Mann-Whitney U test and chi-square test;Logistic regression was used to analyze the association between SHR and the risk of in-hospital mortality and mechanical complications in acute STEMI patients;Restricted cubic spline analysis based on the Logistic re-gression model was utilized to explore non-linear relationship between SHR and the risk of in-hospital mortality and mechan-ical complications;ROC curve was used to evaluate the diagnostic efficacy of SHR;Subgroup analysis was used to assess the predictive efficacy of SHR in each subgroup.Results Patients with high SHR had a significantly higher cardiovas-cular mortality(P=0.007).High SHR was an independent risk factor for in-hospital all-cause mortality(Model 1:OR=3.085,95% CI:1.719~5.538,P<0.001;Model 2:OR=2.738,95% CI:1.4439~5.132,P=0.002),cardiovascular mortality(Model 1:OR=3.406,95% CI:1.869~6.228,P<0.001;Model 2:OR=3.053,95% CI:1.595~5.817,P<0.001),ventricular aneurysm(Model 1:OR=3.203,95%CI:1.665~6.069,P<0.001;Model2:OR=3.93,95%CI:1.785~8.663,P<0.001),cardiac rupture(Model 1:OR=2.461,95% CI:1.389~4.312,P=0.002;Model 2:OR=2.302,95% CI:1.214~4.274,P=0.009)and composite endpoint(Model 1:OR=3.719,95% CI:2.226~6.332,P<0.001;Model 2:OR=2.919,95% CI:1.576~5.405,P<0.001)in patients with acute STEMI.SHR was positively correlated in a linear relationship with the risk of in-hospital all-cause mortality(P for non-linearity=0.250),cardiovascular mortality(P for non-linearity=0.129),ventricular aneurysm(P for non-linearity=0.588),cardiac rupture(P for non-linearity=0.787)and composite endpoint(P for non-linearity=0.399).The SHR had excellent diagnostic efficacy for in-hospital all-cause mortality(AUC=0.694),cardiovascular mortality(AUC=0.697),ventricular aneurysm(AUC=0.706),cardiac rupture(AUC=0.667)and composite endpoint(AUC=0.730),meanwhile SHR predicted efficacy consistently across subgroups.Conclusions High SHR is an independent risk factor for in-hospital all-cause mortality,cardiovascular mortality and cardiac mechanical complications in patients with a-cute STEMI.SHR holds significant predictive value for the prognosis of patients with STEMI.
2.Expert recommendations on mass population vaccination
Wen WANG ; Chunhuan ZHANG ; Yong HUANG ; Qi ZHU ; Shiheng CUI ; Yan LIU ; Zhiwei ZHU ; Fang HUANG ; Lin TANG ; Zhoubin ZHANG ; Wenzhou YU
Chinese Journal of Preventive Medicine 2025;59(1):1-7
Mass vaccination represents a highly effective strategy for accelerating disease control while simultaneously reducing incidence and mortality rates. By developing comprehensive plans and standards for mass vaccination, it is feasible to optimize resource allocation and swiftly enhance vaccination coverage, thereby preventing, controlling, or interrupting outbreaks or epidemics of specific infectious diseases. To standardize the mass vaccination process and establish a population immunity barrier in an orderly, efficient, and safe manner, a panel of experts was convened to develop the Recommendations on Mass Vaccination. These recommendations are grounded in the requirements of relevant policies and regulations in China, as well as the insights gained from the mass vaccination campaign for COVID-19 vaccines conducted in the country. The recommendations outline the system requirements pertaining to initiation conditions, departmental coordination, responsibilities, mobilization, operational specifications, and responses to vaccine reactions, among other aspects of mass vaccination implementation, so as to serve as a reference for future mass vaccination initiatives and the formulation of related policies.
3.Expert recommendations on mass population vaccination
Wen WANG ; Chunhuan ZHANG ; Yong HUANG ; Qi ZHU ; Shiheng CUI ; Yan LIU ; Zhiwei ZHU ; Fang HUANG ; Lin TANG ; Zhoubin ZHANG ; Wenzhou YU
Chinese Journal of Preventive Medicine 2025;59(1):1-7
Mass vaccination represents a highly effective strategy for accelerating disease control while simultaneously reducing incidence and mortality rates. By developing comprehensive plans and standards for mass vaccination, it is feasible to optimize resource allocation and swiftly enhance vaccination coverage, thereby preventing, controlling, or interrupting outbreaks or epidemics of specific infectious diseases. To standardize the mass vaccination process and establish a population immunity barrier in an orderly, efficient, and safe manner, a panel of experts was convened to develop the Recommendations on Mass Vaccination. These recommendations are grounded in the requirements of relevant policies and regulations in China, as well as the insights gained from the mass vaccination campaign for COVID-19 vaccines conducted in the country. The recommendations outline the system requirements pertaining to initiation conditions, departmental coordination, responsibilities, mobilization, operational specifications, and responses to vaccine reactions, among other aspects of mass vaccination implementation, so as to serve as a reference for future mass vaccination initiatives and the formulation of related policies.
4.The predictive value of stress hyperglycemia ratio on in-hospital mortality and mechan-ical complications in patients with acute ST-segment elevation myocardial infarction
Shiheng ZHOU ; Zhen TAN ; Lei LIU ; Kai TANG ; Xuejun DENG ; Yijun LIU
Chinese Journal of Arteriosclerosis 2025;33(5):427-434
Aim To explore the predictive value of stress hyperglycemia ratio(SHR)for in-hospital mortality and mechanical complications in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods This study constituted a retrospective investigation that collected 995 patients diagnosed with acute STEMI at Suining Central Hospital from June 2019 to July 2023.Comparisons of baseline data were conducted using t-test,Mann-Whitney U test and chi-square test;Logistic regression was used to analyze the association between SHR and the risk of in-hospital mortality and mechanical complications in acute STEMI patients;Restricted cubic spline analysis based on the Logistic re-gression model was utilized to explore non-linear relationship between SHR and the risk of in-hospital mortality and mechan-ical complications;ROC curve was used to evaluate the diagnostic efficacy of SHR;Subgroup analysis was used to assess the predictive efficacy of SHR in each subgroup.Results Patients with high SHR had a significantly higher cardiovas-cular mortality(P=0.007).High SHR was an independent risk factor for in-hospital all-cause mortality(Model 1:OR=3.085,95% CI:1.719~5.538,P<0.001;Model 2:OR=2.738,95% CI:1.4439~5.132,P=0.002),cardiovascular mortality(Model 1:OR=3.406,95% CI:1.869~6.228,P<0.001;Model 2:OR=3.053,95% CI:1.595~5.817,P<0.001),ventricular aneurysm(Model 1:OR=3.203,95%CI:1.665~6.069,P<0.001;Model2:OR=3.93,95%CI:1.785~8.663,P<0.001),cardiac rupture(Model 1:OR=2.461,95% CI:1.389~4.312,P=0.002;Model 2:OR=2.302,95% CI:1.214~4.274,P=0.009)and composite endpoint(Model 1:OR=3.719,95% CI:2.226~6.332,P<0.001;Model 2:OR=2.919,95% CI:1.576~5.405,P<0.001)in patients with acute STEMI.SHR was positively correlated in a linear relationship with the risk of in-hospital all-cause mortality(P for non-linearity=0.250),cardiovascular mortality(P for non-linearity=0.129),ventricular aneurysm(P for non-linearity=0.588),cardiac rupture(P for non-linearity=0.787)and composite endpoint(P for non-linearity=0.399).The SHR had excellent diagnostic efficacy for in-hospital all-cause mortality(AUC=0.694),cardiovascular mortality(AUC=0.697),ventricular aneurysm(AUC=0.706),cardiac rupture(AUC=0.667)and composite endpoint(AUC=0.730),meanwhile SHR predicted efficacy consistently across subgroups.Conclusions High SHR is an independent risk factor for in-hospital all-cause mortality,cardiovascular mortality and cardiac mechanical complications in patients with a-cute STEMI.SHR holds significant predictive value for the prognosis of patients with STEMI.
5.The predictive value of peripheral blood-derived inflammatory markers SII and SIRI for in-hospital adverse cardiovascular events in patients with acute myocardial infarc-tion
Kai TANG ; Lei LIU ; Zhen TAN ; Gang ZHUANG ; Xuejun DENG ; Shiheng ZHOU
Chinese Journal of Arteriosclerosis 2024;32(7):606-612
Aim To investigate the relationship between systemic inflammatory immune index(SII)and systemic inflammatory response index(SIRI)and the risk of in-hospital major adverse cardiovascular events(MACE)in patients with acute myocardial infarction(AMI).Methods Retrospective analysis was conducted on AMI patients ad-mitted to the Second Cardiovascular Disease Area of Suining Central Hospital from February 2021 to May 2022.Based on inclusion and exclusion criteria,246 patients were finally enrolled.According to whether MACE occurred during hospital-ization,they were divided into event group and non-event group,and baseline data of the two groups were compared.All variables except SII and SIRI were included in a univariate-multivariate Logistic regression analysis to screen factors af-fecting the risk of MACE,and were used as significant covariates for adjustment to evaluate the relationship between SII and SIRI and the risk of MACE respectively.Results The results of multivariate Logistic regression analysis showed that emergency PCI,left ventricular ejection fraction,albumin level and age were significant factors affecting the risk of in-hos-pital MACE in AMI patients(OR=0.432,95%CI:0.194~0.960,P=0.038;OR=0.930,95%CI:0.890~0.969,P=0.001;OR=0.730,95%CI:0.621~0.845,P<0.001;OR=1.143,95%CI:1.070~1.228,P<0.001),and a basic model was established based on this.After adjusting for the significant covariates,SII and SIRI were both independ-ent risk factors for in-hospital MACE(OR=1.004,95%CI:1.001~1.008,P=0.002;OR=4.467,95%CI:2.597~8.142,P<0.001).The areas under the curves of SII and SIRI were 0.658 and 0.785,respectively,and the optimal cutoff values were 434.83 and 1.03.Restricted cubic spline analysis showed that SII(Nonlinear P=0.639)and SIRI(Nonlinear P=0.683)were linearly related to the risk of MACE after adjusting significant covariates.Threshold effect a-nalysis showed that when SIRI>0.93,the risk of MACE began to increase.Conclusion Elevated levels of SII and SI-RI are independent risk predictors for the occurrence of in-hospital MACE in AMI patients.
6.Path analysis of quality of life in stroke patients based on structural equation model
Shiheng TANG ; Jingshan LIN ; Yiyang WANG ; Xiaoxuan QIAO ; Yuxia LI
Chinese Journal of Nursing 2023;58(22):2747-2753
Objective To construct a structural equation model to analyze the effect of various factors on the quality of life in stroke patients.Methods In this cross-sectional study,a total of 657 stroke patients from 2 ter-tiary A hospitals in Shanghai were enrolled as investigation subjects via convenience sampling methodology.General information questionnaire,Sense of Coherence Scale-13,Perceived Social Support Scale,Medical Coping Modes Questionnaire,National Institutes of Health Stroke Scale,Self-Esteem Scale and Stroke-Specific Quality of Life were utilized as the investigating tools;Mplus 7.4 was used to construct a structural equation model.Results The aver age score of quality of life in stroke patients was(178.30±30.30);neurological status,self-esteem were negatively cor-related with quality of life(P<0.05);sense of coherence,social support,coping style were positively correlated with quality of life(P<0.05);sense of coherence,taking a confrontational approach for coping,yielding and neurological status had a direct impact on quality of life(path coefficients were 0.471,0.169、0.135,-0.089,P<0.05);social sup-port,self-esteem,sense of coherence and neurological status had an indirect impact on quality of life(path coefficients were 0.232,0.108,0.058,-0.058,P<0.001).Conclusion The quality of life in stroke patients is influenced by multi-ple factors interactively,and sense of coherence is an important factor affecting the quality of life;adopting a confron-tational approach as coping styles,good social support and high self-esteem can improve the level of quality of life.

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