To analyze the relationship between serum non-HDL-C levels and cardiovascular disease (CVD) mortality in community populations. A retrospective cohort study was conducted using the Yuecheng District Health Information Platform in Shaoxing City, Zhejiang Province. The study cohort included individuals aged 40 years or older with no prior history of CVD who underwent physical examinations at Yuecheng District healthcare institutions between January and December 2019. A total of 39 038 participants were included, including 19 085 males (48.9%) and 19 953 females (51.1%), with a mean age of (73.64±9.10) years. The mean follow-up duration was 52.3 months. During follow-up, 1 227 CVD death events occurred. The results indicated a significant overall association between non-HDL-C levels and the risk of CVD mortality, including coronary heart disease (CHD) and stroke. Cox models indicated that, using the ideal level of non-HDL-C as the reference, the hazard ratios (HRs) for risk of CVD death in the suitable level, borderline elevated level and elevated level groups were 1.24 (95% CI: 1.08-1.42), 1.57 (95% CI: 1.34-1.85) and 2.31 (95% CI: 1.87-2.86), respectively. The corresponding HRs for CHD death were 1.39 (95% CI: 1.10-1.76), 1.69 (95% CI: 1.28-2.12) and 2.53 (95% CI: 1.76-3.64), respectively. Subgroup analysis revealed significant interaction effects between non-HDL-C and sex, smoking, alcohol consumption, and diabetes (all P interaction<0.05). Sensitivity analyses confirmed that results were consistent with the primary findings regarding the association between non-HDL-C and CVD mortality risk. In conclusion, increasing non-HDL-C levels are associated with higher risks of death from cardiovascular diseases, including stroke and CHD. The risk of CVD death associated with elevated non-HDL-C is greater among males, individuals with a history of diabetes, smokers or drinkers. In the future, attention should be paid to the monitoring of non-HDL-C in community health management, and the intensive and personalized management of blood lipids in high-risk population should be strengthened.

To analyze the relationship between serum non-HDL-C levels and cardiovascular disease (CVD) mortality in community populations. A retrospective cohort study was conducted using the Yuecheng District Health Information Platform in Shaoxing City, Zhejiang Province. The study cohort included individuals aged 40 years or older with no prior history of CVD who underwent physical examinations at Yuecheng District healthcare institutions between January and December 2019. A total of 39 038 participants were included, including 19 085 males (48.9%) and 19 953 females (51.1%), with a mean age of (73.64±9.10) years. The mean follow-up duration was 52.3 months. During follow-up, 1 227 CVD death events occurred. The results indicated a significant overall association between non-HDL-C levels and the risk of CVD mortality, including coronary heart disease (CHD) and stroke. Cox models indicated that, using the ideal level of non-HDL-C as the reference, the hazard ratios (HRs) for risk of CVD death in the suitable level, borderline elevated level and elevated level groups were 1.24 (95% CI: 1.08-1.42), 1.57 (95% CI: 1.34-1.85) and 2.31 (95% CI: 1.87-2.86), respectively. The corresponding HRs for CHD death were 1.39 (95% CI: 1.10-1.76), 1.69 (95% CI: 1.28-2.12) and 2.53 (95% CI: 1.76-3.64), respectively. Subgroup analysis revealed significant interaction effects between non-HDL-C and sex, smoking, alcohol consumption, and diabetes (all P interaction<0.05). Sensitivity analyses confirmed that results were consistent with the primary findings regarding the association between non-HDL-C and CVD mortality risk. In conclusion, increasing non-HDL-C levels are associated with higher risks of death from cardiovascular diseases, including stroke and CHD. The risk of CVD death associated with elevated non-HDL-C is greater among males, individuals with a history of diabetes, smokers or drinkers. In the future, attention should be paid to the monitoring of non-HDL-C in community health management, and the intensive and personalized management of blood lipids in high-risk population should be strengthened.

Objective In response to the new landscape of the DIP payment reform,this study uses a public tertiary comprehensive hospital in Jingzhou as a case study.By focusing on disease analysis,it explores refined operational management strategies to promote the hospital's transformation,upgrade,and operational efficiency.Methods Starting from July 2022,a problem-oriented approach was employed to analyze the characteristics of disease structure using methods such as the Boston Ma-trix,Pareto Analysis,and the Onion Method.A multidisciplinary operational management model was adopted to provide targeted supervision to departments for improving diagnosis and treatment processes,optimizing disease types and cost structures,and im-plementing refined management.Results The sample departments showed continuous growth in medical service capabilities,with the number of disease types increasing by 5.76％year-on-year and the number of discharges rising by 20.9％.The CMI val-ue for DIP-related drug consumption increased by 0.22.The economic structure improved significantly,with average drug costs per inpatient decreasing by 14.19％and average material costs dropping by 30.62％.Medical insurance settlements saw substan-tial improvement,with losses reduced by over 80％.Operational efficiency was notably enhanced,with the average length of stay decreasing by 1.0 days year-on-year.Patient experience improved,with satisfaction rates exceeding 97％.Conclusion The re-fined operational management model based on disease analysis under the DIP framework can facilitate efficient hospital operations,promote rational use of medical insurance funds,and effectively reduce patient burdens,leading to a win-win situation for all stakeholders.

Objective:To understand the genetic variations of the coding gene of the main neutralizing antigen VP7 of G9 group A rotavirus in Xiamen area and the difference between VP7 gene in some domestic and broad areas. Methods:Four types G9 group A rotavirus strains were collected from feces of children with diarrhea in Xiamen Children′s Hospital. The time of collection was October 5, 2017, November 12, 2017, December 7, 2017 and January 15, 2018, respectively. The full-length sequence of type G9 group A rotavirus VP7 gene was obtained by reverse transcription polymerase chain reaction, and the homology, phylogenetic and amino acid sequence alignment were analyzed by using DNA Star, MEGA and other biological software. Results:Phylogenetic tree analysis showed that the local strain of Amoy CHINA/2018 in Xiamen area and the human/SC7/CHN/2013/G9 local strain in Chengdu City had the most closely relationship in the evolutionary tree clusters, and the homology was far from the Hu/JS2016 local strain in Jiangsu Province. The amino acid sequence analysis showed that compared with the reference strain WI61, the Xiamen local strains had variations in the amino acid primary structure, including D100N and Y144H, which were representative mutation sites in the Amoy CHINA/2018 phylogenetic tree cluster.Conclusion:The full-length genome sequence of the type G9 group A rotavirus VP7 shows that the strain is mutated in China.

Objective To investigate the epidemiological characteristics and genotypes of group A rotavirus (RV-A) among inpatients and outpatients children with diarrhea in Xiamen to provide basic data and theoretical basis for prevention and treatment of rotavirus diarrhea.Methods A total of 5 787 fecal samples from children under 10 years old in four hospitals in Xiamen from Jan 2016 to Dec 2017 were detected by immunochromamatoraphy double antibody sandwich assay.Systematic sampling was applied for collection of 98 fecal samples from 1 435 samples with rotavirus positive.Reverse transcription nested PCR was applied for determination of G and P genotypes.Results Among the 5 787 patients, 1 435 specimens were detected to be RV positive (24.8%).Genotyping of 98 rotaviruses showed that G9 (69.4%) was the most predominant , followed by G2 (5.1%), G1 (4.1%) and G3 (1.0%).Twenty cases were undetermined as G type.For P types, P[8]was predominant, accounting for 75.5%and the prevalence of P [4] was 5.1%.Nineteen cases were undetermined as P type.The combination of genotypes were P [8] G9 (64.3%), followed by P[4] G2 (5.1%), P[8]G1 (4.1%) and P[8] G3 (1.0%).Conclusions Rotavirus is the main pathogen among infants and children with diarrhea in Xiamen.P[8]G9 is the most prevalent genotypes.Continuously monitoring RV-A epidemic genotypes is helpful to provide data for local prevention and control of RV -A infection and introduction of rotavirus vaccine.

Currently,a physiologically based pharmacokinetic(PBPK)model plays a key role in pharmaceutical research,which has been widely used at each stage of drug discovery and develop?ment. In the process of drug discovery,the selection of drug candidates is finished using the PBPK model to predict the pharmacokinetic properties of the drugs. In the process of preclinical development , through a combination of in vitro and physiological data amplification coefficient,the PBPK model can be used to predict not only the overall pharmacokinetic behavior of drug candidates in humans and animals and in vitro metabolism experiments,but also drug-drug interactions(DDI). In the course of clinical development,the PBPK model can help predict the difference between reference populations (age,different disease state,and polymorphism),especially the dosage and sampling time of the children. At present,the input parameters of PBPK model are mostly the mean values of the population,making it difficult to serve individuals. It is hoped that the input parameters of the model can reflect more of the individual characters according to the individual requirement,and that the time parameters of the input accord more with the actual physiological condition. In this article ,we briefly introduced the characteristics of common PBPK software,and reviewd the principle and feature of the PBPK model,as well as its application to drug discovery,preclinical development and clinical development,DDI,and individualized medication.

Objectives To evaluate the effect of the positive psychology intervention on SWB in elderly patients with chronic obstructive pulmonary disease(COPD).Methods A total of 108 patients with COPD were divided into control group and intervention group according to the principle of control matches,with 54 patients in each group.Patients in intervention group received a period of three months of positive psychology oriented psychological journal ,patients in control group were blank.Before and after the intervention,both groups of patients were assessed by Memorial University of Newfoundland Scale of Happiness (MNusH) and 12 General Health Questionnaire (GHQ-12),and used t tests andx2 test to compare two groups of patients,as well as the intervention group itself differences.Results After the intervention,the score of MNusH in the intervention group was (35.8 ± 8.3),which was significant higher than that of in the control group,t=7.110,P ＜0.05.The scores of positive emotion and positive experience of MNusH Scale of patients in intervention group were higher than control group,the scores of negative emotions and negative experience of patients in intervention group were lower than control group,the difference was statistically significant,t value was 3.269,6.878,8.156 and 7.801respectively,P ＜0.05.The intervention significantly reduced the incidence of psychological disorder of patients,x2=42.335,P＜0.05.Conclusion Positive psychology interventions can effectively improve negative emotions of the elderly hospitalized COPD patients,improve SWB of the elderly patients with COPD.

Objective To investigate the revaccination efficacy of different dosages of hepatitis B vaccine among adult non-and hyporesponders so as to improve the protection rate of hepatitis B vaccination.Methods The healthy adults who were immunized with hepatitis B vaccine at least one standard scheme in two years and negative for hepatitis B markers were enrolled in this randomized and open-label study.The hepatitis B vaccine was injected intramuscularly in the deltoid muscle on an upper arm according to routine schedule (month 0,1,6).The adults were randomly given four different dosages:73 in group A were given hepatitis B vaccine 10 μg (made in China) each time;69 in group B were given hepatitis B vaccine (made in China) 20 μg each time;70 in group C were given gene recombinant yeast hepatitis B vaccine (Engerix) 20 μg each time and 48 in group D were given gene recombinant yeast hepatitis B vaccine 40 μg each time.The serum anti-HBs was tested before and 1,2,8,12 months after the first injection.The comparison of means was done by one-factor analysis of variance and the comparison of rates was done by chi square test.Results The anti-HBs positive rates were the highest at months 8 of re-immunization in group B,C and D,which were 68.1%,70.0% and 77.1%,respectively,and were all higher than that in group A (53.4%)(χ2=21.465,P＜0.01).The anti-HBs positive rate increased in group B,C and D with increasing immunized times and over time,but there was no significant difference;it went down at 12 months after re-immunization.The anti-HBs positive rates at 1,2,8 and 12 months after re-immunization in group A were 8.2%,19.2%,53.4% and 43.8%,respectively and differences were significant (χ2=53.07,P＜0.01).The anti-HBs levels in group B,C and D were all higher than that of group A(F=7.551,P＜0.05) at month 12 of re-immunization.There were no significant differences of anti-HBs levels at different re-immunization time points in group B,C and D.Conclusion Revaecination of hepatitis B vaccine can induce immune responses and increasing dosages can improve the immune efficacy in non- and hyporesponders.

Objective To evaluate Chinese children’s blood lead levels(BLLs) and identify the distribution features with time and to provide the data for developing the policy to control environmental lead pollution.Methods The papers on children BLLs published from 2004 to Aug.2007 with sampling time since 2001 were collected,by searching Chinese Biomedical Disk(CBMDisk),Chinese Journal Full-test Database(CJFD) and other ways.Thirty-five articles eligible for inclusion criteria were reviewed.Also,the data were compared with our former study carried out in 2004 with articles studying time between 1995 and 2003.Results The mean BLL of Chinese children between 2001 and 2007 was 80.7 ?g/L(45.5-165.3 ?g/L),and 23.9%(3.2%-80.7%)were higher than 100 ?g/L,both of which were lower than the levels in 1995 to 2003.Four of 24 provinces or cities reported had average BLLs≥100 ?g/L.Of the 24 provinces or cities,only four had higher BLL and prevalence rates of lead poisoning(BLL ≥100 ?g/L) than that in 1995 to 2003.The mean BLL of children living in industrial areas was higher than that of children in urban and suburbs areas,and the mean BLL in suburbs was higher compared with urban areas.Boys BLL was 79.3 ?g/L,significantly higher than girls(76.9 ?g/L)(P

In recent years, neurobehavioral end point was often used in environmental epidemiological researches to assess and characterize the adverse effects of environmental pollutants. The applications of neurobehavioral evaluation not only improve the ability to identify the early, sub clinic adverse effects of environmental pollutants exposure, but also help to screen out the victims for further protection. At present, there are many neurobehavioral evaluation methods have been applied in the environmental epidemiological researches at home and abroad, some methods that are considered applicable in China were reviewed in this article.