Objective To systematically evaluate toxicities of nifedipine in pregnant women with hypertension, and provide references for nifedipine’s clinical safety application. Methods Study was conducted with data from US food and drug administration adverse event reporting system（FARES） database from January 1, 2015, to March 31, 2021. Information component （IC） and reporting odds ratio（ROR）methods were applied for signal mining. Results Finally, a total of 539278 records of pregnant women with hypertension were selected for analysis, and 70 positive adverse drug event signals were detected. Premature delivery （IC₀₂₅=2.87，ROR₀₂₅=9.52）, pre-eclampsia （IC₀₂₅=1.82，ROR₀₂₅=3.82） and fetal growth restriction （IC₀₂₅=2.37，ROR₀₂₅=5.69）were positive adverse events with higher frequency. Polydactyly（IC₀₂₅=3.13， ROR₀₂₅=10.05）, fetal death（IC₀₂₅=2.93，ROR₀₂₅=8.57）and premature delivery（IC₀₂₅=2.87，ROR₀₂₅=9.52）were positive adverse events with higher intensity. Vascular resistance systemic increased, small for dates baby and fetal death corresponded to higher death rates. Conclusion Nifedipine-associated drug toxicities were detected in pregnant women with hypertension, and some adverse events with high frequency and high death rate were deserved further attention by medical staffs.

Objective:To analyze the epidemiological characteristics and infection sources of cholera in China from 2005 to 2024.Methods:A total of 2 066 cholera cases were included in the study, which were obtained from the China Disease Control and Prevention Information System (CDPCIS) of China CDC. The information on cholera clusters was downloaded from the National Public Health Emergency Event Surveillance System (PHEESS) of China CDC. A total of 128 cholera clusters were included and analyzed in this study. The epidemiological characteristics and infection sources of cholera were analyzed. The Jointpoint model was applied to analyze the incidence trend, and annual percentage change (APC) was also quantified.Results:From 2005 to 2024, a total of 2 066 cholera cases were reported, with an average of 103 cases reported annually. Specifically, the incidence showed a marked downward trend from 2004 to 2015 ( APC=-26.78%, P=0.006). During 2015-2024, the disease remained at low endemic levels, with an average of 18 reported cases annually ( APC=-2.68%, P=0.807). Cholera peak season was from May to October. A total of 24 provinces reported cholera cases, which were mainly distributed in Zhejiang, Fujian, Beijing, Jiangsu, Anhui, Guangdong, and Hainan provinces, accounting for 78.03% of the total cases. Pathogen surveillance indicated an alternating prevalence of Vibrio cholerae serogroups O1 and O139 among laboratory-confirmed cases between 2005 and 2024. There was a disparity in the dominant serogroup of Vibrio cholerae by region. The results from 128 cholera clusters indicated that cholera outbreaks frequently occurred in rural banquets (64.84%), followed by regular restaurants (13.28%). Among these, 63 clusters (49.22%) with identified infection sources indicated that foodborne transmission (95.24%) was the primary mode of cholera transmission, which mainly through seafood and aquatic products, such as soft-shelled turtles, shrimp and shellfish. The characteristics of cholera clusters caused by Vibrio cholerae serogroups O1 and O139 showed statistically significant differences in scale, attack rate, place of residence, setting, and infection source ( P<0.05). Conclusion:Cholera incidence has remained consistently low since 2015 in China, mainly in sporadic cases. Rural gatherings (e.g., wedding banquets) are the main settings for cholera clusters. The main infection sources are predominantly caused by cross-contamination due to improper processing practices of aquatic products, such as soft-shelled turtles.

Objective:To analyze the financial status of urban public hospitals in China and provide references for promoting the integration of business and finance as well as refined management in urban public hospitals.Methods:Based on the financial data of urban public hospitals in 31 provinces, autonomous regions, municipalities directly under the central government, and the Xinjiang Production and Construction Corps (excluding Hong Kong, Macao, and Taiwan) from the annual financial reports of public hospitals issued by the Department of Finance of the National Health Commission during 2019—2021, the DuPont analysis system was employed to dissect the financial status of urban public hospitals in China, with return on net assets as the core indicator. The profitability was measured by return on net assets, the operational capability was measured by the total asset turnover rate, and the debt-paying ability was measured by the short-term debt-paying ability indicator, current ratio, and the long-term debt-paying ability indicator, debt-to-asset ratio.Results:From 2019 to 2021, the number of urban public hospitals in China were 2 752, 2 797, and 2 815, respectively. The return on net assets was 8.83%, 9.29%, and 7.65%, respectively, with the changes mainly influenced by medical revevene surplus rate. The total asset turnover rate was 81.92%, 68.36%, and 73.54%, respectively, with the changes mainly affected by total assets and medical income. The current ratios were 1.23, 1.20, and 1.16, respectively, while the debt-to-asset ratios were 44.88%, 44.47%, and 43.86%, respectively, which remained at a relatively high level. The proportion of non-current assets was 53.50%, 55.26%, and 56.88%, respectively.Conclusions:From 2019 to 2021, the profitability and operational efficiency of urban public hospitals in China both declined, showing a current operational status of high asset intensity and high debt. It is recommended that national administrative departments increase financial input and optimize asset allocation. Urban public hospitals should enhance comprehensive budget management and improve the refinement level of operational management to achieve efficient and sustainable development.

Objective To explore the correlations of spatial distribution frequency map of posterior reversible encephalopathy syndrome(PRES)and cerebral microvascular density map,cerebral blood flow(CBF)map,standard template of cerebral metabolic imaging and the spatial gene transcription map of human brain based on normative analysis strategy,and to analyze the pathophysiological mechanisms of PRES.Methods Cerebral MRI data of 184 patients with PRES were retrospectively analyzed.ROI of the lesions were delineated on T1WI,then registered to Montreal Neurological Institute(MNI)standard space.The spatial distribution frequency map of PRES lesions were obtained with superposition.Spatial correlation analysis were performed to observe correlations of spatial distribution frequency map of PRES and the cerebral microvascular density map,CBF map and standard template of cerebral metabolic imaging based on large sample.The potential related gene expressions were decoded based on gene expression data of Allen human brain atlas,and the correlations of spatial parts of PRES and those expressions were observed.Results No significant correlation was found between spatial distribution frequency map of PRES and cerebral microvascular density,CBF nor distribution of neurotransmitters(all P＞0.05).PLS1 weighted genes,VEGF-A gene,AQP-4 gene and RGS2 gene were all correlated with spatial distribution of PRES(r=-0.363-0.653,all P＜0.05),among which KCNAB3 gene had the highest weight(Z=17.288).Conclusion The spatial patterns of PRES risk or protective genes in brain regions were correlated with regional distribution of PRES lesions,which was consistent with arginine vasopressin(AVP)theory of the occurrence and development of PRES.

Objective:To analyze the epidemiological characteristics and infection sources of cholera in China from 2005 to 2024.Methods:A total of 2 066 cholera cases were included in the study, which were obtained from the China Disease Control and Prevention Information System (CDPCIS) of China CDC. The information on cholera clusters was downloaded from the National Public Health Emergency Event Surveillance System (PHEESS) of China CDC. A total of 128 cholera clusters were included and analyzed in this study. The epidemiological characteristics and infection sources of cholera were analyzed. The Jointpoint model was applied to analyze the incidence trend, and annual percentage change (APC) was also quantified.Results:From 2005 to 2024, a total of 2 066 cholera cases were reported, with an average of 103 cases reported annually. Specifically, the incidence showed a marked downward trend from 2004 to 2015 ( APC=-26.78%, P=0.006). During 2015-2024, the disease remained at low endemic levels, with an average of 18 reported cases annually ( APC=-2.68%, P=0.807). Cholera peak season was from May to October. A total of 24 provinces reported cholera cases, which were mainly distributed in Zhejiang, Fujian, Beijing, Jiangsu, Anhui, Guangdong, and Hainan provinces, accounting for 78.03% of the total cases. Pathogen surveillance indicated an alternating prevalence of Vibrio cholerae serogroups O1 and O139 among laboratory-confirmed cases between 2005 and 2024. There was a disparity in the dominant serogroup of Vibrio cholerae by region. The results from 128 cholera clusters indicated that cholera outbreaks frequently occurred in rural banquets (64.84%), followed by regular restaurants (13.28%). Among these, 63 clusters (49.22%) with identified infection sources indicated that foodborne transmission (95.24%) was the primary mode of cholera transmission, which mainly through seafood and aquatic products, such as soft-shelled turtles, shrimp and shellfish. The characteristics of cholera clusters caused by Vibrio cholerae serogroups O1 and O139 showed statistically significant differences in scale, attack rate, place of residence, setting, and infection source ( P<0.05). Conclusion:Cholera incidence has remained consistently low since 2015 in China, mainly in sporadic cases. Rural gatherings (e.g., wedding banquets) are the main settings for cholera clusters. The main infection sources are predominantly caused by cross-contamination due to improper processing practices of aquatic products, such as soft-shelled turtles.

Objective To explore the correlations of spatial distribution frequency map of posterior reversible encephalopathy syndrome(PRES)and cerebral microvascular density map,cerebral blood flow(CBF)map,standard template of cerebral metabolic imaging and the spatial gene transcription map of human brain based on normative analysis strategy,and to analyze the pathophysiological mechanisms of PRES.Methods Cerebral MRI data of 184 patients with PRES were retrospectively analyzed.ROI of the lesions were delineated on T1WI,then registered to Montreal Neurological Institute(MNI)standard space.The spatial distribution frequency map of PRES lesions were obtained with superposition.Spatial correlation analysis were performed to observe correlations of spatial distribution frequency map of PRES and the cerebral microvascular density map,CBF map and standard template of cerebral metabolic imaging based on large sample.The potential related gene expressions were decoded based on gene expression data of Allen human brain atlas,and the correlations of spatial parts of PRES and those expressions were observed.Results No significant correlation was found between spatial distribution frequency map of PRES and cerebral microvascular density,CBF nor distribution of neurotransmitters(all P＞0.05).PLS1 weighted genes,VEGF-A gene,AQP-4 gene and RGS2 gene were all correlated with spatial distribution of PRES(r=-0.363-0.653,all P＜0.05),among which KCNAB3 gene had the highest weight(Z=17.288).Conclusion The spatial patterns of PRES risk or protective genes in brain regions were correlated with regional distribution of PRES lesions,which was consistent with arginine vasopressin(AVP)theory of the occurrence and development of PRES.

Objective:To analyze the financial status of urban public hospitals in China and provide references for promoting the integration of business and finance as well as refined management in urban public hospitals.Methods:Based on the financial data of urban public hospitals in 31 provinces, autonomous regions, municipalities directly under the central government, and the Xinjiang Production and Construction Corps (excluding Hong Kong, Macao, and Taiwan) from the annual financial reports of public hospitals issued by the Department of Finance of the National Health Commission during 2019—2021, the DuPont analysis system was employed to dissect the financial status of urban public hospitals in China, with return on net assets as the core indicator. The profitability was measured by return on net assets, the operational capability was measured by the total asset turnover rate, and the debt-paying ability was measured by the short-term debt-paying ability indicator, current ratio, and the long-term debt-paying ability indicator, debt-to-asset ratio.Results:From 2019 to 2021, the number of urban public hospitals in China were 2 752, 2 797, and 2 815, respectively. The return on net assets was 8.83%, 9.29%, and 7.65%, respectively, with the changes mainly influenced by medical revevene surplus rate. The total asset turnover rate was 81.92%, 68.36%, and 73.54%, respectively, with the changes mainly affected by total assets and medical income. The current ratios were 1.23, 1.20, and 1.16, respectively, while the debt-to-asset ratios were 44.88%, 44.47%, and 43.86%, respectively, which remained at a relatively high level. The proportion of non-current assets was 53.50%, 55.26%, and 56.88%, respectively.Conclusions:From 2019 to 2021, the profitability and operational efficiency of urban public hospitals in China both declined, showing a current operational status of high asset intensity and high debt. It is recommended that national administrative departments increase financial input and optimize asset allocation. Urban public hospitals should enhance comprehensive budget management and improve the refinement level of operational management to achieve efficient and sustainable development.

Objective:To observe the multi-modal fundus imaging features of subretinal drusenoid deposit (SDD) in age-related macular degeneration (AMD), and observe image features.Methods:A prospective clinical study. From December 2019 to December 2023, 65 patients (104 eyes) with a diagnosis of AMD-SDD by spectral domain optical coherence tomography (SD-OCT) examination in Shandong Eye Hospital were included. All eyes were examined by best corrected visual acuity (BCVA), traditional color fundus photography (CFP), ultra-wide-angle scanning laser fundus imaging (UWF), multicolor scanning laser fundus imaging (MC) and SD-OCT. The standard MC images were obtained by using Spectralis HRA+OCT for MC examination. The multi-mode image characteristics of SDD were analyzed retrospectively. Area under curve (AUC) was used to evaluate the sensitivity and specificity of CFP, MC and UWF in detecting SDD.Results:Among 65 patients with SDD, 29 cases of males (52 eyes) and 36 cases of females (52 eyes) was included. There were 26 patients with unilateral SDD and 39 patients with bilateral SDD. The average age was (71.74±10.97) years. The early, middle and late stages of AMD were 31 (29.8%, 31/104), 24 (23.1%, 24/104), 49 (47.1%, 49/104) eyes, respectively. The SDD detected by CFP, MC and UWF was 76 (73.1%, 76/104), 94 (90.4%, 94/104), 96 (92.3%, 96/104) eyes. CFP showed that the edge of SDD in the macular area was blurred. UWF showed that the dot and the ribbon SDD were light yellow pale discrete deposits and light yellow interlaced network deposits respectively. MC showed the dot SDD had a strong yellow-green circular reflection, while the edge of the ribbon SDD was surrounded by a weak reflection, and the boundary was clear. SD-OCT showed that SDD had strong reflection signal, which was located between the retinal pigment epithelium layer and the photoreceptor cell layer. The dot SDD could break through the ellipsoid zone and caused slight uplift or interruption of the external membrane, showing a cone-like strong reflection signal. While the ribbon SDD showed a continuous "hill-like" protrusion, which hardly broke through ellipsoid zone. The sensitivity and specificity of CFP, MC and UWF for SDD were 73.1%, 90.4%, 92.3% and 61.1%, 94.4% and 83.3%, respectively.Conclusions:MC and UWF show high sensitivity and specificity in diagnosing AMD-SDD, which is superior to CFP. SD-OCT can effectively reveal the location and morphoLogical characteristics of SDD under retina.

Objective:To analyze the gene sequence of varicella-zoster virus (VZV) in Liaoning Province, and determine the prevailing dominant genotypes and nucleotide and amino acid variations.Methods:The open reading frames (ORFs) of 31 VZV strains from 2017 to 2020 in Liaoning Province were analyzed by PCR, including 1, 6, 12, 16, 17, 21, 22, 35, 37, 38, 50, 54, 55, 56, 60 and 66. The amplified products were sequenced, combined with single nucleotide polymorphism (SNP) and phylogenetic tree to determine the virus genotype, and the variation of nucleotides and amino acids at different sites was analyzed.Results:All 31 VZV strains in Liaoning Province were Clade 2 genotype. Compared with Clade 2 genotype reference strains, the 31 strains had nucleotide and amino acid homology of 99.6%-100.0% and 98.7%-100.0%, respectively, and the genetic distance was 0-0.002. Compared with V-Oka vaccine strain, the 31 strains all had site mutation, which led to amino acid changes, including one strain with ACCTCCCAA deletion at 541-549 sites of ORF1 and two strains with inserted CGG at the 780-781 site of ORF1; the 31 VZV strains had point mutations at 24 sites, including 15 synonymous mutations, 9 missense mutations, 20 mutations in the coding region, 4 mutations outside the coding region, 13 synonymous mutations in the coding region and 7 missense mutations in the coding region. The missense mutations in the coding region included a base mutation of C→T at site 731, a base mutation of C→T at site 790, a base mutation of C→T at site 791, a base mutation of A→G at site 17829, a base mutation of G→A at site 24567, a base mutation of T→C at site 98261, a base mutation of A→C at site 101579, which leaded to the amino acid changes of Arginine→Lysine, Arginine→Glutamine, Arginine→Glutamine, Histidine→Arginine, Arginine→Glutamine, Tyrosine→Histidine, Leucine→Arginine.Conclusions:Clade 2 genotype is the dominant genotype of VZV in Liaoning Province in recent years, and the gene sequences of VZV strains in Liaoning Province is highly conserved. Studying the characteristics of VZV gene is of great significance for studying the molecular epidemiology of VZV in Liaoning Province, and provides important scientific basis for varicella control and vaccination plan.

BackgroundSuicide ideation in adolescent inpatients with depression is a multi-factorial problem， and perceived stress is considered to be closely related to suicide ideation， while its mediating role in suicide ideation among adolescent inpatients with depression remains unclear. ObjectiveTo explore the mediating effect of psychological capital on the relationship between perceived stress and suicide ideation among adolescent inpatients with depression， so as to provide references for preventing the onset of suicide ideation in adolescent inpatients with depression. MethodsA sample of 585 adolescent patients who were hospitalized in Beijing Huilongguan Hospital from June 2021 to March 2023 and fulfilling the International Classification of Diseases， 10th edition （ICD-10） diagnostic criteria for depression were enrolled. All patients were evaluated using self-designed questionnaire， Chinese Perceived Stress Scale （CPSS）， Positive Psychological Capital Questionnaire （PPQ） and Beck Scale for Suicide Ideation-Chinese Version （BSI-CV）. Pearson correlation was used to assess the correlation among the scores of the above scales. Bootstrap method was employed to verify the mediating effect of psychological capital on the relationship between perceived stress and suicide ideation. ResultsCPSS score in adolescent inpatients with depression was positively correlated with BSI-CV score （r=0.375， P<0.01）， and CPSS score and BSI-CV score were negatively correlated with PPQ score （r=-0.481， -0.436， P<0.01）. Psychological capital played a significant yet a partial role in mediating the link between perceived stress and suicide ideation， with an indirect mediating effect value of 0.160 （95% CI： 0.178~0.373）， accounting for 30.42% of the total effect. ConclusionThe perceived stress of adolescent inpatients with depression can affect the onset of suicide ideation both directly and indirectly through psychological capital.