Background Meteorological factors are among the key extrinsic triggers for the onset and exacerbation of cardiovascular and cerebrovascular diseases (CVD). Against the backdrop of sustained global warming, elucidating the impact of ambient temperature and atmospheric pressure on CVD, especially on pre-hospital CVD emergent events, has become imperative for evidence-based prevention and emergency preparedness. Objective To quantify the temporal trends of daily mean temperature and atmospheric pressure and their associations with pre-hospital CVD emergent events in Yantai, and to explore effect modification by demographic subgroups and geographic areas, thereby providing an empirical basis for the rational allocation of emergency medical resources. Methods Pre-hospital CVD emergency data from January 1, 2016 to December 31, 2022 were selected from the Yantai 120 Emergency Medical Command System. Synchronous meteorological factors and environmental pollutant data were obtained from the websites of the National Oceanic and Atmospheric Administration and the National Centers for Environmental Information of the United States. Time-series analysis combined with distributed lag non-linear model was used to analyze the association between daily temperature, atmospheric pressure, and pre-hospital CVD emergencies. Average annual percentage changes (AAPC) were calculated using Joinpoint (version 5.2.0.0) to reflect temporal trends. Spearman correlation analysis was employed to screen variables with low collinearity for inclusion in the multi-pollutant adjusted models. Results From 2016 to 2022, a total of 268275 pre-hospital CVD emergency cases were recorded in Yantai City, showing an increasing annual trend (AAPC=7.16%, P=0.002). Emergency volume, daily temperature, atmospheric pressure, and PM₁₀ displayed marked seasonal patterns, with summer bottoms and winter peaks for emergencies, daily temperature higher in summer and lower in winter, and the inverse for atmospheric pressure. Correlation analysis showed that both daily temperature and atmospheric pressure were positively correlated with O₃, with correlation coefficients of 0.745 and 0.723, respectively; negatively correlated with PM_2.5, with correlation coefficients of −0.246 and −0.235, respectively; and negatively correlated with PM₁₀, with correlation coefficients of −0.241 and −0.229, respectively (P < 0.05). A U-shaped correlation was revealed between daily temperature and pre-hospital CVD emergency risk. Using 24 °C as the reference, risk was elevated at both low and high daily temperatures, with the strongest cold effect at –11 ℃ (RR=1.53, 95%CI: 1.35, 1.73) and strongest heat effect at 30 ℃ (RR=1.06, 95%CI: 1.01, 1.11); cold effects were prolonged (lag0–14d) compared to heat effects. Atmospheric pressure exhibited a positive association with emergencies; using a median of 1012.2 hPa as the reference, the maximum risk occurred at 1037 hPa (RR=1.25, 95%CI: 1.03, 1.52), with a 0–5 d lag. In the subgroup analysis, the impact of low temperature was more pronounced among females (RR_{−9 ℃}=1.66), people over 60 years (RR_{−9 ℃}=1.91), and rural residents (RR_{−9 ℃}=1.76). High atmospheric pressure significantly increased the risk of pre-hospital CVD emergency among females (RR_{1035 hPa}=1.54), people under 18 years (RR_{1035 hPa}=3.62), and rural residents (RR_{1035 hPa}=1.46). The sensitivity analysis results indicated that, after excluding the impact of pandemic and the degrees of freedom for time variations, the effects of daily average temperature and atmospheric pressure on pre-hospital CVD emergency volume were consistent with the primary analysis findings. Conclusion Both non-optimal temperature and atmospheric pressure significantly increase the pre-hospital CVD emergency volume; therefore, emergency medical services should develop targeted response protocols, optimize resource allocation, and intensify public health education to mitigate the pre-hospital burden attributable to temperature and pressure fluctuations.

Objective:To evaluate the clinical efficacy of methylation sensitive-high resolution melting curve (MS-HRM) detection of IFN-induced protein 44-like (IFI44L) gene methylation in the diagnosis of systemic lupus erythematosus (SLE), as well as the relationship between IFI44L gene markers and the early onset of SLE.Methods:From February 2020 to September 2022, the MS-HRM was used to detect the methylation level of the IFI44L gene in peripheral blood mononuclear cells of 602 SLE patients and 524 other autoimmune disease patients (excluding SLE) from Beijing Peking Union Medical College Hospital, Guangdong Provincial People′s Hospital, and Shenzhen People′s Hospital, totaling 1 126 patients. Compared with the 2012 SLICC criteria, the suspected cases were followed up for 6 months until the onset and clinical diagnosis of SLE were confirmed. The measurement data of normal distribution were expressed as mean±SD, and the consistency analysis was performed using the Kappa consistency test. The clinical diagnostic efficacy indicators were calculated using the receiver operating characteristic (ROC) curve. Results:RR (95% CI) of early suspected cases was 17.06 (9.43, 30.82). The results of IFI44L gene methylation level were in good agreement with the 2012 SLICC criteria, and the sensitivity, specificity and total coincidence rate were 90.53%, 92.56% and 91.47%, respectively. The Kappa value (95% CI) was 0.829(0.796, 0.862) ( P<0.001). The diagnostic efficiency of IFI44L gene methylation level ( Kappa value 0.817) was superior to anti-nuclear antibody, anti-SM antibody and anti-dsDNA antibody ( Kappa value 0.418, 0.216 and 0.440, respectively). The Kappa values (95% CI) of methylation between MS-HRM and pyrosequencing was 0.861(0.806, 0.916), P<0.001. Conclusion:The hypomethylation of IFI44L gene methylation level detected by MS-HRM is closely related to the occurrence and development of SLE, and its diagnostic performance is better than that of three autoantibodies in SLE diagnosis, which can be used for the early diagnosis of SLE.

Objective:To evaluate the clinical efficacy of methylation sensitive-high resolution melting curve (MS-HRM) detection of IFN-induced protein 44-like (IFI44L) gene methylation in the diagnosis of systemic lupus erythematosus (SLE), as well as the relationship between IFI44L gene markers and the early onset of SLE.Methods:From February 2020 to September 2022, the MS-HRM was used to detect the methylation level of the IFI44L gene in peripheral blood mononuclear cells of 602 SLE patients and 524 other autoimmune disease patients (excluding SLE) from Beijing Peking Union Medical College Hospital, Guangdong Provincial People′s Hospital, and Shenzhen People′s Hospital, totaling 1 126 patients. Compared with the 2012 SLICC criteria, the suspected cases were followed up for 6 months until the onset and clinical diagnosis of SLE were confirmed. The measurement data of normal distribution were expressed as mean±SD, and the consistency analysis was performed using the Kappa consistency test. The clinical diagnostic efficacy indicators were calculated using the receiver operating characteristic (ROC) curve. Results:RR (95% CI) of early suspected cases was 17.06 (9.43, 30.82). The results of IFI44L gene methylation level were in good agreement with the 2012 SLICC criteria, and the sensitivity, specificity and total coincidence rate were 90.53%, 92.56% and 91.47%, respectively. The Kappa value (95% CI) was 0.829(0.796, 0.862) ( P<0.001). The diagnostic efficiency of IFI44L gene methylation level ( Kappa value 0.817) was superior to anti-nuclear antibody, anti-SM antibody and anti-dsDNA antibody ( Kappa value 0.418, 0.216 and 0.440, respectively). The Kappa values (95% CI) of methylation between MS-HRM and pyrosequencing was 0.861(0.806, 0.916), P<0.001. Conclusion:The hypomethylation of IFI44L gene methylation level detected by MS-HRM is closely related to the occurrence and development of SLE, and its diagnostic performance is better than that of three autoantibodies in SLE diagnosis, which can be used for the early diagnosis of SLE.

Objective To investigate the effects of atorvastatin calcium on thyroid function, immune response and C-Jun N-terminal kinase/p38 mitogen-activated protein kinase (JNK/p38 MAPK) signaling pathway in rats with hypothyroidism. Methods A total of 30 healthy adult male SD rats were randomly divided into control group, hypothyroid group (PTU group) and atorvastatin calcium treatment group (ACT group), with 10 rats in each group. Rats in the PTU group and the ACT group were injected with PTU subcutaneously at the dorsum of the neck every day for 28 consecutive days; instead of PTU, rats in the control group were injected subcutaneously with 0.3 mL of saline. After 2 weeks of PTU treatment, rats in the ACT group were gavaged with 3 mL of atorvastatin calcium saline solution (containing 5 mg/kg of atorvastatin calcium), which was administered once daily; the control group was gavaged with an equal amount of saline in the same way. The body weight, food intake and water intake of rats were measured weekly. The histopathological changes of the thyroid gland were observed in histopathological sections of rats in each group. Enzyme-linked immunosorbent assay (ELISA) was performed to determine the levels of triiodothyronine (T3), thyroxine (T4), thyroid stimulating hormone (TSH), interferon γ (IFN-γ) and interleukin-4 (IL-4) in serum; quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) was performed to detect the mRNA expression levels of IFN-γ, IL-10, Foxp3 and IL-4; western blot was performed to determine the levels of p-JNK/JNK and p-p38/p38 MAPK. Results Compared with control group, PTU-induced hypothyroidism rats showed a significant decrease in body mass and food and water consumption (P < 0.05). After 2 weeks of treatment with atorvastatin calcium, the body mass loss of PTU rats was inhibited, food and water consumption was improved, and the differences were statistically significant (P < 0.05). Atorvastatin calcium was able to significantly increase the serum T3 and T4 levels and decrease the serum TSH level in hypothyroid rats (P < 0.05). Atorvastatin calcium treatment was able to significantly alleviate histopathological changes such as follicular cell proliferation and related hypertrophy induced by PTU, and increase follicular size (P < 0.05). After treatment with atorvastatin calcium, the spleen mass of PTU rats increased significantly, and the expression of IFN-γ mRNA in hypothyroid rats decreased significantly, but the expression levels of IL-10 mRNA, Foxp3 mRNA and IL-4 mRNA increased significantly (P < 0.05). After treatment with atorvastatin calcium, the levels of p-JNK/JNK and p-p38/p38 MAPK in thyroid tissue of hypothyroid rats decreased significantly (P < 0.05). Conclusion Atorvastatin calcium treatment for hypothyroidism has the function of promoting the normalization of thyroid hormone imbalance, balancing Th1/Th2 cytokines, and inhibiting the activation of JNK/p38 MAPK signaling pathway.

OBJECTIVE To improve the diagnosis and treatment level of critically ill infectious diseases， standardize the clinical application of nanopore sequencing and promote the sound development of the technology. METHODS Division of Therapeutic Drug Monitoring of Chinese Pharmacological Society and Expert Committee of Precision Medicine for Clinical Treatment of Guangdong Pharmaceutical Association initiated and organized multidisciplinary experts to discuss and determine the consensus writing outline by using the nominal group method， forming a preliminary consensus draft； expert consultation was performed by using Delphi method， and then experts’ opinions were analyzed and revised to form consensus. RESULTS & CONCLUSIONS Consensuses of Experts on the Application of Nanopore Sequencing Technology in the Detection of Pathogenic Microorganisms covers targeted sequencing， metagenomic sequencing and whole genome sequencing， and is standardized in terms of sample collection and storage， detection process， bioinformatics analysis and report interpretation； the recommendations are provided for the key issues.

Objective:To explore the short-term and long-term effects of pregnancy with aortic dissection (AD) on newborns.Methods:In this retrospective cohort study, 31 live births of pregnant women with AD admitted to Beijing Anzhen Hospital, Capital Medical University from June 2010 to June 2022 were selected as the AD group.Among them, 19 preterm births were in the preterm AD group.Additionally, 100 neonates delivered by pregnant women without pregnancy complications were selected as the normal control group, and 50 preterm infants delivered by pregnant women without pregnancy complications were selected as the preterm control group during the same period.The differences between the AD group and the normal control group, and between the preterm AD group and the preterm control group were compared using the independent samples t-test, Chi-square test, and Fisher′s exact test.Patients in the AD group were followed up for 5 years. Results:(1) The incidence rates of small for gestational age (SGA) (12.90% vs. 1.00%), neonatal respiratory distress syndrome (NRDS) (16.13% vs. 2.00%), digestive tract hemorrhage (16.13% vs. 1.00%), nervous system disease (16.13% vs. 1.00%), multiple organ dysfunction syndrome (MODS) (12.90% vs. 0), premature infant (61.29% vs. 5.00%), asphyxia (35.48% vs. 1.00%), cardiopulmonary resuscitation (64.52% vs. 1.00%), respiratory support (38.71% vs. 2.00%), transfer to the department of pediatrics within 24 hours of birth (90.32% vs. 13.00%), caesarean section (100% vs. 25.00%), and low birth weight infant (38.71% vs. 2.00%) in the AD group were significantly higher than those in the normal control group, while the gestational age[(34.90±2.80) weeks vs. (38.87±1.50) weeks], length [(45.65±3.56) cm vs. (50.17±0.81) cm], and weight [(2 456.77±634.02) g vs. (3 383.90±413.05) g] were significantly less than those in the normal control group, and the differences were statistically significant (all P<0.05).(2) The gestational age [(33.26±2.31) weeks vs. (34.80±1.29) weeks], length [(43.89±3.36) cm vs. (46.64±2.89) cm], and weight [(2 158.95±558.92) g vs. (2 418.20±431.20) g] in the preterm AD group were less than those in the preterm control group, while the incidence rates of NRDS (26.32% vs. 4.00%), digestive tract hemorrhage (21.05% vs. 4.00%), nervous system disease (26.32% vs. 6.00%), MODS (21.05% vs. 2.00%), caesarean section (100% vs. 52.00%), cardiopulmonary resuscitation (73.68% vs. 8.00%), respiratory support (63.16% vs. 10.00%), and asphyxia (47.37% vs. 2.00%) were significantly higher than those in the preterm control group, and the differences were statistically significant (all P<0.05).(3) Twenty-seven cases in the AD group survived, and 4 cases were lost to follow-up.Among them, 9 cases had abnormal physical development, 3 cases had eye disease, and 1 case was mentally retarded.None of them underwent genetic detection. Conclusions:Neonates born to mothers with AD in pregnancy have poor physical development, high incidence of complications, and reduced quality of life, and need long-term monitoring and follow-up in their growth and development.

The incidence of postoperative delirium in elderly patients with hip fractures is high, which seriously affects their prognosis. Rapid identification and early prevention of postoperative delirium are crucial for improving the prognosis of elderly hip fractures. This article reviews the overview, classification, risk factors, selection of rapid screening tools and intervention strategies of postoperative delirium in elderly hip fracture patients, in order to provide reference and guidance for management of postoperative delirium in elderly patients with hip fractures.

Objective:To investigate the effect of ultrasonic debridement mediated by 0.9% sodium chloride solution and 0.5% iodophor volt combined with eddy current washing and high pressure pulse washing on the removal of colonized bacteria on the wound surface of diabetic foot and wound healing.Methods:From March to November 2020, a total of 60 patients using ultrasonic therapy for debridement were divided into control group, experimental group 1, experimental group 2 and experimental group 3 by random digit table in the fourth People′s Hospital of Dalian. The final effective data collected was 15 cases in each group. The control group was given ultrasonic debridement mediated by 0.9% sodium chloride solution and eddy current washing.Experimental group 1 was given ultrasonic debridement mediated by 0.9% sodium chloride solution and high pressure pulse washing. Experimental group 2 received 0.5% iodophor mediated ultrasonic debridement and eddy current washing. Experimental group 3 0.5% iodophor mediated ultrasonic debridement and high pressure pulse washing. The size of the wound was measured, sampled and bacterial cultured before and after the first, fifth and 10th intervention. The wound bacterial clearance rate and wound area reduction rate were calculated and compared.Results:Before and after 3 interventions, the bacterial clearance rate and the total reduction of wound surface in 4 groups were increased ( P<0.01), the total bacterial clearance rate of experimental group 3 was the highest, which was (93.85 ± 9.87)%.The total reduction rate of wound in experimental group 2 was the highest, which was (20.831 4 ± 9.379 8)%. Conclusions:0.5% iodophor mediated ultrasonic debridement combined with high pressure pulse washing is the most effective way in the removal of diabetic foot wounds, and 0.5% iodophor solution mediated ultrasonic debridement combined with eddy current washing is the most effective in reducing diabetic foot wounds.

Objective:To translate the Tilburg Pregnancy Distress Scale (TPDS) into Chinese and test its reliability and validity.Methods:The Chinese version of TPDS was formed by adopting forward and back translation, cross-cultural semantic equivalence assessment and pilot testing. A questionnaire survey was conducted among 309 pregnant women who were examined in the obstetrical clinic of Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science & Technology from September 2019 to January 2020 by convenience sampling method to test the reliability and validity of questionnaire.Results:The content validity of each item ranged from 0.83 to 1.00, while the total table was 0.91. Confirmatory factor analysis showed that the two-factor model fitted well, χ 2/df was 1.380, goodness of fit index was 0.955, normal of fit index was 0.941, Tucker-Lewis index was 0.977, comparative fit index was 0.983, root mean square error of approximation was 0.035. The Cronbach α coefficient of the total scale was 0.834, and the test-retest reliability was 0.826. Conclusions:The Chinese version of TPDS has good reliability and validity, and can be used to measure the level of pregnancy distress in Chinese pregnant women.

Objective:To investigate the information demand level and its influencing factors of cardiac rehabilitation in patients after PCI, in order to provide scientific basis for doctors and nurses to formulate cardiac rehabilitation intervention strategies.Methods:A total of 146 patients after PCI were investigated with general data questionnaire and Cardiac Rehabilitation Inventory in the First Affiliated Hospital of Dalian Medical University from December 2019 to February 2020, and multiple linear regression was used to analyze the influencing factors of cardiac rehabilitation information demand.Results:The average scores of each dimension of Cardiac Rehabilitation Inventory after PCI were autonomy, process anxiety and result anxiety from high to low. Multiple linear regression showed that occupational type was a significant predictor of autonomy of patients after PCI, which could explain 4.6% of the variation of autonomy, and autonomy of in-service patients after PCI was higher than that of retirees ( t=2.81, P<0.05). Sex and age were significant predictors of process anxiety of patients after PCI, which could explain the variation of 8.6% of process anxiety. The occupational type, the medical insurance type and whether they had received professional rehabilitation guidance during hospitalization were significant predictors of anxiety after PCI, which could explain the 15.2% variation of anxiety, and the anxiety of in-service patients after PCI was lower than that of retirees ( t=-3.76, P<0.05). Conclusions:The level of cardiac rehabilitation information needs of patients after PCI is worthy of attention. Medical staff can give targeted, personalized and different forms of cardiac rehabilitation in the process of cardiac rehabilitation, and emphasize the implementation of health education and guidance for their cardiac rehabilitation in order to meet their cardiac rehabilitation information needs, improve their autonomy and alleviate their anxiety.