Objective To observe the value of CT angiography(CTA)for classifying type of peripheral arteriovenous fistula(AVF)in children.Methods Totally 22 children with peripheral AVF were retrospectively enrolled,the type of AVF was classified with preoperative CTA,and therapeutic planning was developed.Taken digital subtraction angiography(DSA)findings during interventional therapy as gold standards,the efficacy of CTA for classifying type of AVF was analyzed.Results Among 22 cases,DSA detected 3 cases of type Ⅰ,13 cases of type Ⅱa and 6 cases of typeⅡb peripheral AVF,while 3 cases of type Ⅰ,14 cases of type Ⅱa and 5 cases of type Ⅱb peripheral AVF were classified based on CTA.CTA misdiagnosed 1 case of type Ⅱa as type Ⅱb,and 2 cases of type Ⅱb as type Ⅱa peripheral AVF,its accuracy of CTA for classifying type Ⅰ,Ⅱa and Ⅱb peripheral AVF was 100%(3/3),92.31%(12/13)and 66.67%(4/6),respectively.Among 22 cases,13 cases underwent interventional closure,2 cases underwent interventional therapy combined with surgery,while 3 cases did not receive relevant treatment due to drainage vein occlusion.One month after treatments,the symptoms of 19 cases who underwent treatment improved significantly,and no signs of AVF was found with re-examination of ultrasound nor CTA.Conclusion CTA was helpful to classifying type of peripheral AV in children,which could provide references for interventional therapy.

Objectives:This study aims to investigate the association between Chinese visceral adiposity index(CVAI)and the risk of cardiovascular disease(CVD),and explore the sex differences.Methods:Participants were screened from the three sub-cohorts of Prediction for Atherosclerotic Cardiovascular Disease Risk in China(China-PAR)project,baseline information on body measure and biochemistry examinations were collected from 1998,2000-2001,and 2007-2008,separately.Participants were followed up to 2015.Cohort-stratified Cox proportional risk models were used to analyze the relationship between CVAI,both in continuous(per standard deviation increase)and categorical(quartiles,with Q1 as reference)scales,and CVD risk in the total population,men and women.The multiplicative interaction between sex and CVAI on CVD risk were calculated.Restricted cubic spline regression was employed to investigate the dose-response relationship.Results:A total of 98 464 participants without CVD at baseline were included.During the 723 508 person-years of follow-up,3 605 CVD events were recorded.After multivariate adjustment,the HRs(95％CIs)of CVD were 1.25(1.20-1.29),1.09(1.04-1.15),and 1.54(1.46-1.64)for per standard deviation increment in CVAI in the general population,men and women,respectively.Besides,compared with Q1 group,the HRs(95％CIs)in Q4 group were 1.87(1.67-2.10),1.33(1.14-1.54)and 3.84(3.09-4.78),correspondingly,and the effect of CVAI on the risk of CVD was significantly higher in women than in men(Pinteraction<0.05).Additionally,there was a positive dose-response relationship between CVAI and the risk of CVD.Conclusions:Elevated CVAI is an independent risk factor for CVD,especially in women.

Objective:To investigate the relationship between lipid levels and cognitive impairment in the elderly Chinese population using prospective cohort data.Methods:Based on the China-PAR (Prediction for Atherosclerotic Cardiovascular Disease Risk in China) cohort, this study included 24 380 individuals aged ≥60 years who participated in the cognitive function follow-up survey from 2018 to 2019. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), with cognitive impairment defined according to different educational levels: MMSE ≤17 for illiterate individuals, MMSE ≤20 for those with primary education and MMSE ≤24 for those with secondary education or above. Multivariable linear regression and logistic regression models were employed to examine the associations between six baseline lipid indicators and cognitive scores, as well as cognitive impairment. Additionally, restricted cubic splines were used to explore the exposure-dose relationship between lipid levels and cognitive function.Results:The study population had a median follow-up time of 11.6 years, with a baseline age of (59.7±6.8) years. Among the participants, 9 510 (39.0%) were males, and the mean MMSE score was 24.7±6.8. A total of 3 887 individuals (15.9%) were identified as cognitively impaired. The results of multivariable linear regression and logistic regression indicated that total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) levels were not only significantly positively associated with cognitive scores but also significantly associated with a lower risk of cognitive impairment. Each 1 mmol/L increase in these lipid levels corresponded to β values (95% CI) of 0.267 (0.173-0.361), 0.385(0.271-0.499) and 0.331(0.231-0.431), respectively. Each 1 mmol/L increase in these lipid levels corresponded to odds ratio ( OR) (95% CI) values of 0.915 (0.876-0.956), 0.875 (0.830-0.923) and 0.886 (0.848-0.927), respectively. The dose-response curve demonstrated that the negative association was primarily observed within the guideline-recommended optimal lipid level range. Specifically, when LDL-C was less than 3.4 mmol/L and non-HDL-C was less than 4.1 mmol/L, the corresponding OR (95% CI) values were 0.859 (0.796-0.926) and 0.876 (0.818-0.939). Conclusion:Lipid levels exhibit a certain linear negative association with cognitive impairment in elderly Chinese adults, with LDL-C and non-HDL-C demonstrating a stronger effect, particularly within the guideline-recommended optimal range.

Objectives:To explore the independent and combined effects of sleep duration and physical activity(PA)on the incidence of cardiovascular disease(CVD).Methods:The study subjects were derived from three sub-cohorts of the China-PAR project.Information on sleep and PA was collected from the surveys conducted in 2007-2008,and the incidence and mortality data of CVD were obtained during the follow-up survey from 2012 to 2015.Sleep duration was categorized into≤6 h/d,>6-8 h/d,and>8 h/d,and the PA level was classified according to the tertiles of PA volume(MET-h/d).The Cox proportional hazards model stratified by cohort source was applied to estimate the associations of PA and sleep duration with CVD incidence,coronary heart disease(CHD)incidence,and stroke incidence.Results:A total of 93 933 participants were included.During an average follow-up of(5.82±0.98)years,3 862 CVD events were documented.Compared with the low PA group,the hazard ratios(HRs)and 95%confidence intervals(CIs)of the CVD incidence,CHD incidence,and stroke incidence for the high PA group were 0.73(0.65-0.82),0.62(0.49-0.77)and 0.88(0.76-1.01),respectively.A U-shaped relation between sleep duration and incidence of CVD and stroke was observed.Compared with those who slept for>6-8 h/d,the risk of CVD(HR[95%CI]:1.10[1.00-1.21],P=0.04)and stroke(HR[95%CI]:1.33[1.18-1.49],P<0.01)was higher among participants slept>8 h/d.The risk of CVD,CHD and stroke tended to be higher in the≤6 h/d sleep group.Compared with the high PA combined with>6-8 h/d,the risk of stroke was highest in the high PA combined with>8h/d sleep group(HR[95%CI]:1.74[1.37-2.22],P<0.05),while the risks of CVD(HR[95%CI]:1.69[1.39-2.04],P<0.05)and CHD(HR[95%CI]:1.99[1.41-2.81],P<0.05)were highest in the low PA combined with≤6 h/d sleep group.Conclusions:Adequate physical activity and appropriate sleep duration are associated with lower risk of morbidity from CVD,CHD and stroke.

Objective To observe the value of CT angiography(CTA)for classifying type of peripheral arteriovenous fistula(AVF)in children.Methods Totally 22 children with peripheral AVF were retrospectively enrolled,the type of AVF was classified with preoperative CTA,and therapeutic planning was developed.Taken digital subtraction angiography(DSA)findings during interventional therapy as gold standards,the efficacy of CTA for classifying type of AVF was analyzed.Results Among 22 cases,DSA detected 3 cases of type Ⅰ,13 cases of type Ⅱa and 6 cases of typeⅡb peripheral AVF,while 3 cases of type Ⅰ,14 cases of type Ⅱa and 5 cases of type Ⅱb peripheral AVF were classified based on CTA.CTA misdiagnosed 1 case of type Ⅱa as type Ⅱb,and 2 cases of type Ⅱb as type Ⅱa peripheral AVF,its accuracy of CTA for classifying type Ⅰ,Ⅱa and Ⅱb peripheral AVF was 100%(3/3),92.31%(12/13)and 66.67%(4/6),respectively.Among 22 cases,13 cases underwent interventional closure,2 cases underwent interventional therapy combined with surgery,while 3 cases did not receive relevant treatment due to drainage vein occlusion.One month after treatments,the symptoms of 19 cases who underwent treatment improved significantly,and no signs of AVF was found with re-examination of ultrasound nor CTA.Conclusion CTA was helpful to classifying type of peripheral AV in children,which could provide references for interventional therapy.

Objective:To investigate the relationship between lipid levels and cognitive impairment in the elderly Chinese population using prospective cohort data.Methods:Based on the China-PAR (Prediction for Atherosclerotic Cardiovascular Disease Risk in China) cohort, this study included 24 380 individuals aged ≥60 years who participated in the cognitive function follow-up survey from 2018 to 2019. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), with cognitive impairment defined according to different educational levels: MMSE ≤17 for illiterate individuals, MMSE ≤20 for those with primary education and MMSE ≤24 for those with secondary education or above. Multivariable linear regression and logistic regression models were employed to examine the associations between six baseline lipid indicators and cognitive scores, as well as cognitive impairment. Additionally, restricted cubic splines were used to explore the exposure-dose relationship between lipid levels and cognitive function.Results:The study population had a median follow-up time of 11.6 years, with a baseline age of (59.7±6.8) years. Among the participants, 9 510 (39.0%) were males, and the mean MMSE score was 24.7±6.8. A total of 3 887 individuals (15.9%) were identified as cognitively impaired. The results of multivariable linear regression and logistic regression indicated that total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) levels were not only significantly positively associated with cognitive scores but also significantly associated with a lower risk of cognitive impairment. Each 1 mmol/L increase in these lipid levels corresponded to β values (95% CI) of 0.267 (0.173-0.361), 0.385(0.271-0.499) and 0.331(0.231-0.431), respectively. Each 1 mmol/L increase in these lipid levels corresponded to odds ratio ( OR) (95% CI) values of 0.915 (0.876-0.956), 0.875 (0.830-0.923) and 0.886 (0.848-0.927), respectively. The dose-response curve demonstrated that the negative association was primarily observed within the guideline-recommended optimal lipid level range. Specifically, when LDL-C was less than 3.4 mmol/L and non-HDL-C was less than 4.1 mmol/L, the corresponding OR (95% CI) values were 0.859 (0.796-0.926) and 0.876 (0.818-0.939). Conclusion:Lipid levels exhibit a certain linear negative association with cognitive impairment in elderly Chinese adults, with LDL-C and non-HDL-C demonstrating a stronger effect, particularly within the guideline-recommended optimal range.

Objectives:To explore the independent and combined effects of sleep duration and physical activity(PA)on the incidence of cardiovascular disease(CVD).Methods:The study subjects were derived from three sub-cohorts of the China-PAR project.Information on sleep and PA was collected from the surveys conducted in 2007-2008,and the incidence and mortality data of CVD were obtained during the follow-up survey from 2012 to 2015.Sleep duration was categorized into≤6 h/d,>6-8 h/d,and>8 h/d,and the PA level was classified according to the tertiles of PA volume(MET-h/d).The Cox proportional hazards model stratified by cohort source was applied to estimate the associations of PA and sleep duration with CVD incidence,coronary heart disease(CHD)incidence,and stroke incidence.Results:A total of 93 933 participants were included.During an average follow-up of(5.82±0.98)years,3 862 CVD events were documented.Compared with the low PA group,the hazard ratios(HRs)and 95%confidence intervals(CIs)of the CVD incidence,CHD incidence,and stroke incidence for the high PA group were 0.73(0.65-0.82),0.62(0.49-0.77)and 0.88(0.76-1.01),respectively.A U-shaped relation between sleep duration and incidence of CVD and stroke was observed.Compared with those who slept for>6-8 h/d,the risk of CVD(HR[95%CI]:1.10[1.00-1.21],P=0.04)and stroke(HR[95%CI]:1.33[1.18-1.49],P<0.01)was higher among participants slept>8 h/d.The risk of CVD,CHD and stroke tended to be higher in the≤6 h/d sleep group.Compared with the high PA combined with>6-8 h/d,the risk of stroke was highest in the high PA combined with>8h/d sleep group(HR[95%CI]:1.74[1.37-2.22],P<0.05),while the risks of CVD(HR[95%CI]:1.69[1.39-2.04],P<0.05)and CHD(HR[95%CI]:1.99[1.41-2.81],P<0.05)were highest in the low PA combined with≤6 h/d sleep group.Conclusions:Adequate physical activity and appropriate sleep duration are associated with lower risk of morbidity from CVD,CHD and stroke.

Objectives:This study aims to investigate the association between Chinese visceral adiposity index(CVAI)and the risk of cardiovascular disease(CVD),and explore the sex differences.Methods:Participants were screened from the three sub-cohorts of Prediction for Atherosclerotic Cardiovascular Disease Risk in China(China-PAR)project,baseline information on body measure and biochemistry examinations were collected from 1998,2000-2001,and 2007-2008,separately.Participants were followed up to 2015.Cohort-stratified Cox proportional risk models were used to analyze the relationship between CVAI,both in continuous(per standard deviation increase)and categorical(quartiles,with Q1 as reference)scales,and CVD risk in the total population,men and women.The multiplicative interaction between sex and CVAI on CVD risk were calculated.Restricted cubic spline regression was employed to investigate the dose-response relationship.Results:A total of 98 464 participants without CVD at baseline were included.During the 723 508 person-years of follow-up,3 605 CVD events were recorded.After multivariate adjustment,the HRs(95％CIs)of CVD were 1.25(1.20-1.29),1.09(1.04-1.15),and 1.54(1.46-1.64)for per standard deviation increment in CVAI in the general population,men and women,respectively.Besides,compared with Q1 group,the HRs(95％CIs)in Q4 group were 1.87(1.67-2.10),1.33(1.14-1.54)and 3.84(3.09-4.78),correspondingly,and the effect of CVAI on the risk of CVD was significantly higher in women than in men(Pinteraction<0.05).Additionally,there was a positive dose-response relationship between CVAI and the risk of CVD.Conclusions:Elevated CVAI is an independent risk factor for CVD,especially in women.

Objective:To investigate the effect of five-element music therapy combined with meridian-based acupoint massage timed according to qi circulationon on negative emotions and sleep quality in older adults with chronic heart failure. Methods:A total of 112 older adult patients with chronic heart failure who received treatment at The Affiliated Hospital of Hangzhou Normal University between January 2022 and June 2023 were included in this study. They were randomly divided into a control group ( n = 56) and a study group ( n = 56) using the random number table method. Based on conventional treatment, the control group received five-element music therapy, while the intervention group underwent a combination of five-element music therapy and meridian-based acupoint massage timed according to qi circulation. Before and after the intervention, a comparison was made between the two groups in terms of the scores of the Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Pittsburgh Sleep Quality Index (PSQI), and various dimensions of the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Additionally, the sleep outcome and patient satisfaction were also compared between the two groups. Results:After intervention, the scores of the HAMA and HAMD in the study group were (11.29 ± 2.48) points and (12.48 ± 3.36) points, respectively. In contrast, the control group had scores of (15.93 ± 3.35) points and (16.50 ± 4.32) points, respectively. After intervention, the scores of the HAMA and HAMD scales in both the study and control groups demonstrated a significant reduction in comparison with their respective pre-intervention scores [study group: (20.13 ± 5.18) points, (23.95 ± 8.97) points, control group: (19.36 ± 5.45) points, (23.79 ± 7.61) points, t = 15.35, 10.24, 5.65, 8.93, all P < 0.001). After intervention, the scores of the HAMA and HAMD scales in the study group were significantly lower than those in the control group ( t = -8.34, -5.49, both P < 0.001). After intervention, the scores of the PSQI in the study and control groups were (7.05 ± 0.96) points and (9.91 ± 1.28) points, respectively. After intervention, the scores of PSQI in both the study and control groups demonstrated a significant reduction compared with their respective pre-intervention scores [study group: (12.98 ± 2.21) points, control group: (12.50 ± 2.48) points, t = 24.68, 9.79, both P < 0.05]. After intervention, the score of the PSQI in the study group was significantly lower than that in the control group ( t = 13.34, P < 0.05). Based on the scores across various dimensions of the MLHFQ, it was observed that after intervention, the scores of emotional, physical, and other domains in both the study and control groups [study group: (9.36 ± 2.29) points, (16.95 ± 3.80) points, (18.50 ± 2.33) points; control group: (12.93 ± 2.00) points, (19.98 ± 3.98) points, (20.04 ± 2.24) points] decreased significantly compared with their pre-intervention scores [study group: (15.57 ± 1.55) points, (26.23 ± 4.63) points, (21.18 ± 2.50) points, control group: (16.09 ± 1.87) points, (25.32 ± 4.40) points, (21.57 ± 2.69) points, t = 21.66, 18.55, 8.44, 11.29, 11.73, 4.61, all P < 0.001]. After intervention, the scores of emotional, physical, and other domains in the study group were significantly lower than those in the control group ( t = -8.79, -4.13, -3.56, all P < 0.05). Patient satisfaction in the study group was superior to that that in the control group [98.21% (55/56) vs. 87.50% (49/56), χ2 = -3.09, P < 0.05]. Total effective rate of intervention on sleep in the study group was significantly higher than that in the control group [92.86% (52/56) vs. 78.57% (44/56), χ2 = -2.09, P < 0.05]. Conclusion:Five-element music therapy combined with meridian-based acupoint massage timed according to qi circulationon in the treatment of chronic heart failure in older adults can effectively alleviate negative emotions, improve the quality of life and sleep, and increase patient satisfaction with nursing care.

Objective:To establish and optimize a detection method of dibutyryl cyclic adenosine phosphate related substances.Methods:On the basis of the JP,the experimental conditions were optimized to obtain the optimal detection conditions.The column was CAPCEILPAK C18;mobile phase was pH 6.0 phosphate buffer solution-meth-anol with gradient elution;detection wavelength was 258 mm.The method validation was carried out.Results:In the system applicability solution,the separation degree of the main peak and adjacent peaks in each destruction solution was greater than 1.5;the solution was stable within 48 h.The content of each impurity showed a good line-ar relationship with the peak area in the range of 50％-150％of the limit concentration,R2＞0.999 4.In the spike experiment,the average recovery rate of N6-butyryl 3',5-cyclophosphatin sodium was 99.4％-106.6％.The average recoveries of 2'-0 butyryl 3,5-cycloadenosine monophosphate sodium were 88.8％-103.6％,and the average recoveries of cyclophosphaminate sodium were 96.9％-102.5％,which met the requirements.Three bat-ches of samples were tested,and the above impurities were detected.Conclusion:This method has high sensitivi-ty,good separation effect,accuracy and durability,and can be used for the detection of bucladesine sodium,provi-ding a basis for its quality control.