Background: This study was performed to characterize the incidence, costs, and risk factors associated with renal and cardiovascular adverse outcomes following primary percutaneous coronary intervention (pPCI) in patients with ST-elevation myocardial infarction (STEMI). Methods: Patients with STEMI who underwent pPCI using iso-osmolar contrast were enrolled at 39 centers. The incidence of acute kidney injury (AKI) and major adverse renal and cardiovascular events (MARCE) was analyzed, as well as inpatient costs. Logistic regression analysis was performed to identify risk factors. Results: Among 2,293 patients, the incidence of AKI and MARCE within 72 hours post-pPCI was 4.14% (n = 95) and 4.40% (n = 101), respectively. AKI and/or MARCE were associated with systolic blood pressure (AKI: odds ratio [OR], 1.009; 95% confidence interval [CI], 1.000–1.018), hypertension (AKI: OR, 1.815; 95% CI, 1.133–2.906; MARCE: OR, 1.760;95% CI, 1.118–2.769), anterior wall infarction (AKI: OR, 1.895; 95% CI, 1.196–3.004; MARCE:OR, 1.939; 95% CI, 1.240–3.032), Killip class (AKI: OR, 1.465; 95% CI, 1.117–1.922; MARCE:OR, 1.467; 95% CI, 1.131–1.903), and serum creatinine (SCr; MARCE: OR, 1.006; 95% CI, 1.000–1.012). Hospitalization costs for patients with STEMI who developed AKI or MARCE were significantly higher than for those without AKI (9,595 ± 5,795 vs. 8,279 ± 3,872 USD, P = 0.003) or without MARCE (9,890 ± 5,616 vs. 8,255 ± 3,859 USD, P < 0.001). Conclusions In patients with STEMI undergoing pPCI with iso-osmolar contrast, the incidence of AKI and MARCE was associated with higher hospitalization costs. Systolic blood pressure, hypertension, anterior wall infarction, Killip class, and SCr were identified as risk factors for these outcomes.

ObjectiveTo conduct an epidemiological investigation and analysis of a clustered scabies outbreak in a middle school, so as to provide evidence for developing targeted prevention and control strategies. MethodsCase data on a clustered scabies outbreak occurring in a middle school of Shaanxi Province in 2025 were collected. Field epidemiological approaches were adopted to define cases, search for infected individuals, and describe the temporal, spatial, and population distribution. Specimens were collected from individuals and surrounding environments for laboratory testing. ResultsA total of 25 scabies cases were identified in 4 classes and 9 dormitories of the school. All cases were first-year high school students. The overall attack rate was 6.00% (25/414); the attack rate was 10.53% (22/209) among male students and 1.46% (3/205) among female students. The disease course ranged from 10 to 30 days, with a median duration of 14 days, and 3 students (12.00%) continued attending classes with ongoing infection. Skin scrapings collected from lesion sites of 3 patients were examined under microscopy, all of which were positive for Sarcoptes scabiei; no laboratory testing was performed for the remaining cases. This clustered scabies infection outbreak lasted for one month. All affected students recovered completely without severe complications or deaths, and the outbreak was effectively contained. ConclusionThis scabies infection is a clustered school-based scabies outbreak caused by Sarcoptes scabiei. Affected patients present relatively severe symptoms and a prolonged disease course. Scientific and standardized preventive systems should be established to enable timely early warning and emergency response.

Objective:To evaluate a transhiatal tunnel flap designed to reconstruct the cardiac functional structure in proximal gastric cancer patients in our center.Methods:A descriptive case study method was used to select the data of 11 patients undergoing surgery for upper gastric cancer from Jan to Jul 2024. After laparoscopic dissection is completed, the esophagus is transected 2 cm from the upper edge of the tumor and the specimen is removed. The distance from the lower edge of the tumor is 5 cm. The cutting width is 4 cm, and the length of sleeve distal stump stomach is 20 cm. A seromuscular flap tunnel was made with a length of 2 cm and a width of 2 cm, 2 cm away from the top of the remnant stomach. The digestive tract was reconstructed using the Overlap hybridization method.Results:The median operation time was 175 (139-285) minutes. The median muscle flap production time and reconstruction time was 10.5 (5.5-21.0) minutes and 15.0 (11.8-33.6) minutes, respectively. The median blood loss is 50 (20-100) ml. The median postoperative hospitalization was 8 (6-25) days. The median tumor size was 2.5 (1.0-4.0) cm, and 31 (15-52) lymph nodes were dissected. The median follow-up after surgery was 3.5 (0.7-6.0) months, and no tumor recurrence or metastasis was found. Postoperative anastomotic leakage (Clavien-Dindo grade Ⅱ) occurred in one case, and there was no perioperative death. The Visick score of the whole group was 1 point in 8 cases and 2 points in 3 cases, and there was no anastomotic stenosis. Reflux esophagitis (Los Angeles classification grade B) was found in 1 case after gastroscopy, and the symptoms were relieved by conservative treatment.Conclusion:The transhiatal tunnel flap arthroplasty method has high surgical safety, low reconstruction difficulty, and an reliable anti-reflux effect.

Hospice care services provide physical, emotional and sometimes spiritual care for a terminally ill patient, and community-home hospice care is one of the main service modes. The study analyzed the community-home hospice care services conducted by Minglou and Zhonghe Community Health Service Centers of Yinzhou District in Ningbo city using SWOT analysis method, presenting theadvantages and disadvantages, the opportunities and challenges of the services, and also put forward the countermeasures and suggestions for further improvement. The study may provide reference for the implementation and promotion of home hospice service in China.

Hospice care services provide physical, emotional and sometimes spiritual care for a terminally ill patient, and community-home hospice care is one of the main service modes. The study analyzed the community-home hospice care services conducted by Minglou and Zhonghe Community Health Service Centers of Yinzhou District in Ningbo city using SWOT analysis method, presenting theadvantages and disadvantages, the opportunities and challenges of the services, and also put forward the countermeasures and suggestions for further improvement. The study may provide reference for the implementation and promotion of home hospice service in China.

Objective:To evaluate a transhiatal tunnel flap designed to reconstruct the cardiac functional structure in proximal gastric cancer patients in our center.Methods:A descriptive case study method was used to select the data of 11 patients undergoing surgery for upper gastric cancer from Jan to Jul 2024. After laparoscopic dissection is completed, the esophagus is transected 2 cm from the upper edge of the tumor and the specimen is removed. The distance from the lower edge of the tumor is 5 cm. The cutting width is 4 cm, and the length of sleeve distal stump stomach is 20 cm. A seromuscular flap tunnel was made with a length of 2 cm and a width of 2 cm, 2 cm away from the top of the remnant stomach. The digestive tract was reconstructed using the Overlap hybridization method.Results:The median operation time was 175 (139-285) minutes. The median muscle flap production time and reconstruction time was 10.5 (5.5-21.0) minutes and 15.0 (11.8-33.6) minutes, respectively. The median blood loss is 50 (20-100) ml. The median postoperative hospitalization was 8 (6-25) days. The median tumor size was 2.5 (1.0-4.0) cm, and 31 (15-52) lymph nodes were dissected. The median follow-up after surgery was 3.5 (0.7-6.0) months, and no tumor recurrence or metastasis was found. Postoperative anastomotic leakage (Clavien-Dindo grade Ⅱ) occurred in one case, and there was no perioperative death. The Visick score of the whole group was 1 point in 8 cases and 2 points in 3 cases, and there was no anastomotic stenosis. Reflux esophagitis (Los Angeles classification grade B) was found in 1 case after gastroscopy, and the symptoms were relieved by conservative treatment.Conclusion:The transhiatal tunnel flap arthroplasty method has high surgical safety, low reconstruction difficulty, and an reliable anti-reflux effect.

Objective:To construct a remote screening network for breast cancer based on automated breast ultrasound (ABUS) and explore the value of ABUS with remote reading for breast cancer screening.Methods:We constructed a remote breast cancer screening network including one remote reading center and 48 image-acquisition centers. We recruited women to participate in breast cancer screening at one of these image-acquisition centers from January 2021 to January 2023. The technicians collected the whole breast images using the ABUS. The images were then sent to the reading center through the PVBUS System and interpreted independently by two radiologists using the Breast Imaging Reporting and Data System (BI-RADS). BI-RADS categories 1 and 2 indicate negative screening results, and women diagnosed with these categories were recommended for annual breast ultrasound screening. BI-RADS categories 3, 4, and 5 indicate positive results. Women with BI-RADS category 3 lesions were recommended for follow-up examinations every 6 months using ABUS or handheld ultrasound, while those with BI-RADS 4 and 5 lesions were suggested to undergo pathological examinations.Results:In our study, we enrolled 10 344 women who completed the ABUS screening and were followed up for more than 12 months. After remote reading, 6 164 women were diagnosed with BI-RADS category 1 and 2 626 woman were within BI-RADS category 2. In contrast, 1 404 women were within BI-RADS category 3, a total of 135 women were within BI-RADS category 4, and 15 women were within BI-RADS category 5. The positive screening rate of ABUS was 15.0% (1 554/10 344). The ABUS with remote reading had a detection rate of 3.7/1 000 (38/10 344) for breast cancer screening, with a sensitivity of 97.4% (38/39) and a specificity of 85.3% (8 789/10 305). Among the 38 breast cancer cases detected, 92.1% (35/38) were invasive carcinomas, and 63.2% (24/38) were stage 0 or Ⅰ breast cancers.Conclusions:Breast cancer screening based on ABUS with remote reading provided an efficient and feasible solution to the problem of unevenly distributed medical resources and medical staff levels in various regions of China, enabling the decentralization of high-quality medical resources and improving the accessibility of high-quality screening services. It has provided an alternative for breast cancer screening in China.

Objective:To evaluate the safety and feasibility of the laparoscopic indocyanine green (ICG) fluorescence imaging during the sentinel node navigational surgery for the early gastric cancer.Methods:Patients with <4 cm early gastric cancer were chosen. 0.5 ml ICG (2.5 mg/ml) was preoperatively injected into submucosa around the lesion in four points by the endoscopy. The sentinel lymph node basin including the stained tissue and lymph node (LN) were completely resected guided by the fluorescence mapping under ICG laparoscopy. The specimen was inspected by frozen pathology section. The radical gastrectomy was dependent on the pathology result.Result:Between 2019 and 2021, a total of 18 patients were included in the final analysis. Most tumors (16/18) located in the middle or distal stomach. Median tumor size was 2.0 cm. Lymph vessel invasion was revealed in five cases and perineural invasion in three cases. According to AJCC tumor grading system, tumor depth was classified as Tis in 2 cases, T1a in 5 cases and T1b in 11 cases. Lymph node metastasis (LNM) was revealed in four patients (4/18, 22%). Median sentinel lymph node basins per patient were 2 (range, 1-5). An average 6 (range, 2-13) LNs were harvested in each case, including 6 (1-13) ICG stained LNs and 1 (0-5) non stained LNs. All of four LNM patients were detected by sentinel node navigational surgery. The rate of the sensitivity and accuracy were 100% and 100%, respectively. The median follow-up for the entire group was 58.3 months (0.3-59.9 months), with no recurrence or metastasis observed in any patient.Conclusion:The sensitivity and accuracy of the laparoscopic indocyanine green fluorescence imaging during the sentinel node navigational surgery were satisfactory.

Objective:To analyze the expression levels and clinical significance of interferon (IFN)-α/β in the renal cortex and serum of children with lupus nephritis (LN).Methods:A total of 32 children with LN diagnosed in the pediatric nephrology department of the Second Xiangya Hospital of Central South University from December 2017 to September 2020 were selected as the study subjects (LN group). The normal kidney control group consisted of 3 normal kidney transplant volunteers who underwent biopsy of kidney tissue (normal kidney control group), while 14 healthy children who underwent physical examination were collected as the normal control group. According to the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), LN patients were divided into mild activity group ( n=8), moderate activity group ( n=9), and severe activity group ( n=15). According to the International Society of Nephrology/Society of Nephrology (ISN/RPS) 2003 LN classification criteria, pathological classification was performed (3 cases in the mild pathological damage group, 8 cases in the moderate pathological damage group, and 11 cases in the severe pathological damage group); Immunohistochemistry was used to detect the expression and distribution of IFN-α/β in glomeruli and renal interstitium; Enzyme linked immunosorbent assay (ELISA) was used to detect the concentration of IFN-α/β in serum samples and analyze its correlation with the pathological classification and disease activity of LN patients. Results:The serum and renal cortex IFN-α/β levels in the LN group were higher than those in the normal control group and normal kidney control group, respectively (all P<0.05). The average level of serum IFN-α/β in the heavy activity group was higher than that in the light and moderate activity groups (all P<0.05). The serum and renal cortex IFN-α/β levels in the severe pathological damage group were significantly higher than those in the mild and moderate pathological damage groups (all P<0.05). Conclusions:IFN-α/β in the renal cortex is closely related to renal injury in LN; Serum IFN-α/β can assist in evaluating the disease activity level of LN to a certain extent.

Objective To compare the changes of brain voxel-mirrored homotopic connectivity(VMHC)of patients before and after Tai Chi Chuan training based on functional magnetic resonance imaging(fMRI)technology;To discuss the central effect mechanism of Tai Chi Chuan in treating chronic fatigue syndrome(CFS).Methods A total of 25 CFS patients(experiment group)and 27 healthy individuals(control group)were recruited to undergo a 1-month Tai Chi Chuan intervention.All receive one month of Tai Chi Chuan training.Differences in SF-36 scores and VMHC between CFS patients and HCs were compared.Results Before training,the SF-36 scores in the experimental group were significantly lower than those in the control group(P<0.001),and the VMHC in the bilateral inferior occipital gyrus,paracentral lobule,lingual gyrus,insula and superior temporal gyrus brain areas were weakened.After training,the scores of SF-36 in the experimental group significantly increased(P<0.001),and the VMHC in bilateral inferior occipital gyrus,superior temporal gyrus,anterior cuneiform lobe and paracentral lobule were significantly enhanced.The difference in whole brain VMHC was positively correlated with the difference in energy scores in SF-36(r=0.456,P=0.025);some scores of SF-36 in the control group significantly increased(P<0.05),and no significant changes in VMHC were observed in brain regions.Conclusion Tai Chi Chuan can effectively improve the quality of life of patients with CFS.This change may be related to the enhancement of functional connections in brain regions such as inferior occipital gyrus,superior temporal gyrus,precuneus,paracentral lobule,et al.