Objective:To explore the independent risk factors of acute respiratory distress syndrome (ARDS) in patients with sepsis, establish an early warning model, and verify the predictive value of the model based on synthetic minority oversampling technique (SMOTE) algorithm.Methods:A retrospective case-control study was conducted. 566 patients with sepsis who were admitted to Jinan People's Hospital from October 2016 to October 2022 were enrolled. General information, underlying diseases, infection sites, initial cause, severity scores, blood and arterial blood gas analysis indicators at admission, treatment measures, complications, and prognosis indicators of patients were collected. The patients were grouped according to whether ARDS occurred during hospitalization, and the clinical data between the two groups were observed and compared. Univariate and binary multivariate Logistic regression analysis were used to select the independent risk factors of ARDS during hospitalization in septic patients, and regression equation was established to construct the early warning model. Simultaneously, the dataset was improved using the SMOTE algorithm to build an enhanced warning model. Receiver operator characteristic curve (ROC curve) was drawn to validate the prediction efficiency of the model.Results:566 patients with sepsis were included in the final analysis, of which 163 developed ARDS during hospitalization and 403 did not. Univariate analysis showed that there were statistically significant differences in age, body mass index (BMI), malignant tumor, blood transfusion history, pancreas and peripancreatic infection, gastrointestinal tract infection, pulmonary infection as the initial etiology, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, sequential organ failure assessment (SOFA) score, albumin (Alb), blood urea nitrogen (BUN), mechanical ventilation therapy, septic shock and length of intensive care unit (ICU) stay between the two groups. Binary multivariate Logistic regression analysis showed that age [odds ratio ( OR) = 3.449, 95% confidence interval (95% CI) was 2.197-5.414, P = 0.000], pulmonary infection as the initial etiology ( OR = 2.309, 95% CI was 1.427-3.737, P = 0.001), pancreas and peripancreatic infection ( OR = 1.937, 95% CI was 1.236-3.035, P = 0.004), septic shock ( OR = 3.381, 95% CI was 1.890-6.047, P = 0.000), SOFA score ( OR = 9.311, 95% CI was 5.831-14.867, P = 0.000) were independent influencing factors of ARDS during hospitalization in septic patients. An early warning model was established based on the above risk factors: P1 = -4.558+1.238×age+0.837×pulmonary infection as the initial etiology+0.661×pancreas and peripancreatic infection+1.218×septic shock+2.231×SOFA score. ROC curve analysis showed that the area under the ROC curve (AUC) of the model for ARDS during hospitalization in septic patients was 0.882 (95% CI was 0.851-0.914) with sensitivity of 79.8% and specificity of 83.4%. The dataset was improved based on the SMOTE algorithm, and the early warning model was rebuilt: P2 = -3.279+1.288×age+0.763×pulmonary infection as the initial etiology+0.635×pancreas and peripancreatic infection+1.068×septic shock+2.201×SOFA score. ROC curve analysis showed that the AUC of the model for ARDS during hospitalization in septic patients was 0.890 (95% CI was 0.867-0.913) with sensitivity of 85.3% and specificity of 79.1%. This result further confirmed that the early warning model constructed by the independent risk factors mentioned above had high predictive performance. Conclusions:Risk factors for the occurrence of ARDS during hospitalization in patients with sepsis include age, pulmonary infection as the initial etiology, pancreatic and peripancreatic infection, septic shock, and SOFA score. Clinically, the probability of ARDS in patients with sepsis can be assessed based on the warning model established using these risk factors, allowing for early intervention and improvement of prognosis.

Objective: The purpose of the research was to draw up the questionnaire of the integrated services demand for medicine, pension, rehabilitation and care of community elderly and to provide elderly people with a effective tool for evaluating the needs of medicine, pension, rehabilitation and care. Methods: The theoretical framework of the questionnaire was based on the qualitative interview results of 12 community elderly and community health care workers. A preliminary draft was formed through two rounds of expert consultation and a preliminary survey of 102 elderly people in 3 communities in Taian. Construct validity was used to evaluate the validity of the questionnaire, and Cronbach's alpha coefficient and split half reliability were used to evaluate the reliability of the questionnaire. Results: Sixteen experts were invited to conduct two rounds of consultation on 61 items of the questionnaire. The authoritative coefficient of experts was 0.881, and the positive coefficient of experts was 100%. In the first round, items I-CVI, S-CVI/UA and S-CVI/Ave were 0.68-1.00, 0.72 and 0.83, respectively. Seven items were modified, six items were deleted and three items were added. In the second round, one item was deleted and one item was added, and a questionnaire consisting of seven dimensions and 58 items was formed.7 common factors were extracted from exploratory factor analysis, and the cumulative contribution rate was 63.078%. Finally, 7 dimensions and 51 item questionnaires were formed. Each dimension is the community public health service and general services, health education, pension services, rehabilitation services, family beds, service charges The total Cronbach's alpha coefficient was 0.919, the Cronbach' s alpha coefficient of each dimension was 0.615-0.808, the retest reliability coefficient of the total questionnaire was 0.862.and the Guttman half coefficient is 0.865. The total questionnaire CVI was 0.85 and the item CVI was 0.80-1.00. Item analysis showed that the correlation coefficients of the 7 items were lower than 0.3, and the rest were all between 0.3~0.7, and were significantly correlated at P<0.05 level. Conclusion The questionnaire of the integrated services demand for medicine, pension, rehabilitation and care of community elderly had good reliability and validity, and it could be used to evaluate the needs of medicine, pension, rehabilitation and care in the elderly.

Hydatid disease does seriously harm to human and livestock ,and causes huge economic losses to the livestock in‐dustry .Despite the fact that people have made some success in prevention and control of animal hydatid disease after making great efforts during the past few decades ,however ,there still remain many problems and challenges .In order to facilitate the research in animal hydatid disease in China ,here we reviewed the problems and challenges in the prevention and control of this disease and put forward several proposals on the treatment and management of dogs ,immunization ,diagnose ,surveillance , etc .