COMPERA 2.0 risk stratification has been demonstrated to be useful in patients with precapillary pulmonary hypertension (PH). However, its suitability for patients at risk for post-capillary PH or PH associated with left heart disease (PH-LHD) is unclear. To investigate the use of COMPERA 2.0 in patients with severe aortic stenosis (SAS) undergoing transcatheter aortic valve replacement (TAVR), who are at risk for post-capillary PH, a total of 327 eligible SAS patients undergoing TAVR at our institution between September 2015 and November 2020 were included in the study. Patients were classified into four strata before and after TAVR using the COMPERA 2.0 risk score. The primary endpoint was all-cause mortality. Survival analysis was performed using Kaplan-Meier curves, log-rank test, and Cox proportional hazards regression model. The study cohort had a median (interquartile range) age of 76 (70‒80) years and a pulmonary arterial systolic pressure of 33 (27‒43) mmHg (1 mmHg=0.133 kPa) before TAVR. The overall mortality was 11.9% during 26 (15‒47) months of follow-up. Before TAVR, cumulative mortality was higher with an increase in the risk stratum level (log-rank, both P<0.001); each increase in the risk stratum level resulted in an increased risk of death (hazard ratio (HR) 2.53, 95% confidential interval (CI) 1.54‒4.18, P<0.001), which was independent of age, sex, estimated glomerular filtration rate (eGFR), hemoglobin, albumin, and valve type (HR 1.76, 95% CI 1.01‒3.07, P=0.047). Similar results were observed at 30 d after TAVR. COMPERA 2.0 can serve as a useful tool for risk stratification in patients with SAS undergoing TAVR, indicating its potential application in the management of PH-LHD. Further validation is needed in patients with confirmed post-capillary PH by right heart catheterization.
Humans ; Aortic Valve Stenosis/complications* ; Aged ; Hypertension, Pulmonary/mortality* ; Male ; Female ; Transcatheter Aortic Valve Replacement ; Aged, 80 and over ; Risk Assessment/methods* ; Proportional Hazards Models ; Kaplan-Meier Estimate ; Retrospective Studies

Objective:To investigate the influencing factors for dysphagia in the elderly,to construct a predictive model for dysphagia,and to provide a theoretical basis for clinical practice.Methods:In this case-control study,the patients with dysphagia who attended Department of Geriatrics in the first affiliated hospital of Chongqing Medical University from March 2016 to June 2023 were enrolled as case group,and the patients without dysphagia who attended the same department during the same period of time were enrolled as con-trol group.The correlation analysis,least absolute shrinkage and selection operator(LASSO)regression,and multivariate logistic re-gression analysis were used to investigate the influencing factors for dysphagia;the 10-fold cross-validation Extreme Gradient Boosting(XGBoost)model was used to predict dysphagia,and the SHapley additive exPlanations(SHAP)method was used for model visualiza-tion.Results:There were 1009 cases in the case group and 2125 cases in the control group.The correlation analysis and LASSO re-gression analysis identified 12 factors for the multivariate logistic re-gression analysis,and the results showed that sarcopenia,increasing age,children or caretakers as caregivers,frail health,poor oral health,poor self-care ability,depression,and cognitive impairment were risk factors for dysphagia(odds ratio[OR]>1,P<0.05),and fe-male sex and participation in community activities were protective factors against dysphagia(OR<1,P<0.05).The XGBoost model had a good predictive efficacy,with an accuracy rate of 0.795,a preci-sion rate of 0.711,a sensitivity of 0.613,a specificity of 0.881,an F1 value of 0.661,and an area under the ROC curve of 0.855.The SHAP plot showed that the top five important characteristics were caregiver,oral score,frail health condition,activities of daily living,and cognitive function.Conclusion:There are various influencing factors for dysphagia in the elderly,and the elderly patients with poor oral health,frailty,dependence on others for daily life,and cognitive impairment should be taken seriously in clinical practice.The XGBoost model has a good performance in predicting dysphagia in the elderly,which can provide a reference for clinical practice.

This article focuses on the application of artificial intelligence in clinical hematology laboratory teaching. By analyzing the current situation of clinical hematology test teaching and combining the advantages of artificial intelligence technology, this paper explores its application prospects in clinical hematology laboratory teaching from multiple perspectives, such as case library construction, atlas resource library construction, virtual simulation training, auxiliary teaching, and clinical thinking training, and analyzes the possible problems of artificial intelligence in teaching practice.

Objective:To assess any effect of combining kinesio taping with Baduanjin in the management of upper cross syndrome (UCS).Methods:Thirty-nine college students with UCS were randomly divided into a kinesio taping group ( n=14), a Baduanjin group ( n=12) and a combined treatment group ( n=13). The kinesio taping and Baduanjin groups received taping and underwent Baduanjin training, respectively, while the combined treatment group received both interventions for 6 weeks. Before, as well as 3 and 6 weeks after the intervention, all were evaluated using a visual analogue scale (VAS), a neck disability index (NDI), and for forward head extension (FHA), round shoulder angle (FSA) and vital capacity (VC). Results:A significant decrease in the average VAS ratings and NDI scores, and better average FHA and FSA was observed in both groups after the experiment. There was also a significant increase in VC. At 6 weeks, all of the indicators were significantly better than three weeks earlier. The kinesio taping and Baduanjin groups showed significantly smaller average improvements than the combined group.Conclusions:Kinesio taping combined with Baduanjin can effectively alleviate pain associated with UCS, relieve cervical dysfunction, correct abnormal posture and increase lung capacity. Its efficacy is superior to that achieved through single interventions.

Objective:To assess any effect of combining kinesio taping with Baduanjin in the management of upper cross syndrome (UCS).Methods:Thirty-nine college students with UCS were randomly divided into a kinesio taping group ( n=14), a Baduanjin group ( n=12) and a combined treatment group ( n=13). The kinesio taping and Baduanjin groups received taping and underwent Baduanjin training, respectively, while the combined treatment group received both interventions for 6 weeks. Before, as well as 3 and 6 weeks after the intervention, all were evaluated using a visual analogue scale (VAS), a neck disability index (NDI), and for forward head extension (FHA), round shoulder angle (FSA) and vital capacity (VC). Results:A significant decrease in the average VAS ratings and NDI scores, and better average FHA and FSA was observed in both groups after the experiment. There was also a significant increase in VC. At 6 weeks, all of the indicators were significantly better than three weeks earlier. The kinesio taping and Baduanjin groups showed significantly smaller average improvements than the combined group.Conclusions:Kinesio taping combined with Baduanjin can effectively alleviate pain associated with UCS, relieve cervical dysfunction, correct abnormal posture and increase lung capacity. Its efficacy is superior to that achieved through single interventions.

This article focuses on the application of artificial intelligence in clinical hematology laboratory teaching. By analyzing the current situation of clinical hematology test teaching and combining the advantages of artificial intelligence technology, this paper explores its application prospects in clinical hematology laboratory teaching from multiple perspectives, such as case library construction, atlas resource library construction, virtual simulation training, auxiliary teaching, and clinical thinking training, and analyzes the possible problems of artificial intelligence in teaching practice.

Objective:To evaluate the epidemiological characteristics and explore the associated factors of breakthrough cases (BC) from Public Health Emergency Events (PHEEs) of varicella in Zhejiang Province from 2019 to 2022.Methods:Data on cases were obtained from the China Information System for Disease Control and Prevention and the PHEEs Reporting Information Database of Varicella in Zhejiang Province. History records were matched through the Zhejiang Provincial Immunization Information System. Descriptive analysis and multiple logistic regression model with a bidirectional stepwise selection method were performed to explore associated factors for BC during 2019-2022.Results:A total of 144 276 varicella cases were reported from 2019 to 2022, with the annual reported incidence of 47.35-82.80 cases per 100 000 population. Among these cases, 109 172 were non-breakthrough cases (NBC, accounting for 75.67%), 34 517 were BC (23.92%), and the rest 587 cases had unclear vaccination history on varicella (0.41%). A total of 214 PHEEs of varicella were reported, of which 99.07% occurred in school settings. The proportion of PHEEs that occurred in high school increased significantly as time went on ( χ2trend=5.742, P=0.017). Multiple logistic regression model which focused on "BC vs. NBC (as the reference)" indicated that the year of onset ( OR=1.585, 95% CI:1.343-1.878), the month of onset (taking January as the reference, OR=2.311-15.652), city (taking Hangzhou as the reference, Jiaxing OR=2.370, Jinhua OR=2.197, Lishui OR=0.134), age ( OR=0.887, 95% CI: 0.826-0.944), PHEEs setting (taking "primary school and below" as the reference, "high school and above" OR=0.516, 95% CI: 0.305-0.897), and the number of rashes ( OR=0.569, 95% CI: 0.458-0.703) were associated factors. Multiple logistic regression model which focused on "two-dose BC vs. one-dose BC (as the reference)" showed that the age of initial vaccination ( OR=0.045, 95% CI: 0.014-0.107), the time interval from onset to the last dose ( OR=0.037, 95% CI: 0.011-0.087) and the age of onset ( OR=20.724, 95% CI: 8.383-72.485) were associated factors. Conclusion:During 2019-2022, the reported high-risk group of varicella in Zhejiang Province has shifted to adolescents and young adults. Although vaccination could not completely prevent the onset of VZV, it could relieve clinical symptoms and delay the age of onset.

Objective:To evaluate the epidemiological characteristics and explore the associated factors of breakthrough cases (BC) from Public Health Emergency Events (PHEEs) of varicella in Zhejiang Province from 2019 to 2022.Methods:Data on cases were obtained from the China Information System for Disease Control and Prevention and the PHEEs Reporting Information Database of Varicella in Zhejiang Province. History records were matched through the Zhejiang Provincial Immunization Information System. Descriptive analysis and multiple logistic regression model with a bidirectional stepwise selection method were performed to explore associated factors for BC during 2019-2022.Results:A total of 144 276 varicella cases were reported from 2019 to 2022, with the annual reported incidence of 47.35-82.80 cases per 100 000 population. Among these cases, 109 172 were non-breakthrough cases (NBC, accounting for 75.67%), 34 517 were BC (23.92%), and the rest 587 cases had unclear vaccination history on varicella (0.41%). A total of 214 PHEEs of varicella were reported, of which 99.07% occurred in school settings. The proportion of PHEEs that occurred in high school increased significantly as time went on ( χ2trend=5.742, P=0.017). Multiple logistic regression model which focused on "BC vs. NBC (as the reference)" indicated that the year of onset ( OR=1.585, 95% CI:1.343-1.878), the month of onset (taking January as the reference, OR=2.311-15.652), city (taking Hangzhou as the reference, Jiaxing OR=2.370, Jinhua OR=2.197, Lishui OR=0.134), age ( OR=0.887, 95% CI: 0.826-0.944), PHEEs setting (taking "primary school and below" as the reference, "high school and above" OR=0.516, 95% CI: 0.305-0.897), and the number of rashes ( OR=0.569, 95% CI: 0.458-0.703) were associated factors. Multiple logistic regression model which focused on "two-dose BC vs. one-dose BC (as the reference)" showed that the age of initial vaccination ( OR=0.045, 95% CI: 0.014-0.107), the time interval from onset to the last dose ( OR=0.037, 95% CI: 0.011-0.087) and the age of onset ( OR=20.724, 95% CI: 8.383-72.485) were associated factors. Conclusion:During 2019-2022, the reported high-risk group of varicella in Zhejiang Province has shifted to adolescents and young adults. Although vaccination could not completely prevent the onset of VZV, it could relieve clinical symptoms and delay the age of onset.

Objective:To analyze the influencing factors of community hospice care service needs of the elderly based on structural equation model.Methods:A multi-stage sampling method was used to survey 564 elderly people from 40 community health service centers in four districts of Chaoyang District in Beijing from September to November 2020 with a self-designed questionnaire. The survey content included three dimensions: tendency characteristics (population characteristics, health beliefs), enabling resources and demand factors. The chi-square test and rank sum test were used to analyze the influencing factors of the community hospice care needs of the elderly. At the same time, based on Anderson theory, structural equation model was used to analyze the action path and effect size of the influencing factors.Results:Registered residence, occupation, understanding of community elderly care services, recognition of community medical convenience, recognition of community health services in reducing family burden, recognition of community health services in improving their own health, understanding of community hospice care services, mean monthly income of their families, degree of income satisfaction, self-paid medical expenses of the previous year, living status, acceptance of community medical expenses, satisfaction with the number of community medical staff, self-assessment of health status, whether the elderly was ill in the last two weeks and the number of chronic diseases and etc affected the needs of the elderly for community hospice care services (all P<0.05). In the three dimensions of Anderson model, enabling resources had a direct effect, and could also be affected by demand factors indirectly, the total effect value was 0.404; demand factors had direct impact, and the effect value was 0.193; propensity characteristics exerted impact indirectly through enabling resources and demand factors, and the total effect value was 0.176. Among them, the acceptance of community health service fees in the enabling resource dimension has the greatest impact (FL=0.535), the number of chronic disease in the demand factor dimension had the greatest impact (FL=1.018), and the recognition of community health service in reducing family burden in the propensity characteristic dimension had the greatest impact (FL=0.612) (all P<0.05). Conclusions:There are various factors and action paths that affect the needs of community hospice care services for the elderly. Among them, the acceptance of community health service fees, the number of chronic disease, and the recognition of community health service in reducing family burden have a greater impact.

OBJECTIVE: To investigate the distribution and descriptions of the common antigens of allergic rhinitis occurred in the population of Kunshan district so as to provide evidence for clinical diagnosis,treatment and prevention. METHOD: Eight hundred and twenty allergic rhinitis patients were examined skin prick test (SPT) with 18 kinds of antigen extract of allergic rhinitis. RESULT: Six hundred and ninety-four (84.6%) cases were detected at least one antigen, 581 (83.7%) cases were detected two or more antigens. The most common antigens among all the positive cases of skin prick tests were dust mite 492 (70.9%), house dust mite 473 (68.2%), crab 32 (4.5%) and egg white 26 (3.7%). CONCLUSION Mite, crab and egg white are the most common antigens of allergic rhinitis in Kunshan. SPT is important for the diagnosis, treatment and prevention.
Adolescent ; Adult ; Aged ; Allergens ; analysis ; immunology ; Animals ; Child ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Mites ; immunology ; Rhinitis, Allergic, Perennial ; epidemiology ; Skin Tests ; Young Adult