Objective To investigate the relationship between the comorbidity of dyslipidemia, hypertension and diabetes and lifestyle of adult residents in Hebei Province in 2018, and to provide reference for the development of chronic diseases prevention measures. Methods Using data from the surveillance of chronic diseases and their risk factors among adults in Hebei in 2018, 7 711 permanent residents aged ≥18 years were selected as the research subjects. Multivariate logistic regression analysis was used to analyze the relationship between the comorbidity of dyslipidemia, hypertension, and diabetes and lifestyle in adult residents. Results A total of 7 711 subjects aged ≥18 years were included in 2018. The comorbidity rates of hypertension and dyslipidemia, diabetes and dyslipidemia, and hypertension and diabetes were 16.88%, 7.91%, and 8.13%, respectively. The comorbidity rate of hypertension, diabetes, and dyslipidemia was 22.65%. These comorbidity rates increased with age and BMI. Multivariate logistic regression results showed that male, age, overweight/obesity, physical inactivity, daily sedentary behavior time ≥5 hours, and sleep problems were risk factors for the comorbidity of the "three highs". Conclusion The prevalence of the "three highs" comorbidities is relatively high in Hebei Province, and there are multiple common risk factors. Maintaining a healthy lifestyle and implementing comprehensive prevention and control measures are the key to improving the health level of residents.

Objective To investigate the influencing factors of stroke patients with hypertension and their compliance with antihypertensive drugs, and to provide targeted intervention measures for stroke prevention in hypertensive patients.  Methods Using the method of multi-stage cluster sampling, a total of 59,434 permanent residents aged 40 and above were selected from 48 monitoring sites in 9 cities of Hebei Province from December 2019 to December 2020. Unconditional logistic regression analysis was used to explore the influencing factors of stroke complicated with hypertension and the compliance of patients with antihypertensive drugs.  Results Among the 59 434 subjects, the prevalence rate of stroke was 4.33% and the prevalence rate of stroke complicated with hypertension was 82.47%. The results of univariate analysis showed that the proportion of women, rural areas, dyslipidemia, diabetes, obesity, and people with family history of stroke was higher in stroke patients with hypertension, and the difference was statistically significant (P<0.05). Multivariate logistic regression analysis showed that rural areas, dyslipidemia, diabetes, obesity, and family history of stroke significantly increased the risk of stroke, and the OR (95%CI) values were 1.29 (1.03-1.62), 1.39 (1.12-1.72), 1.58 (1.25-1.99), 1.61 (1.22-2.12) and 1.60 (1.26-2.04), respectively. Among stroke patients with hypertension, 92.71% of patients took antihypertensive drugs. It was found that women's compliance with antihypertensive drugs was good, with an OR (95%CI) value of 1.46 (1.01-2.09).  Conclusion The prevalence rate of stroke complicated with hypertension is high in people aged 40 and above in Hebei Province. Hypertensive people should lower blood lipids, control blood glucose, and lose weight as soon as possible to prevent the occurrence of stroke.

Objective To discuss the correlation between noninvasive hemodynamic parameters and major adverse cardiovascular events(MACE)in patients with acute anterior wall myocardial infarction after receiving percutaneous coronary intervention(PCI).Methods A total of 132 patients with acute anterior wall myocardial infarction,who received PCI at the Affiliated People's Hospital of Shandong First Medical University of China between October 2021 and February 2024,were collected.At 24 h and 7 d after surgery,the hemodynamic parameters,including mean arterial pressure(MAP),cardiac index(CI),cardiac output(CO),stroke volume(SV),peripheral vascular resistance index(SVRI),were recorded.Spearman correlation analysis was used to analyze the relationship between Killip grade of cardiac function and hemodynamic parameters.According to the presence or absence of MACE within 6 months after PCI,the patients were divided into MACE group and non-MACE group.The predictive value of hemodynamic parameters for MACE was analyzed by receiver operating characteristic(ROC)curves.Results The postoperative 7-day levels of CO,CI and SV were higher than their postoperative one-day levels,while the postoperative 7-day level of SVRI was lower than its postoperative one-day level(P＜0.05).Of the 132 patients,Killip classification of grade Ⅰ was seen in 39,grade Ⅱ in 62,grade Ⅲin 23 and grade Ⅳ in 8.The postoperative 7-day levels of CO,CI and SV in the patients with Killip gradeⅢ-Ⅳ were lower than those in the patients with Killip grade Ⅰ-Ⅱ,while the level of SVRI in the patients with Killip grade Ⅲ-Ⅳ was higher than that in the patients with Killip grade Ⅰ-Ⅱ(P＜0.05).The results of Spearman correlation analysis showed that Killip grade of cardiac function was negatively correlated with the postoperative 7-day levels of CO,CI and SV,while positively correlated with the postoperative 7-day level of SVRI after PCI(r=-0.518,r=-0.480,r=-0.416 and r=0.493 respectively,all P＜0.05).Six months after PCI,34 patients developed MACE.The levels of CO,CI and SV in MACE group were lower than those in the non-MACE group,while the level of SVRI in MACE group was higher than that in the non-MACE group(P＜0.05).The area under the ROC curve(AUC)of MAP,CO,CI,SV,SVRI and combination of the five indicators for predicting MACE was 0.620,0.687,0.676,0.649,0.710 and 0.860 respectively,and the AUC value of the combination of the five indicators was the greatest one.Conclusion In patients with acute anterior wall myocardial infarction after receiving PCI,the changes in the levels of MAP,CO,CI,SV and SVRI can reflect cardiac function level to a certain extent and can predict the occurrence of MACE events in the short term.

Objective:To review the clinical and pathological features, pathogenesis, and differential diagnosis of leiomyomatosis peritonealis disseminata (LPD) during pregnancy.Methods:We report the diagnosis and treatment of LPD in a pregnant woman admitted to Jiaozhou Central Hospital of Qingdao. We retrieved relevant literature from China and abroad to review the clinical characteristics and outcomes.Results:(1) Case report: The 33-year-old pregnant woman who had had previous cesarean sections was admitted at 37 +2 weeks gestation due to premature rupture of membranes 30 minutes before arriving at the hospital with a pelvic mass which was first diagnosed seven months earlier, in the first trimester. A lower segment cesarean section was performed, and the pelvic mass was removed on admission. No relapse was reported during the postoperative follow-up for 26 months. (2) Literature review: thirteen papers involving 15 cases, including the present case, were retrieved. The age at onset was 32 years old (19-47 years old); five of them had a history of myomectomy. Twelve cases had no significant symptoms, and the diagnosis was made at delivery or postpartum; the other three had noticeable features, mainly with abdominal pain. Six had obstetrical complications, including hypertensive disorders of pregnancy, premature rupture of membrane, abnormal fetal position, and oligohydramnios. Two cases had a history of assisted reproductive technology. Eleven cases delivered after 32 gestational weeks, three before 28 weeks, one aborted at ten gestational weeks due to severe complications. Twelve had cesarean section and myomectomy and the uterus and appendages were preserved. Three cases had a cesarean hysterectomy and two of them also had bilateral salpingo-oophorectomy. The pathological manifestations of seven cases were extensive and massively distributed small fibroids, similar to malignant tumor infiltration, with the diameter of 0.5 to 1.0 cm; five cases had multiple large fibroids, accompanied by scattered small fibroids. Conclusion:LPD during pregnancy is rare, and usually benign, with no obvious clinical symptoms. LPD is more likely to be misdiagnosed as a malignant tumor before the operation, and the diagnosis is usually confirmed by postoperative histopathology. A common surgical strategy is a cesarean section combined with pelvic mass resection.

Objective To investigate the effects and mechanism of remifentanil on renal ischemia/reperfusion(IR) injury via mediating Fas apoptosis signal pathway in rats.Methods Sprague-Dawley rats were divided into 3 groups (n =20 each) by using the random number table method:sham operation group (S group),IR control group (IR group),experimental group (Rgroup).The renal IR model was prepared by clamping the bilateral renal arteries for 45 min followedby reperfusion in IR group and R group.In R group,remifentanil was infused at 1.0μg·kg-1 ·min-1 via the tail vein starting from 15 min before ischemia until 30 min of reperfusion.In S group and IR group,the same volume of physiological saline was given.At 15 min before ischemia and at 3 h,12 h,24 h of reperfusion,the renal tissue samples were obtained for detecting the apoptosis rate by flow cytometry,determining the level of Fas mRNA expression by RT-PCR,the level of caspase-8 and caspase-3 activation by Western blotting,and scoring the number of kidney tubules injury by Paller'method.Results In IR group,the renal tubular injury score,the apoptosis rate,the expression of Fas mRNA and the activation of caspase-3 in renal tissue increased at 3 h after reperfusion,and those continued to increase at 12 h after reperfusion and reached the peak at 24 h after reperfusion (P＜0.01),and the activity of caspase-8 increased at 3 b,reached the peak at 12 h after reperfusion and decreased at 24 h after reperfusion (P＜0.01).As compared with S group,the renal tubular injury score,apoptosis rate,the expression of Fas mRNA and the activation of caspase-3 at 3 h,12 h and 24 h of reperfusion and the activation of caspase-8 at 12 h,24 h of reperfusion were all increased in IR group and R group (P＜0.05 or 0.01).As compared with IR group,the renal tubular injury score,apoptosis rate,the expression of Fas mRNA and the activation of caspase-8 and caspase-3 at 3 h,12 h and 24 h of reperfusion were decreased in R group (P＜0.05 or 0.01).Conclusion Remifentanil inhibits cell apoptosis and alleviates renal IR damage by reducing the expression of Fas receptor and the activation of caspase-8 and caspase-3,and regulating the apoptotic signal pathway of Fas.

Objective To evaluate CT findings and the common causes of calcification of the eyeball wall.Methods CT manifestations of 26 cases of calcification of the eyeball wall were reviewed.3 cases were confirmed by surgery and pathology.Etiological diagnosis was made in 23 cases on the basis of detailed history,ophthalmic examination,clinical laboratory and follow-up results.Results Of the 26 patients with calcification of the eyeball wall,19 occurred in unilateral eye,7 occurred in bilateral eyes.The common causes of calcification of the eyeball wall included choroidal osteoma(n= 7),sclerochoroidal calcification(n= 5),subconjunctival lipoma with calcification(n= 4),optic diskdrusen(n=3),long-standing retinal detachment(n=3),recurrent traumatic endophthalmitis(n=2),chronic uveitis(n=1)and postkeratoplasty (n=1).The calcified lesions located in the back of equator of eyeball were showed in 17 patients(66%),in the front of equator in 5 patients(19%),both in the front and back of equator were seen in 4 patients(15%)with multiple lesions.On CT,calcified lesions of the eyeball wall mainly demonstrated some punctiformed,stippled,flat,peltate and irregular high density lesions,and 4 cases with ocular atrophy.Conclusion Most diseases that result in calcification of the eyeball wall have typical location and lesion shape.CT scan is valuable for finding the etiological factors and guiding the clinical treatment.

Objective To investigate the antimicrobial resistance of main clinical isolates from ICU during 2012 .Methods Auto-matic microbiology analysis system and the disk diffusion method were performed to determine the antimicrobial susceptibility .All the data were analyzed by WHONET5 .6 software according to the breakpoints of The American Association of Clinical Laboratory Standardization Institute (CLSI) 2012 .Results A total of non-repeated 1 374 clinical isolates were collected in ICU during 2012 , including 1 089 strains (79 .3% ) of Gram-negative bacilli and 285 strains (20 .7% )of Gram-positive cocci ;The top five pathogens were Acinetobacter baumannii ,Pseudomonas aeruginosa ,Escherichia coli ,Klebsiella pneumoniae and Staphylococcus aureus ;Some Enterobacteriaceae strains were resistant to imipenem or ertapenem .2 strains of Enterococcus faecium were found resistant to van-comycin .Conclusion Non-fermenting bacteria ,Enterobacteriaceae and Staphylococci remain the predominant pathogens isolated from the patients in ICU ,their drug resistance is serious ,it is important to use antibacterial agents rationally and strengthen the sur-veillance of bacterial drug resistance .

Objective To investigate CT features of subconjunctival fat prolapse and choristoma. Methods Thirty-eight patients, including 18 with subconjunctival fat prolapse and 20 with choristoma, were retrospectively analyzed. Transverse plain CT scan was performed in all the patients, and then coronal plane images was reconstructed at CT workstation. Results CT features of subconjunctival fat prolapse revealed a crescent-shaped or horn-shaped fat density mass continuous with the orbital fat in the superior temporal quadrant of the orbit. CT features of choristoma revealed a crescent-shaped or triangle fat density mass incontinuous with the orbital fat in the temporal side. Conclusion Subconjunctival fat prolapse typically occurs in bilateral superior temporal quadrant of the orbit in elderly males. Subconjunctival choristoma occurs in the unilateral temporal side in adolescent. CT is helpful to distinguish subconjunctival fat prolapse and choristoma.

Clinical data of 129 young pafienm with lung cancer were analyzed retrospectively.Adenocarcinoma was the main pathologic type of lung cancer(n=62,48.1%),followed by undifferentiated small cell carcinoma(n=35,27.1%),squamous carcinoma(n=20,15.5%).Forty four cases were misdiagnosed at first consultation with a misdiagnosis rate of 34.1%.To avoid misdiagnosis seems to be the key issue for improvement of prognosis in young patients with lung cancer.

Objective:To study the influence of astragalus injection(黄芪注射液) plus Shenmai injection(参麦注射液) on each stage of hemorrhagic fever with renal syndrome(HFRS).Methods:Thirty-six cases with HFRS were randomly divided into treated group(n=19) which was treated with western medicine and traditional Chinese medicine (astragalus injection and Shenmai injection) and control group (n=17) which was treated with western medicine alone during fever stage.The curative effects were compared.Results:In treated group the rates of over hypotensive shock stage and over oliguria stage were both 94.74％ ,they were significantly heigher than those in control group(both P<0.05).The prolonged times of polyguria,increased blood urea nitrogen(BUN),and proteinuria in treated group were significantly shorter than those in control group (all P<0.01).Conclusions:The astragalus injection and Shenmai injection possess the ability to enhance the antidisease capability in patient with HFRS and are able to shorten the shock stage,to reduce the occurance rate of oliguria,to shorten the duration of each stage,and finally to shorten ill course and promote the patients to recovery as early as possible.