Objective To systematically analyze the characteristics of the disease burden of hypertensive heart disease (HHD) in the elderly (≥60 years) globally and in China from 1990 to 2021, and to predict its future trends from 2022 to 2040, with the aim of providing data support for optimizing comprehensive prevention and control strategies for HHD. Methods Based on the Global Burden of Disease (GBD) 2021 database, the number of prevalent cases and disability-adjusted life years (DALYs) of HHD in the elderly were extracted for the world, China, and five regions categorized by sociodemographic index (SDI). Joinpoint regression was used to analyze the temporal trends of age-standardized prevalence rate and age-standardized DALYs rate of HHD in the elderly. A three-factor decomposition method was applied to evaluate the relative contributions of aging, population growth, and epidemiological changes to the variations in the elderly HHD burden. Additionally, a Bayesian age-period-cohort model was used to predict the elderly HHD burden from 2022 to 2040. Results In 2021, the number of prevalent elderly HHD cases reached 10 283 000 globally and 3 412 400 in China, representing increases of 179.20% and 159.20% respectively, compared with 1990. The DALYs of elderly HHD were 18 812 700 person-years globally and 4 731 400 person-years in China, rising by 76.08% and 29.45% respectively from 1990. Meanwhile, the growth rates of the number of prevalent cases and DALYs of elderly HHD varied across different SDI regions. From 1990 to 2021, the age-standardized prevalence rate of elderly HHD in China, as well as the age-standardized DALYs rate of elderly HHD both globally and in China, showed significant downward trends (all average annual percentage changes<0, all P<0.001). In 2021, the 70-74 years age group accounted for the highest proportion of prevalent cases and DALYs of elderly HHD, both globally and in China. Decomposition analysis revealed that population growth was the dominant factor driving the increase in the elderly HHD burden across all regions. The prediction model results indicated that the number of prevalent cases and DALYs of elderly HHD would continue to rise globally and in China from 2022 to 2040, with the growth rate of the elderly HHD burden in China between 2021 and 2040 expected to exceed the global average. Conclusion Over the past 32 years, although the age-standardized disease rates of elderly HHD have mainly shown a downward trend globally and in China, the absolute number of the disease burden has increased substantially. The projection model indicates a continued upward trajectory, with the growth rate in China higher than the global average. Therefore, there is an urgent need to implement precise prevention and control strategies to effectively mitigate the disease burden of elderly HHD.

Objective:To explore the value of paediatric age-adjusted shock index（SIPA）in early identification of septic shock in children，and to evaluate the relationship between SIPA and disease severity and prognosis.Methods:The infected children admitted to the department of critical care medicine of the Children's Hospital Affiliated to Capital Institute of Pediatrics from May 2023 to July 2024 were collected. Dynamic assessment was performed 0 to 6 hours after admission. Patients diagnosed with sepsis without septic shock were classified as the sepsis group and those diagnosed with sepsis with septic shock were classified as the septic shock group. According to whether the blood pressure of the children decreased，they were divided into two groups：compensated septic shock group and decompensated septic shock group. The difference of SIPA among the three groups was analyzed，and the predictive value of SIPA on case fatality rate，lactate level，pediatric critical illness score，ventilator utilization rate and length of hospital stay were analyzed.Results:Among 203 children with sepsis，112 were males and 91 were females. There were 146 cases in the sepsis group，37 cases in the compensated septic shock group and 20 cases in the decompensated septic shock group. There was no significant difference between the three groups in gender（ P>0.05），but there was a statistically significant difference in age（ χ 2=32.905， P<0.001）. There was no significant difference in age between the sepsis group and the compensated septic shock group（ P>0.05）. The age of sepsis group and decompensated septic shock group，compensated septic shock group and decompensated septic shock group were statistically significant（ χ 2=29.431， P<0.001； χ 2=19.764， P=0.001）. The proportion of increased SIPA was statistically different among the three groups，with both the compensated septic shock group and the decompensated septic shock group being higher than the sepsis group（ χ2=20.383， P<0.001； χ2=33.600， P<0.001）. The decompensated septic shock group was higher than the compensated septic shock group（ χ2=6.555， P=0.01）. SIPA was correlated with case fatality rate，lactate level，pediatric critical illness score，ventilator use rate and length of stay of the children，with statistically significant differences（ P<0.05）. Conclusion:The increase of SIPA can be used for the early identification of septic shock in children，and it has a certain early warning value for the prognosis assessment of sepsis and septic shock.

Objective:To explore the value of paediatric age-adjusted shock index（SIPA）in early identification of septic shock in children，and to evaluate the relationship between SIPA and disease severity and prognosis.Methods:The infected children admitted to the department of critical care medicine of the Children's Hospital Affiliated to Capital Institute of Pediatrics from May 2023 to July 2024 were collected. Dynamic assessment was performed 0 to 6 hours after admission. Patients diagnosed with sepsis without septic shock were classified as the sepsis group and those diagnosed with sepsis with septic shock were classified as the septic shock group. According to whether the blood pressure of the children decreased，they were divided into two groups：compensated septic shock group and decompensated septic shock group. The difference of SIPA among the three groups was analyzed，and the predictive value of SIPA on case fatality rate，lactate level，pediatric critical illness score，ventilator utilization rate and length of hospital stay were analyzed.Results:Among 203 children with sepsis，112 were males and 91 were females. There were 146 cases in the sepsis group，37 cases in the compensated septic shock group and 20 cases in the decompensated septic shock group. There was no significant difference between the three groups in gender（ P>0.05），but there was a statistically significant difference in age（ χ 2=32.905， P<0.001）. There was no significant difference in age between the sepsis group and the compensated septic shock group（ P>0.05）. The age of sepsis group and decompensated septic shock group，compensated septic shock group and decompensated septic shock group were statistically significant（ χ 2=29.431， P<0.001； χ 2=19.764， P=0.001）. The proportion of increased SIPA was statistically different among the three groups，with both the compensated septic shock group and the decompensated septic shock group being higher than the sepsis group（ χ2=20.383， P<0.001； χ2=33.600， P<0.001）. The decompensated septic shock group was higher than the compensated septic shock group（ χ2=6.555， P=0.01）. SIPA was correlated with case fatality rate，lactate level，pediatric critical illness score，ventilator use rate and length of stay of the children，with statistically significant differences（ P<0.05）. Conclusion:The increase of SIPA can be used for the early identification of septic shock in children，and it has a certain early warning value for the prognosis assessment of sepsis and septic shock.

To analyze the methodological and reporting quality of systematic reviews of prediction models published in Chinese journals, with the aim of providing reference for enhancing the overall quality of Chinese systematic reviews of prediction models.

Objective:To explore the effects of the "Internet +" hospital-family standardized feeding management model in premature infants.Methods:From May 2019 to November 2020, 240 moderately-risk and low-risk premature infants hospitalized at the Department of Neonatal Medicine in Henan Children's Hospital were selected by convenience sampling and divided into a control group and an experimental group according to the random number table and order of admission, with 120 infants in each group. Infants in the control group received standardized nursing, while infants in the experimental group underwent "Internet +" hospital-family standardized feeding management on this basis. The weight, body length and head circumference of the two groups of premature infants were measured at the age of 40 weeks, 6 months, and 12 months after correction; the hemoglobin and serum ferritin levels were detected, and the incidence of anemia and iron deficiency were observed at the age of 6 months and 12 months after correction; the readmission rate, neurological function, and parental satisfaction with care were investigated at the age of 12 months after correction.Results:At the age of 40 weeks after correction, there was no significant difference in weight, body length, and head circumference between the experimental and control groups ( P>0.05) . At the age of 6 and 12 months after correction, the weight, body length, and head circumference were larger in the experimental group than in the control group, and the difference was statistically significant ( P<0.01) . At the age of 6 months after correction, there was no significant difference in the hemoglobin and serum ferritin levels between the two groups of premature infants ( P>0.05) . At the age of 12 months after correction, the hemoglobin and serum ferritin levels in the experimental group was improved compared with the control group; The incidences of anemia and iron deficiency in the experimental group were lower than those in the control group; the readmission rate in the experimental group was lower than that in the control group, and the neurological function score was higher than that in the control group, with statistically significant difference ( P<0.05) ; parents of premature infants in the experimental group had better nursing satisfaction than the control group, and the difference was statistically significant ( P<0.05) . Conclusions:The "Internet +" hospital-family standardized feeding management model can improve the nutritional status of premature infants, promote their catch-up growth, improve prognostic outcomes, and elevate the satisfaction of parents of premature infants with continuous care.

Objective:To screen and identify differentially expressed long non-coding RNA (lncRNAs) in peripheral blood of children with sepsis, and to explore the role of lncRNAs in the pathogenesis of sepsis in children.Methods:The peripheral blood samples of 3 children with sepsis admitted to the ICU of Children′s Hospital of Capital Institute of Pediatrics from January to December 2016 and 3 healthy children who underwent physical examination in our hospital during the same period were selected, and the differential expression profiles of lncRNAs and mRNAs were screened by lncRNAs sequencing technology.The target genes of differentially expressed lncRNAs were predicted and the relationship pairs of lncRNA-mRNA related to F 1F O-ATPase activity were constructed according to the results of GO analysis.Further increasing the sample size, we verified the expression of some F 1F O-ATPase activity-related mRNAs and lncRNAs which were differentially expressed in the screening results by real-time fluorescent quantitative polymerase chain reaction(qRT-PCR). Results:Sequencing results showed that there were 252 lncRNAs with significant differential expression in peripheral blood of children with sepsis compared with healthy children, of which 86 were up-regulated and 166 were down-regulated; meanwhile, there were 2 652 mRNAs with significant differential expression, of which 955 were up-regulated and 1 697 were down-regulated.The results of qRT-PCR showed that the expression of lncRNA ENST00000621933.1, ENST00000616950.1 and ENST00000595748.1 in peripheral blood of children with sepsis increased( P<0.05), while the expression of MT-ATP8, ATP5E and ENST00000624705.1, ENST00000615535.1 in peripheral blood of children with sepsis decreased( P<0.05), which was consistent with the sequencing results. Conclusion:lncRNAs are differentially expressed in peripheral blood of children with sepsis compared with healthy children.The expression levels of lncRNA ENST00000621933.1, ENST00000616950.1, ENST00000595748.1, ENST00000624705.1 and ENST00000615535.1 which their target genes are MT-ATP8 and ATP5E may be related to the development of sepsis in children.

Objective To study effect of atypical antipsychotics on glial cell line-derived neurotrophic factor (GDNF) levels in schizophrenia patients.Methods A total of 104 drug-free schizophrenic patients and 70 healthy controls were recruited.All patients were treated with atypical antipsychotic monotherapy.GDNF serumlevels and psychiatric symptoms were assessed at baseline and at 2,4,6 and 8 weeks of treatment.Results Baseline serum GDNF levels were significantly lower in schizophrenic patients than healthy controls (t =5.596,P ＜ 0.001).GDNF levels gradually increased accompanied by a reduction in psychiatric symptoms during antipsychotic therapy (P ＜ 0.01).The levels of GDNF in responders were significantly changed after treatment (P ＜ 0.01),however,no significant change was found in non-responders (P ＞ 0.05).Furthermore,a negative association between GDNF levels after pharmacotherapy and disease duration in schizophrenic subjects could be observed (r =-0.270,P =0.024).Conclusion The present study suggests that GDNF may be involved in the mechanisms of schizophrenia pathogenesis and pharmacological efficacy.

Objective To study effect of atypical antipsychotics on glial cell line-derived neurotrophic factor (GDNF) levels in schizophrenia patients.Methods A total of 104 drug-free schizophrenic patients and 70 healthy controls were recruited.All patients were treated with atypical antipsychotic monotherapy.GDNF serumlevels and psychiatric symptoms were assessed at baseline and at 2,4,6 and 8 weeks of treatment.Results Baseline serum GDNF levels were significantly lower in schizophrenic patients than healthy controls (t =5.596,P ＜ 0.001).GDNF levels gradually increased accompanied by a reduction in psychiatric symptoms during antipsychotic therapy (P ＜ 0.01).The levels of GDNF in responders were significantly changed after treatment (P ＜ 0.01),however,no significant change was found in non-responders (P ＞ 0.05).Furthermore,a negative association between GDNF levels after pharmacotherapy and disease duration in schizophrenic subjects could be observed (r =-0.270,P =0.024).Conclusion The present study suggests that GDNF may be involved in the mechanisms of schizophrenia pathogenesis and pharmacological efficacy.

Objective To summarize the situations and characteristics of adverse drug reactions (ADR)of bevacizumab(Bev)combined with chemotherapy in treatment of advanced colorectal cancer. Methods The medical data of the patients with advanced colorectal cancer who received Bev combined with chemotherapy in Shanxi Tumor Hospital from April 2010 to December 2016 were collected for retrospective analysis. The sexual distinction,age,therapeutic regimen,time of using Bev,types and grades of adverse reactions which were related to chemotherapy and Bev respectively,the time from medication to appearance of ADR,and the patients′outcomes were comparied. Results A total of 83 patients were enrolled in the study. Of them,39 were males and 44 were females. Fifty-eight cases were <65 years old,25 cases were≥65 years old. There were 43 patients with colon cancer and 40 patients with rectal cancer. Forty-five patients received the treatment with Bev combined with first-line chemotherapy,and the number of cases who received mFOLFOX,FOLFIRI and fluorouracil were 18,22 and 5,respectively. Thirty-eight patients received the treatment with Bev combined with second-line chemotherapy,and the number of cases receiving mFOLFOX,FOLFIRI and fluorouracil were 9,19 and 10,respectively. Of 83 patients,71 patients developed totally 152 case-times ADRs which were related to chemotherapy drugs,among them 31 patients developed 31 case-times ADRs related to Bev. The incidences of ADRs associated with chemotherapy drugs and Bev were 85.5% and 37.3%,respectively. The forenamed proportions were 83.1%(152/183)and 16.9%(31/183)respectively in the total case-times of ADRs. The top five incidences of ADRs associated with chemotherapy drugs were bone marrow suppression(59.0%,49/83),nausea and vomiting(51.8%, 43/83),fatigue(19.3%,16/83),peripheral neuritis(15.7%,13/83)and abnormal liver function (10.8%,9/83),successively. The proportions of levels of I,II,III and IV of ADRs were 28.2%(20/71),36.6%(26/71),23.9%(17/71)and 11.3%(8/71),respectively. The highest incidence of ADRs associated with Bev was hypertension(13.3%,11/83),after that the incidences were hemorrhage (12. 0%,10/83),thrombosis(6. 0%,5/83),intestinal perforation(2. 4%,2/83),proteinuria (2.4%,2/83)and wound healing syndrome(1.2%,1/83),successively. The proportions of levels ofⅠ,Ⅱ,ⅢandⅣof ADR were 58.1%(18/31),19.4%(6/31),16.1%(5/31)and 6.5%(2/31), respectively. The ADRs related to the chemotherapy drugs appeared on day 1-115 after medications,the proportion of less than or equal to 3 months were 73.2%(52/71). The ADRs related to Bev appeared on day 5-130 after medications,the proportion of less than or equal to 3 months were 87.1%(27/31). The results of stratification analysis of gender,age(<65 years old and≥65 years old),using time(first-line or second-line chemotherapy),cumulant of Bev(≤6 periods and >6 periods),and combined with different chemotherapy regimens(mFOLFOX,FOLFIRI and fluorouracil)showed that there were no significant differences between the incidences of ADRs related to chemotherapeutic drugs and Bev among the groups of different clinical features. The proportion of levels III and IV ADRs related to chemotherapeutic drugs were higher than those of Bev combining with single drug regimen of 5-FU(P<0.05). There were no significant differences in ADR level distributions of chemotherapeutic drugs and Bev in other clinical features groups (all P>0.05). Conclusions The main ADRs caused by Bev combined with different chemotherapies in treatment of advanced colorectal cancer are ADR related to chemotherapeutic drugs. The ADRs associated with chemotherapeutic drugs and Bev are level Ⅰ-Ⅱ mainly and had better safety.

Objective To summarize the situations and characteristics of adverse drug reactions (ADR)of bevacizumab(Bev)combined with chemotherapy in treatment of advanced colorectal cancer. Methods The medical data of the patients with advanced colorectal cancer who received Bev combined with chemotherapy in Shanxi Tumor Hospital from April 2010 to December 2016 were collected for retrospective analysis. The sexual distinction,age,therapeutic regimen,time of using Bev,types and grades of adverse reactions which were related to chemotherapy and Bev respectively,the time from medication to appearance of ADR,and the patients′outcomes were comparied. Results A total of 83 patients were enrolled in the study. Of them,39 were males and 44 were females. Fifty-eight cases were <65 years old,25 cases were≥65 years old. There were 43 patients with colon cancer and 40 patients with rectal cancer. Forty-five patients received the treatment with Bev combined with first-line chemotherapy,and the number of cases who received mFOLFOX,FOLFIRI and fluorouracil were 18,22 and 5,respectively. Thirty-eight patients received the treatment with Bev combined with second-line chemotherapy,and the number of cases receiving mFOLFOX,FOLFIRI and fluorouracil were 9,19 and 10,respectively. Of 83 patients,71 patients developed totally 152 case-times ADRs which were related to chemotherapy drugs,among them 31 patients developed 31 case-times ADRs related to Bev. The incidences of ADRs associated with chemotherapy drugs and Bev were 85.5% and 37.3%,respectively. The forenamed proportions were 83.1%(152/183)and 16.9%(31/183)respectively in the total case-times of ADRs. The top five incidences of ADRs associated with chemotherapy drugs were bone marrow suppression(59.0%,49/83),nausea and vomiting(51.8%, 43/83),fatigue(19.3%,16/83),peripheral neuritis(15.7%,13/83)and abnormal liver function (10.8%,9/83),successively. The proportions of levels of I,II,III and IV of ADRs were 28.2%(20/71),36.6%(26/71),23.9%(17/71)and 11.3%(8/71),respectively. The highest incidence of ADRs associated with Bev was hypertension(13.3%,11/83),after that the incidences were hemorrhage (12. 0%,10/83),thrombosis(6. 0%,5/83),intestinal perforation(2. 4%,2/83),proteinuria (2.4%,2/83)and wound healing syndrome(1.2%,1/83),successively. The proportions of levels ofⅠ,Ⅱ,ⅢandⅣof ADR were 58.1%(18/31),19.4%(6/31),16.1%(5/31)and 6.5%(2/31), respectively. The ADRs related to the chemotherapy drugs appeared on day 1-115 after medications,the proportion of less than or equal to 3 months were 73.2%(52/71). The ADRs related to Bev appeared on day 5-130 after medications,the proportion of less than or equal to 3 months were 87.1%(27/31). The results of stratification analysis of gender,age(<65 years old and≥65 years old),using time(first-line or second-line chemotherapy),cumulant of Bev(≤6 periods and >6 periods),and combined with different chemotherapy regimens(mFOLFOX,FOLFIRI and fluorouracil)showed that there were no significant differences between the incidences of ADRs related to chemotherapeutic drugs and Bev among the groups of different clinical features. The proportion of levels III and IV ADRs related to chemotherapeutic drugs were higher than those of Bev combining with single drug regimen of 5-FU(P<0.05). There were no significant differences in ADR level distributions of chemotherapeutic drugs and Bev in other clinical features groups (all P>0.05). Conclusions The main ADRs caused by Bev combined with different chemotherapies in treatment of advanced colorectal cancer are ADR related to chemotherapeutic drugs. The ADRs associated with chemotherapeutic drugs and Bev are level Ⅰ-Ⅱ mainly and had better safety.