OBJECTIVES: To develop an early atrial fibrillation (AF) risk prediction model based on large-scale electrocardiogram (ECG) data from the Chinese population. METHODS: The data of multiple ECG records of 30 383 patients admitted in the Chinese PLA General Hospital between 2009 and 2023 were randomly divided into the training set and the internal testing set in a 7:3 ratio. The predictive factors were selected based on the training set using univariate analysis, LASSO regression, and the Boruta algorithm. Cox proportional hazards regression was used to establish the ECG model and the composite model incorporating age, gender, and ECG model score. The discrimination power, calibration, and clinical net benefits of the models were evaluated using the area under the receiver operating characteristic curve (AUROC), calibration curves, and decision curves. RESULTS: The cohort included 51.1% male patients with a median age of the patients of 51 (36, 62) years and an AF incidence of 4.5% (1370/30 383). In the ECG model, the parameters related to the P wave and QRS complex were identified as significant predictors. In the testing set, the AUROC of the ECG model for predicting 5-year AF risk was 0.77 (95% CI: 0.74-0.80), which was increased to 0.81 (95% CI: 0.78-0.83) after incorporating age and gender, with a net reclassification improvement of 0.123 and an integrated discrimination improvement of 0.04 (P<0.05). The calibration curve of the model was close to the diagonal line. Decision curve analysis showed that the clinical net benefit of the composite model was higher than that of the ECG model across the majority of threshold probability. CONCLUSIONS The composite model incorporating quantitative ECG features during sinus rhythm, along with age and gender, can effectively predict AF risk in the Chinese population, thus providing a low-cost screening tool for early AF risk assessment and management.
Humans ; Atrial Fibrillation/epidemiology* ; Electrocardiography ; Middle Aged ; Male ; Female ; China/epidemiology* ; Proportional Hazards Models ; Adult ; Risk Factors ; Risk Assessment ; East Asian People

Ulcerative colitis(UC)is a chronic,progressive inflammatory bowel disease associated with an increased risk of color-ectal cancer.In recent years,traditional Chinese medicine(TCM)has been increasingly utilized in the treatment of UC,and its thera-peutic efficacy has gained widespread recognition.Nevertheless,several challenges remain in optimizing TCM's role in UC manage-ment,which hinder the full realization of its potential benefits.This paper reviews the current status of TCM in treating UC,identifies existing challenges,and proposes targeted strategies to promote the advancement of TCM in this field.

Ulcerative colitis(UC)is a chronic,progressive inflammatory bowel disease associated with an increased risk of color-ectal cancer.In recent years,traditional Chinese medicine(TCM)has been increasingly utilized in the treatment of UC,and its thera-peutic efficacy has gained widespread recognition.Nevertheless,several challenges remain in optimizing TCM's role in UC manage-ment,which hinder the full realization of its potential benefits.This paper reviews the current status of TCM in treating UC,identifies existing challenges,and proposes targeted strategies to promote the advancement of TCM in this field.

Objective:To explore the effectiveness of predictive exercise intervention combined with information-knowledge-attitude-practice (IKAP) model-based nursing in patients with gestational hypertension (GH) .Methods:Convenience sampling was used to select 130 GH patients admitted to Taizhou Hospital of Zhejiang Province from January 2022 to December 2024 for the study. Sixty-five GH patients admitted from January 2022 to June 2023 were set as control group, and 65 GH patients admitted from July 2023 to December 2024 were set as observation group. Control group implemented conventional nursing, and observation group was treated with predictive exercise intervention combined with IKAP model-based nursing on the basis of conventional nursing. Depression, delivery outcomes, and incidence of complications were compared between two groups of GH patients after intervention.Results:During the study period, no patients were excluded from observation group and one patient was withdrawn from control group for personal reasons, resulting in the inclusion of 64 patients. Patients in observation group at 6 weeks postpartum had lower scores on the Chinese version of the Edinburgh Postnatal Depression Scale than those in control group, and the incidence of premature labor, cesarean section, and lower limb swelling were lower than those in control group, and the differences were all statistically significant ( P<0.05) . Conclusions:Predictive exercise intervention combined with IKAP model-based nursing can improve the coagulation function of GH patients, reduce the incidence of lower limb swelling, alleviate the patient's postpartum depression, and facilitate safe delivery.

Objective:To explore the effectiveness of predictive exercise intervention combined with information-knowledge-attitude-practice (IKAP) model-based nursing in patients with gestational hypertension (GH) .Methods:Convenience sampling was used to select 130 GH patients admitted to Taizhou Hospital of Zhejiang Province from January 2022 to December 2024 for the study. Sixty-five GH patients admitted from January 2022 to June 2023 were set as control group, and 65 GH patients admitted from July 2023 to December 2024 were set as observation group. Control group implemented conventional nursing, and observation group was treated with predictive exercise intervention combined with IKAP model-based nursing on the basis of conventional nursing. Depression, delivery outcomes, and incidence of complications were compared between two groups of GH patients after intervention.Results:During the study period, no patients were excluded from observation group and one patient was withdrawn from control group for personal reasons, resulting in the inclusion of 64 patients. Patients in observation group at 6 weeks postpartum had lower scores on the Chinese version of the Edinburgh Postnatal Depression Scale than those in control group, and the incidence of premature labor, cesarean section, and lower limb swelling were lower than those in control group, and the differences were all statistically significant ( P<0.05) . Conclusions:Predictive exercise intervention combined with IKAP model-based nursing can improve the coagulation function of GH patients, reduce the incidence of lower limb swelling, alleviate the patient's postpartum depression, and facilitate safe delivery.

Objective:To explore the function of LIM and calponin homology domains 1(LIMCH1)in the development and progression of oral squamous cell carcinoma(OSCC),along with their potential clinical applications.Methods:By utilizing transcriptome sequencing data from two groups of oral squa-mous cell carcinoma patients,along with bioinformatics analytical techniques such as Gene Ontology(GO)and gene co-expression networks,we identified genes that might play a pivotal role in the patho-genesis of oral squamous cell carcinoma.We employed real-time quantitative PCR and Western blotting to validate the expression patterns of these genes across twelve patient tissue samples.Furthermore,we con-ducted CCK-8 assays,flow cytometry analyses,and scratch wound healing assays to assess the impact of key genes on the biological behaviors of both the Ca127 oral squamous cell carcinoma cell line and the po-tentially malignant DOK oral lesion cell line.Additionally,we examined correlations between these key genes and clinical disease parameters in 214 oral squamous cell carcinoma patients using The Cancer Ge-nome Atlas(TCGA)data;gene set enrichment analysis(GSEA)analysis results were also incorporated to enhance our findings from real-time quantitative PCR and Western blotting regarding potential mecha-nisms underlying the action of these key genes.Results:The integrated analysis of sequencing data and bioinformatics revealed that LIMCH1 exhibited significantly reduced mRNA(P＜0.001)and protein levels(P＜0.01)in the oral squamous cell carcinoma tissues compared with normal control tissues.In the Ca127 cells,the low LIMCH1 level group demonstrated a larger wound healing area within 24 hours than the control group(P＜0.01),enhanced proliferation capacity over 72 hours relative to the control group(P＜0.01),and an increased apoptosis rate within 24 hours compared with the high expression group(P＜0.05).However,no significant differences were observed between the low and high level groups in DOK cells.Furthermore,it was determined that low LIMCH1 level correlated with poor prognosis in the patients(P=0.013)and a higher lymph node metastasis rate(P＜0.05).Investigations into the poten-tial mechanisms of action indicated that LIMCH1 did not influence the onset or progression of oral squa-mous cell carcinoma via the epithelial-mesenchymal transition pathway.Conclusion:LIMCH1 level may function as a promising biomarker to aid in the prognostic assessment of oral squamous cell carcinoma;however,its precise mechanistic role requires further investigation.

The structure and common faults of Philips iU22 and iE33 ultrasound diagnostic equipment were introduced,the fault phenomena,causes and maintenance ideas in the daily work of this series of ultrasonic equipment were analyzed.The equipment was repaired after the failure occurred by analyzing the fault causes,replacing the corresponding components or reinstalling the system software etc.,so as to etc.,so as to provide a reference for the daily maintenance work of medical engineers.

Nowadays the contents and form of community pharmaceutical services have become more complex, it is necessary to develop pharmaceutical services in line with the characteristics of community and meeting the actual needs of patients. The "dual drug" refers the combination of pharmaceutical effects of the drug with the language effects of pharmacists. This paper reviews the status quo of pharmaceutical services at home and abroad, patient needs and demands, problems and challenges in pharmaceutical services. The article introduces the experiences of development and implementation of pharmaceutical services based on the"dual drug"priciple, and the preliminary results in author′s institution, to provide reference for a nevel model of pharmaceutical services.

Objective:To explore the clinical characteristics and genetic basis for a child with global developmental delay and autism.Methods:A child who had presented at West China Second University Hospital of Sichuan University on April 13, 2021 was selected as the study subject. Clinical manifestations, laboratory examination and result of genetic testing were analyzed.Results:The main symptoms of the child had included cognitive, language and motor delay, autism and epilepsy. Electroencephalogram revealed multiple focal discharges in both waking and sleeping stages, with the remarkable one seen at the sleeping stage. Cranial MRI showed pachygyria and local cortical thickening, Whole exome sequencing (WES) revealed that the child has harbored a heterozygous c. 1589_1595dup (p.Gly533Leufs*143) frameshifting variant in the TBR1 gene (OMIM 604616). Based on the guidelines from the American College of Medical Genetics and Genomics, the variant was predicted to be likely pathogenic (PS2+ PVS1_Supporting+ PM2_Supporting). After treated with levetiracetam and rehabilitation training, the child did not have seizure in the past 5 months, and his motor development has also significantly improved. Conclusion:The c. 1589_1595dup variant of the TBR1 gene probably underlay the disease in this patient.

Objective:To investigate the application value of intraoperative motor nerve monitoring in cervical neurogenic tumor surgery.Methods:The efficacy of intraoperative neuromonitoring (IONM) was analyzed retrospectively in 18 patients, including 6 males and 12 females, aged from 15 to 74 years, treated in Affiliated Drum Tower Hospital, Medical School of Nanjing University from June 2019 to September 2022 who underwent total cystectomy of cervical neurogenic tumors under intraoperative nerve monitoring.Results:All 18 patients had complete tumor removal, including 8 patients with tumors from the vagus nerve and 10 patients with tumors from the brachial plexus nerve. Postoperative nerve functions were normal in patients with tumors from brachial plexus nerve, and incomplete vocal cord paralysis occurred in 2 patients with tumors from vagus vagus nerve. The total incidence of motor nerve injury was 11.1% (2/18). All patients were followed up for 6 to 45 months, with no tumor recurrence.Conclusion:Intraoperative neuromonitoring has significant values in surgery of cervical neurogenic tumors, which is helpful to remove completely the tumors on the basis of protecting the nerve functions to the maximum extent.