Objective To explore the changing trend in the disease burden of gout in China from 1990 to 2021, and analyze the incidence, prevalence, and disability-adjusted life years (DALYs) by age and gender, with comparisons to global patterns, and to predict the disease burden of gout in China in 2030. Methods Data from the Global Burden of Disease (GBD) database were used to analyze changes in gout burden. Joinpoint regression was used to estimate the average annual percentage change (AAPC) with 95% confidence intervals (CIs). Comparative analyses were conducted on data from China and the world, and an ARIMA model was used to project China's gout burden in 2030. Results From 1990 to 2021, China's age-standardized incidence rate (ASIR) rose from 122.52 to 151.61/100,000, exceeding the global rise from 93.09 to 109.07/100,000. The age-standardized prevalence rate (ASPR) in China increased from 640.67/100,000 to 810.35/100,000, compared to a global rise from 536.54/100,000 to 653.81/100,000. The age-standardized DALYs rate (ASDR) in China increased from 20.2/100,000 to 25.43/100,000, surpassing the global increase from 16.67/100,000 to 20.21/100,000. AAPCs for ASIR, ASPR, and ASDR in China were 0.70%, 0.77%, and 0.75%, respectively, all higher than global rates. Middle-aged and elderly men faced the highest burden. It was predicted that there will be a decline in China's ASIR and ASPR by 2030, while ASDR will remain stable. Conclusion The disease burden of gout in China has increased significantly, outpacing global trends. Targeted interventions for hyperuricemia, particularly in elderly men, are crucial to reduce the future disease burden.

ObjectiveThis study aims to investigate the therapeutic effects of Wenweishu granule （WWSG） on functional dyspepsia （FD） with spleen-stomach deficiency cold syndrome in rats by integrating network pharmacology， molecular docking， and animal experiments. MethodsActive components and corresponding targets of WWSG were collected from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP） and the Bioinformatics Analysis Tool for Molecular Mechanism of Traditional Chinese Medicine （BATMAN-TCM）. Disease-related targets for FD with spleen-stomach deficiency cold syndrome were screened using GeneCards and the Integrative Pharmacology-based Research Platform of Traditional Chinese Medicine （TCMIP）. Core therapeutic targets were identified via Cytoscape and validated by molecular docking. A rat model of FD with spleen-stomach deficiency cold syndrome was established using vinegar gavage combined with tail-clamping. The rats were randomly divided into a model group， low-， medium-， and high-dose WWSG groups （2.0， 4.0， 8.0 g·kg^-1）， a domperidone group （3.0 mg·kg^-1）， a Fuzi Lizhong pillwan （0.8 g·kg^-1）， and a normal control group （n=10 per group）. Drugs were administered once daily by gavage for 14 consecutive days. After treatment， body weight， symptom scores， and gastrointestinal motility indices were recorded. Gastric and duodenal pathologies changes were observed via hematoxylin-eosin （HE） staining. Brain-gut peptides were measured in serum and tissue using enzyme-linked immunosorbent assay （ELISA）. Immunohistochemistry and Western blot were performed to assess stem cell factor （SCF） and receptor tyrosine kinase （c-Kit） protein expression in gastric tissues. ResultsA total of 305 drug targets， 1 140 disease targets， and 116 overlapping targets were identified. Cytoscape analysis revealed 104 core targets. Enrichment analysis indicated that the SCF/c-Kit signaling pathway was the key mechanism. Molecular docking confirmed a strong binding affinity between active components of WWSG and SCF/c-Kit proteins （binding energy<-5.1 kcal·mol^-1）. Compared with the normal group， model rats exhibited slower weight gain （P<0.05）， reduced gastric emptying and intestinal propulsion （P<0.01）， mild gastric mucosal shedding， duodenal inflammatory cell infiltration， decreased levels of gastrin （GAS）， 5-hydroxytryptamine （5-HT）， and vasoactive intestinal peptide （VIP） （P<0.05， P<0.01）， and elevated somatostatin （SS） expression （P<0.05， P<0.01）. WWSG treatment ameliorated weight gain， symptom scores， and low-grade inflammation in gastric/duodenal tissues. High-dose WWSG significantly improved gastric emptying and intestinal propulsion， upregulated GAS， 5-HT， and VIP， and downregulated SS expression in serum and tissues （P<0.05， P<0.01）. Immunohistochemistry and Western blot demonstrated that SCF and c-Kit protein expression was decreased in the model group （P<0.05， P<0.01）， which was reversed by WWSG intervention （P<0.05）. ConclusionWWSG exerts therapeutic effects on FD with spleen-stomach deficiency cold syndrome in rats， potentially by regulating the SCF/c-Kit signaling pathway to enhance gastrointestinal motility.

Objective:To explore the characteristics of SLCO1B1/ SLCO1B3 gene variants among children with Rotor syndrome (RS). Methods:Four children who were admitted to the Department of Hepatology of Hunan Children′s Hospital between January 2019 and January 2022 were selected as the study subjects. Trio-whole exome sequencing was carried out for the four families, and gel electrophoresis was used to verify an insertional variant of long-interspersed element-1 (LINE-1).Results:Genetic testing has identified three variants of the SLCO1B1 gene, including c. 1738C>T (p.R580*), c. 757C>T (p.R253*) and c. 1622A>C (p.Q541P), and two variants of the SLCO1B3 gene, including c. 481+ 22insLINE-1 and c. 1747+ 1G>A among the children. Three of them were found to harbor homozygous variants of the SLCO1B1/ SLCO1B3 genes, and one has harbored compound heterozygous variants. Sanger sequencing confirmed the existence of all variants, and gel electrophoresis has confirmed the existence of the LINE-1 insertional variant of about 6 kb within intron 6 of the SLCO1B3 gene in all children. Conclusion:The pathogenesis of the RS among the four children may be attributed to the variants of the SLCO1B1/ SLCO1B3 genes. The LINE-1 insertion variant of the SLCO1B3 gene may be common among Chinese RS patients.

A 72-year-old female patient was admitted to the emergency department of Qintang District People′s Hospital of Guigang City in August 2023 due to chills and fever, abdominal distension and pain, diarrhea, cough and shortness of breath for 1 day. She had a history of chronic obstructive and pulmonary heart disease, stage Ⅲ hypertension, and ceftazidime allergy. Clinical diagnosis of acute bacterial infection of chronic obstructive pneumonia was made and levofloxacin combined with piperacillin/tazobactam were given as symptomatic treatment. The blood culture reported Campylobacter fetus after four days, and the patient was cured and discharged after seven days with negative blood culture. The morphology and mass spectrometry identification of the strain were consistent with the definition of Campylobacter fetus. Whole genome sequencing predicted the multi-site sequence type as Campylobacter fetus subsp. fetus( Cff) ST20, carrying the tetracycline resistance gene tet (O/M/O), 18 flagella genes (including rpoN gene from Campylobacter jejuni. these genes were not found in the other two Campylobacter fetus subspecies), and six virulence genes (including like-typhoidal toxin and typhoid toxin genes). The pathogen has the ecological characteristics of parasitic farmed animal colonization and the biological characteristics of high mobility and virulence. These attributes facilitated its entry into the bloodstream via the fecal-oral route, leading to invasive infections.

Objective:To study the operational efficiency of township health centers in poverty-lifted and non-poverty counties in Hubei Province in the new era of rural revitalization, so as to provide a reference for further promoting township health centers to make up for their shortcomings and improve their service capabilities.Methods:Data was sourced from databases such as the Health and Health Statistics Annual Report, Health Finance Annual Report of Hubei Province for the year 2022. The number of health technicians, business premises area, actual bed count, and the number of equipment worth more than 10 000 yuan in 1 010 township health centers from 36 poverty-lifted counties and 47 non-poverty counties in Hubei Province were taken as input variables. The number of discharged patients, total outpatient visits, the number of people aged 65 and above receiving health management, and the number of hypertensive and type 2 diabetes patients receiving standardized management were taken as output variables. The number of permanent population, per capita regional GDP, population density, urbanization rate, and local general public budget investment were taken as environmental variables. The three-stage data envelopment analysis(DEA) method was applied to measure the operational efficiency of township health centers in poverty-lifted and non-poverty counties in Hubei Province.Results:Environmental variables had different impacts on the operational efficiency of township health centers in poverty-lifted and non-poverty counties ( P<0.01). After removing the impacts, the comprehensive technical efficiency, pure technical efficiency, and scale efficiency of township health centers in poverty-lifted and non-poverty counties in Hubei Province were 0.894, 0.960, 0.931 and 0.840, 0.919, 0.911, respectively; there were 22 pure technical efficiency township health centers in poverty-lifted counties, accounting for 61.10%, with 13 having a scale efficiency of 1, accounting for 36.00%, and 19 with increasing returns to scale, accounting for 52.78%; there were 22 pure technical efficiency township health centers in non-poverty counties, accounting for 46.80%, with 13 having a scale efficiency of 1, accounting for 27.66%, and 22 with increasing returns to scale, accounting for 46.81%. Conclusions:The operational efficiency of poverty-lifted counties was better than that of non-poverty counties. The main reason for the poor operation efficiency of township health centers in poverty-lifted counties was the low scale efficiency, and the poor operation efficiency of township health centers in non-poverty counties was mainly due to insufficient investment in technology development and scale. It is suggested that township health centers in poverty-lifted counties should seize the strategic opportunity of rural revitalization and expand reasonably. Township health centers in non-poverty counties should innovate development methods while improving the capacity of basic medical services.

Objective:To study the operational efficiency of township health centers in poverty-lifted and non-poverty counties in Hubei Province in the new era of rural revitalization, so as to provide a reference for further promoting township health centers to make up for their shortcomings and improve their service capabilities.Methods:Data was sourced from databases such as the Health and Health Statistics Annual Report, Health Finance Annual Report of Hubei Province for the year 2022. The number of health technicians, business premises area, actual bed count, and the number of equipment worth more than 10 000 yuan in 1 010 township health centers from 36 poverty-lifted counties and 47 non-poverty counties in Hubei Province were taken as input variables. The number of discharged patients, total outpatient visits, the number of people aged 65 and above receiving health management, and the number of hypertensive and type 2 diabetes patients receiving standardized management were taken as output variables. The number of permanent population, per capita regional GDP, population density, urbanization rate, and local general public budget investment were taken as environmental variables. The three-stage data envelopment analysis(DEA) method was applied to measure the operational efficiency of township health centers in poverty-lifted and non-poverty counties in Hubei Province.Results:Environmental variables had different impacts on the operational efficiency of township health centers in poverty-lifted and non-poverty counties ( P<0.01). After removing the impacts, the comprehensive technical efficiency, pure technical efficiency, and scale efficiency of township health centers in poverty-lifted and non-poverty counties in Hubei Province were 0.894, 0.960, 0.931 and 0.840, 0.919, 0.911, respectively; there were 22 pure technical efficiency township health centers in poverty-lifted counties, accounting for 61.10%, with 13 having a scale efficiency of 1, accounting for 36.00%, and 19 with increasing returns to scale, accounting for 52.78%; there were 22 pure technical efficiency township health centers in non-poverty counties, accounting for 46.80%, with 13 having a scale efficiency of 1, accounting for 27.66%, and 22 with increasing returns to scale, accounting for 46.81%. Conclusions:The operational efficiency of poverty-lifted counties was better than that of non-poverty counties. The main reason for the poor operation efficiency of township health centers in poverty-lifted counties was the low scale efficiency, and the poor operation efficiency of township health centers in non-poverty counties was mainly due to insufficient investment in technology development and scale. It is suggested that township health centers in poverty-lifted counties should seize the strategic opportunity of rural revitalization and expand reasonably. Township health centers in non-poverty counties should innovate development methods while improving the capacity of basic medical services.

Objective:To explore the effect of "WeChat official account"+multidisciplinary team (MDT) cooperative nursing in discharged patients with cerebral infarction.Methods:From January 2019 to December 2020, 118 discharged patients with cerebral infarction were selected by convenience sampling from Qingdao Hospital affiliated to Shandong First Medical University as the research object. The patients admitted from January to December 2019 were taken as the control group, and the patients admitted from January to December 2020 were taken as the observation group, with 59 cases each. The control group was given routine intervention and follow-up after discharge. The observation group received "WeChat official account"+ MDT cooperative nursing on the basis of the control group. Both groups were intervened for three months. The Stroke Behavior Change Questionnaire, Fugl-Meyer Assessment (FMA) , Self-Rating Anxiety Scale (SAS) , Self-Rating Depression Scale (SDS) , compliance and adverse events of the two groups were compared before and after the intervention.Results:Before the intervention, there was no statistical difference between the two groups in the scores of Stroke Behavior Change Questionnaire, FMA, SDS and SAS ( P>0.05) . After the intervention, the scores of Stroke Behavior Change Questionnaire and FMA in the observation group were higher than those before the intervention and the control group, and the SDS and SAS scores were lower than those before the intervention and the control group, with statistical differences ( P<0.01) . The treatment compliance of the observation group was 94.92% (56/59) , higher than 81.36% (48/59) of the control group, with a statistical difference ( P<0.05) . Conclusions:"WeChat official account" + MDT cooperative nursing can effectively improve the exercise behavior of discharged cerebral infarction patients, increase compliance, promote neurological recovery, alleviate negative emotions, and reduce the incidence of adverse events after discharge, which is worthy of clinical practice.

Objective:To explore the effect of mind mapping combined with continuous quality improvement in the teaching of interns in gastroenterology department.Methods:The 55 students who interned in the gastroenterology department of our hospital from September 2019 to January 2020 were set as the control group and adopted traditional teaching methods; the other 54 students who interned in the gastroenterology department of our hospital from February 2020 to June 2020 were set as the control group; 55 students who interned in the gastroenterology department of our hospital from July 2020 to November 2020 were set as a combined group, and received mind mapping combined with continuous quality improvement teaching. The gastroenterology knowledge and theory assessment results, practical skills operation assessment results and learning initiative, self-study ability, comprehensive thinking ability, teamwork ability, analysis and problem-solving ability, induction and summary ability and so on were compared between the two groups, and the teaching satisfaction rate at the time of leaving the department were also compared. SPSS 20.0 was used for t test and chi-square test. Results:Before the training, there was no statistically significant difference in the three groups of theoretical assessment scores, practical skills operation assessment scores and various ability scores. When leaving the department, the theoretical assessment scores of the combined group and the mind mapping group were (89.74±4.18) points and (86.52±3.72) points, and the performance evaluation scores of practical skills were (90.04±4.86) points and (87.46±4.52) points, respectively. The theoretical evaluation scores and practical skills evaluation scores of the two groups were higher than those of the control group, and the combined group was higher than the mind mapping group, with statistically significant differences ( P<0.05). The scores of various abilities of the combined group and the mind mapping group were higher than those of the control group, and the scores of all indicators in the combined group were higher than those of the mind mapping group, with statistical significance ( P<0.05). The total teaching satisfaction of combined group and mind mapping group was higher than that of the control group, and the total teaching satisfaction of the combined group was higher than that of the mind mapping group. Conclusion:Mind mapping combined with continuous quality improvement has a significant effect on the teaching of gastroenterology interns, which can improve students' abilities and the teaching satisfaction.

Objective:To explore the influencing factors of fear of falling in patients with first cerebral infarction in recovery period.Methods:Using the convenient sampling method, a total of 221 patients with first cerebral infarction who were hospitalized and treated in Department of Neurology and Department of Cardiology in Qingdao Hospital of Shandong First Medical University from May 2017 to October 2019 were selected as research objects. Short Falls Efficacy Scale International (SFES-I) was used to evaluate the patients, and the influencing factors of the fear of falling in patients with first cerebral infarction in recovery period were analyzed.Results:The results of univariate analysis showed that SFES-I scores of patients with different ages, marital status, family monthly income, history of falls, number of chronic diseases, anxiety, depression, activity of daily living (ADL) limitation and walking ability had statistically significant differences ( P<0.05) . The results of multivariate logistic regression analysis showed that five variables including age (65-80) , marital status, history of falls, anxiety, and depression were retained in the regression model, and the differences were statistically significant ( P<0.05) . Among them, the marital status of the spouse was the protective factors of fear of falling of patients ( OR<1) , while the other 4 factors were risk factors of fear of falling of patients ( OR>1) . Conclusions:Age, marital status, history of falling, anxiety, and depression are the influencing factors of falling fear in patients with first cerebral infarction in recovery period, so targeted nursing measures should be taken according to different characteristics of patients.

Objective:To evaluate the efficacy of roxatidine and omeprazolein on preventing gastrointestinal bleeding in critically ill patients.Methods:A prospective cohort study was conducted in adult patients admitted to an intensive care unit (ICU), who had risk factors for stress related mucosal disease (SRMD), and had an estimated stay of no less than 5 days and mechanical ventilation for more than 48 h. Patients were randomized into the experiment group (Roxatidine 75 mg IV Q12 h) and control group (Omeprazole 40 mg IV Q12 h). Demographic data, acute physiology and chronic health score (APACHEⅡ) and SOFA score on day 1 were collected, intragastric pH values were tested every 2 hours for the first 5 days, the daily average of pH and proportion of patients with average pH≥4 were calculated. Stool occult blood were detected at day 1 and bacterial culture of gastric juice were performed before medication administration and on day 5 after medication administration. The implementation of enteral nutrition support, situation of gastrointestinal hemorrhage and adverse effects were analyzed. Furthermore, length of hospital stay and mortality in ICU and on the 28th day were acquired. SPSS 22.0 software was used for data analysis. Consecutive data were expressed as mean and standard deviation, categorical data were expressed as frequencies (percentage). Comparison of measurement data between groups was performed by analysis of variance or rank sum test. Comparison of count data between groups was performed by the Chi-square test. P<0.05 was regarded as statistically significant. Results:A total of 91 patients were recruited and randomly separated into experimental group ( n=46) and control group ( n=45) from October 2017 to March 2018. There were no statistical differences in gender, age, body mass index (BMI), enteral nutrition status, APACHEⅡ and SOFA score on day 1 between the two groups (all P>0.05). Roxatidine in the experiment group rapidly increased the intragastric pH to ≥4.0 and continued to stabilize at pH ≥4.0 during the monitoring period. Omeprazole increased and maintained intragastric pH≥5.0. The proportion of patients with average pH≥4.0 was 82.5% in the second 24 hours in the experiment group, and stably increased to 90% on day 5. There were no significant differences between groups in gastrointestinal bleeding, length of hospital stay, and mortality in ICU and on 28th day(all P> 0.05). No drug related adverse effects occurred during the study period. Logistic-regression analysis did not screen for risk factors of SRMD. Conclusions:Roxatidine acetate hydrochloride can rapidly elevate and maintain the gastric pH above 4.0, and has similar efficacy and safety as omeprazole in inhibiting gastric acid secretion and preventing SRMD with gastrointestinal bleeding.