Objective To investigate whether there exist differences in the improvement of left ventricular diastolic function between angiotensin receptor-neprilysin inhibitor(ARNI)and angiotensin-converting enzyme inhibitor(ACEI)/angiotensin receptor blocker(ARB)in patients with hypertensive heart disease(HHD).Methods A retrospective cohort study was conducted on the HHD patients admitted in Department of Cardiovascular Diseases of our hospital from January 2021 to December 2024.The general information,echocardiographic parameters before and after treatment,and results of routine tests were collected.Finally,517 HHD patients were subjected,including 117 receiving ARNI treatment(ARNI group)and 400 getting ACEI/ARB treatment(ACEI/ARB group).A 1∶1 propensity score matching(PSM)was performed with a caliper value of 0.02,resulting in 89 matched cases for each group.Electrocardiography was performed to assess left ventricular diastolic dysfunction(LVDD),with various parameters,including left atrial volume index,early diastolic peak velocity at the interventricular septal portion of mitral annulus(septal e'),early diastolic peak velocity at the lateral wall portion of mitral annulus(lateral e'),tricuspid regurgitation velocity,and E/e'.These parameters were followed up and reassessed during the treatment period.Kaplan-Meier survival curve was plotted to compare the incidence of LVDD between the 2 groups.Multivariable logistic regression model was employed to identify the risk factors contributing to LVDD.Results The median follow-up time was 412(309,736)d in the whole cohort,and was 409(300,729)d for the patients after PSM.Kaplan-Meier survival analysis demonstrated that the incidence of LVDD was lower in the ARNI group than the ACEI/ARB group both before and after PSM(P<0.05).After treatment,the ARNI group obtained lower lateral e'[8.00(7.00,9.40)vs 9.00(7.10,10.30)cm/s,P<0.001],thinner left ventricular posterior wall thickness[12.20(10.80,12.80)vs 12.30(11.20,12.90)mm,P<0.048]when compared with the ACEI/ARB group.After adjusting for confounding factors,multivariable logistic regression analysis revealed that advanced age(OR=1.082,P<0.001),increased systolic blood pressure(OR=1.009,P=0.005),thicker left ventricular posterior wall thickness(OR=1.462,P<0.001),left atrial enlargement(OR=1.081,P<0.001),and use of calcium channel blocker(OR=1.548,P=0.006)were independent risk factors for LVDD,and positively correlated with the risk of LVDD.While,male(OR=0.709,P=0.043)and BMI(OR=0.933,P=0.006)were protective factors,which were negatively correlated with LVDD risk.Conclusion In HHD patients,ARNI is superior to ACEI/ARB in reducing the incidence of LVDD.

Objective Investigate the expression level of discs large homolog associated protein 5(DLGAP5)in oral squamous cell carcinoma(OSCC)and analyze its effects on cell proliferation,migration,invasion capacity,and the Warburg effect.Methods Bioinformatics analysis was performed to identify the potential therapeutic targets for OSCC.A total of 72 OSCC tissue samples and 40 adjacent non-cancerous tissue samples collected in the First Affiliated Hospital of Shihezi University from 2013 to 2024 were included,and the clinical pathological and prognostic data were collected from patients.Immunohistochemistry assay was applied to detect the protein expression of DLGAP5,and its association with clinical pathological features was analyzed.Kaplan-Meier survival curve was plotted for survival analysis,and Cox regression model was employed to analyze the prognostic factors.The expression of DLGAP5 at mRNA and protein levels was detected in HOK,SCC-9,SCC-15,SCC-25,and CAL-27 cell lines with RT-qPCR and Western blotting,respectively.Four small interfering RNAs(siRNAs)were designed to target the DLGAP5 sequence,and then based on the transfection efficiency,the sequence with optimal silencing effect was selected for subsequent functional studies.After DLGAP5 was silenced in the CAL-27 and SCC-15 cells,Western blotting was applied to detect the expression of hexokinase 2(HK2)and enolase 1(ENO1),CCK-8,scratch healing and Transwell assays were conducted to assess cell proliferation,migration,and invasion capabilities,and glucose,lactate,and ATP detection kits were utilized to determine the glycolytic metabolic levels in OSCC cells.Results Bioinformatics analysis indicates that DLGAP5 is a potential key therapeutic target for OSCC.Experimental validation demonstrated that DLGAP5 was highly expressed in both OSCC tissues and cells(P<0.05).Analysis of clinical pathology and prognostic data revealed that DLGAP5 expression level was significantly correlated with tumor TNM stage,lymph node metastasis,and differentiation grade in OSCC patients,and high DLGAP5 expression was associated with poor prognosis(P<0.05).DLGAP5 silencing resulted in significantly reduced expression of HK2 and ENO1,markedly decreased levels of glycolytic metabolites(P<0.05),and notably declined cell proliferation,migration,and invasion capabilities(P<0.05).Conclusion DLGAP5 is highly expressed in OSCC.Silencing DLGAP5 may inhibit OSCC cell proliferation,migration,and invasion by indirectly regulating the Warburg effect,and the molecule is associated with poor prognosis in the OSCC patients.

Objective:To realize the accurate prediction of the fall risk of the elderly by a convolutional neural network prediction model.Methods:Stratified random cluster sampling was used from June 2019 to February 2020, Python′s Matlabplot library and Opencv library were used to perform data preprocessing on the plantar pressure data of 1 093 subjects who had come from medical institutionsand community or elderly care institutions of Chongqing and Nanjing, such as data visualization, compression and clipping, grayscale, Gaussian blur, etc., and then the data were divided into training set (983 cases) and verification set (110 cases), the training set data were used to train the convolutional neural network model, the verification set was used to verify the model, and the ReLU function was used to suppress overfitting to obtain the final prediction model.Results:The sensitivity of the fall warning model to the validation set for predicting falls was 91.2%, the specificity was 81.4%, the accuracy was 91.5%, and the AUC was 0.865.Conclusions:The fall prediction model can predict the fall risk of the elderly in a specific scenario. In the subsequent improvement, the software and hardware construction should be comprehensively improved to further improve the prediction accuracy.

Objective:To explore the differences of clinical features and surgical efficacy between the elderly and the middle-aged and young patients with meningiomas in the central cortex area.Methods:Forty-three elderly patients with meningiomas in the central cortex area (≥60 years old) and 63 middle-aged and young patients with meningiomas in the central cortex area (18-59 years old), accepted surgery in Department of Neurosurgery, Guangdong 999 Brain Hospital from January 2011 to December 2020, were chosen. The differences of symptom, gross tumor volume, peritumoral edema degrees, intraoperative blood loss, tumor resection degrees, complications, and hospital stays between the 2 groups were analyzed.Results:The elderly patients had significantly higher proportion of preoperative muscle strength decline, lower proportion of preoperative headache, larger preoperative tumor volume, more severe peritumoral edema degrees before and after surgery, small volume of intraoperative blood loss, and longer hospital stays compared with the middle-aged and young patients ( P<0.05). However, no significant differences in distributions of tumor resection Simpson grades, proportion of new neurological dysfunction, incidence of postoperative complications, and proportions of reoperations and tumor recurrence were noted between the 2 groups ( P>0.05). Significant difference in distributions of peritumoral edema degrees among patients with different WHO grades was noted in the elderly group ( P<0.05), and significant difference in distribution of peritumoral edema degrees among patients with different tumor volumes was noted in the middle-aged and young group ( P<0.05). Conclusions:Although differences in clinical characteristics exist between the elderly and the middle-aged and young patients with meningiomas in the central cortex area, no significant difference in surgical efficacy is noted between the 2 groups. The peritumoral edema degree in the elderly patients is related to tumor pathological grades, while that in middle-aged and young patients is related to tumor volumes.

Objective:To evaluate the clinical value of different shimming methods at 7.0 T MR in two-dimensional (2D) and three-dimensional (3D) T 2WI. Methods:Totally 23 healthy volunteers were prospectively recruited from the First Medical Center of PLA General Hospital from November, 2022 to May, 2023, including 12 volunteers who underwent 2D shimming mode and 14 volunteers who underwent 3D shimming mode. 2D shimming mode included patient-specific (PS) mode, direct signal control (DSC) mode, the standard circularly polarized (CP) mode, and volume-specific (VS) mode. 3D shimming mode included universal pulses (UP) mode and CP mode. The image quality for the subtentorial and supratentorial region was assessed by the subjective image quality score and signal-to-noise ratio. Comparisons of quantitative indices between multiple groups were performed using repeated-measures ANOVA or Friedman′s test; comparisons of quantitative indices between 2 groups were performed using paired-samples t test or Wilcoxon signed-rank test. Results:The image quality of subtentorial region and SNR was significant differences in 2D T 2WI with PS mode, DSC mode, CP mode and VS mode ( F=26.74, P<0.001; F=28.24, P<0.001), and the image quality score and SNR of PS mode, DSC mode, VS mode were better than CP mode ( P<0.05). In 2D T 2WI, there was no significant difference in image quality score and SNR of supratentorial region in PS mode, DSC mode, CP mode ( P>0.05). Besides, in 3D T 2WI, the image quality score for subtentorial and supratentorial region of UP mode were better than those of CP mode ( Z=-2.74, P=0.006; Z=-3.24, P=0.001); SNR of subtentorial region was significantly better in UP mode than those in CP mode ( t=3.49, P=0.004). But there was no significant difference in SNR of supratentorial region between the UP mode and CP mode in 3D T 2WI ( P>0.05). Conclusion:T 2WI with different shimming methods at 7.0 T MR can provide data support for the clinical application, which is helpful for the accurate diagnosis of patients with subtentorial lesions.

Objective : To investigate the mortality of cardiovascular and cerebrovascular diseases and to examine the effects on life expectancy among residents in Yuhang District of Hangzhou City from 2010 to 2020, so as to provide insights into the management of cardiovascular and cerebrovascular diseases. Methods: The mortality surveillance data of cardiovascular and cerebrovascular diseases of registered residents in Yuhang District from 2010 to 2020 were collected from Zhejiang All-cause Death Surveillance System. The crude mortality, standardized mortality, annual percent change ( APC ), Fulfillment index, life expectancy, cause-eliminated life expectancy and years of life lost, and the mortality of cardiovascular and cerebrovascular diseases and the impact on life expectancy were analyzed. Results: A total of 21 761 deaths occurred due to cardiovascular and cerebrovascular diseases in Yuhang District from 2010 to 2020, and the annual average crude and standardized mortality rates of cardiovascular and cerebrovascular diseases were 206.14/105 and 129.62/105, respectively. The annual crude and standardized mortality of cardiovascular and cerebrovascular diseases both appeared a tendency towards a decline from 2010 to 2020, with APC of -3.63% and -5.45%, respectively ( P<0.05 ), and the Fulfillment index showed a tendency towards a reduction in residents at ages of 50 to 79 years ( P<0.05 ). The mean life expectancy and cause-eliminated life expectancy were 82.71 and 88.39 years in Yuhang District from 2010 to 2020, which both appeared a tendency towards a rise, both with APC of 0.50% ( P<0.05 ). The years of life lost were 5.02 to 6.47 years due to cardiovascular and cerebrovascular diseases, and the life loss rates were 6.00% to 7.73%. Conclusions The mortality of cardiovascular and cerebrovascular diseases appeared a tendency towards a decline decreased and the cause-eliminated life expectancy appeared a tendency towards a rise in Yuhang District from 2010 to 2020. Intensifying the management of cardiovascular and cerebrovascular diseases death may increase the life expectancy.

This study aims to analyze the biomechanical stability of Magic screw in the treatment of acetabular posterior column fractures by finite element analysis. A three-dimensional finite element model of the pelvis was established based on the computed tomography (CT) and magnetic resonance imaging (MRI) data of a volunteer and its effectiveness was verified. Then, the posterior column fracture model of the acetabulum was generated. The biomechanical stability of the four internal fixation models was compared. The 500 N force was applied to the upper surface of the sacrum to simulate human gravity. The maximum implant stresses of retrograde screw fixation, single-plate fixation, double-plate fixation and Magic screw fixation model in standing and sitting position were as follows: 114.10, 113.40 MPa; 58.93, 55.72 MPa; 58.76, 47.47 MPa; and 24.36, 27.50 MPa, respectively. The maximum stresses at the fracture end were as follows: 72.71, 70.51 MPa; 48.18, 22.80 MPa; 52.38, 27.14 MPa; and 34.05, 30.78 MPa, respectively. The fracture end displacement of the retrograde tension screw fixation model was the largest in both states, and the Magic screw had the smallest displacement variation in the standing state, but it was significantly higher than the two plate fixations in the sitting state. Magic screw can satisfy the biomechanical stability of posterior column fracture. Compared with traditional fixations, Magic screw has the advantages of more uniform stress distribution and less stress, and should be recommended.
Biomechanical Phenomena ; Bone Plates ; Bone Screws ; Finite Element Analysis ; Fracture Fixation, Internal/methods* ; Fractures, Bone/surgery* ; Humans ; Spinal Fractures

Objective:To investigate the disability status of the elderly in medical-nursing integrated pension institutions in Beijing and analyze its influencing factors.Methods:Using the convenient sampling method, a total of 359 elderly people from 5 medical-nursing integrated pension institutions in Beijing were selected from May to August 2019. General data and Elderly Disability Assessment Scale (EDAS) were used to evaluate the disability status of the included population, and univariate and multivariate analysis were conducted.Results:A total of 95.3% (342/359) of the elderly had disability. The single factor analysis result showed that male, low education level, a large number of chronic diseases, history of fall, history of smoking, history of drinking, widowed and elderly people living in nursing homes at their public expense were more disabled ( P<0.05) . Multivariate analysis showed that, history of falls, the number of chronic diseases greater than or equal to 3 and widowhood were the influencing factors for aggravated disability ( P<0.05) . Conclusions:In this survey, the rate of disability of the elderly in medical-nursing integrated pension institutions in Beijing is relatively high and the degree of disability is serious. The focus should be on the elderly who are male, with low educational level, smoking history, drinking history, falling history, comorbidities of the aged, the loss of spouse and those who bear the expenses of pension institutions at public expense.

The teaching laboratory is the central place to teach lab courses to undergraduate students. It is thus critical to evaluate how lab skills of students will be affected by the management of this lab. This study attempts to introduce the 6S concept, referring to "Seiri", "Seiton", "Seiso", "Seiketsu", "Shisuke", and "Safety", to the management of teaching laboratory, in particular, to the management of environments, safety, item deposition, reagents and consumables in the laboratory. We find that applying the "6S" management maintains a tidy lab environment, facilitates teaching the lab skills, and improves the quality of teaching, which together achieves the goal of education with the atmosphere. This study can provide a guideline for establishing and managing teaching laboratories in universities.
Education ; organization & administration ; standards ; Environment Design ; Humans ; Laboratories ; organization & administration ; standards ; Students ; Universities ; organization & administration ; standards

Objective? To analyze the paper on traditional Chinese medicine (TCM) nursing in hypertension and understand the paper published and hot topics to explore the new trend of research in this field. Methods? Literatures were retrieved in China National Knowledge Infrastructure (CNKI) according to the search terms "hypertension" and "traditional Chinese medicine nursing" from building database to 27th June 2019. CiteSpace visualization software was used to visual analysis on the keywords, authors and published institutions of the literatures. Results? After eliminating duplication, a total of 308 literatures were included. Among those literatures, the number of published papers increased year by year, but total number was small. The number of papers co-authored and co-institution was small; there were only 17 authors and 16 institutions publishing papers more than two. The hot topics focused on researches on elderly hypertension, nursing for hypertension complications, TCM nursing for hypertension, effects of TCM nursing on quality of life;in recent years, the research hot topics was that TCM nursing guided hypertension patients' self-management. Conclusions? Self-management is an effective method for prevention and control of hypertension. With ageing populations,self-management is the prerequisite for being the healthy aged. Self-service nursing for hypertension guided by TCM nursing may become a trend.