Objective This study aims to analyze the characteristics of inpatients in the cardiovascular department of a tertiary hospital following the chest-pain-center accreditation,and provide guidance for the prevention and treatment of cardiovas-cular diseases.Methods A retrospective descriptive epidemiological approach was adopted to analyze the data of 2115 inpatients at the department of cardiovascular medicine in a tertiary hospital from 2022 to 2024 following chest pain center accreditation.Re-sults The number of the inpatients in 2022,2023,and 2024 was 582 cases(27.52％),684 cases(32.34％),and 849 cases(40.14％),respectively,with the total rising year by year.The proportion of males was higher than that of females,with a male-to-female sex ratio of 1.45∶1.The group aged 40 to 79 years accounted for the highest percentage(80.90％).The top three diseases categorized by percentage were coronary heart disease(754 cases,35.64％),hypertension(479 cases,22.64％),and arrhythmia(167 cases,7.89％).Epidemiological characterization exhibited a statistically significant difference in the disease composition of hospitalized cardiovascular patients in years,genders,ages,and seasons(x2=155.40,36.591,900.597,856.659,P＜0.05).Specific classification showed significant differences in hypertension and other conditions by age(P＜0.05);coronary heart disease and valvular heart disease by gender(P＜0.05);and significant differences across ages in coronary heart disease,hypertension,heart failure,pericardial disease,peripheral vascular disease,congenital heart disease,and others(all P＜0.05).Seasonal differences in coronary heart disease,hypertension,arrhythmia,cardiomyopathy,valvular heart disease,heart failure,pericardial disease,and others were also statistically significant(P＜0.05).Conclusion Against the backdrop of chest pain center accreditation in our hospital,inpatients in our department now demonstrate extinct demographic profiles and seasonal patterns among hospitalized cardiovascular patients.We should strengthen the prevention and treatment of coronary heart disease and hypertension,and establish a comprehensive prevention and control system based on these epidemio-logical characteristics.

Objective This study aims to analyze the characteristics of inpatients in the cardiovascular department of a tertiary hospital following the chest-pain-center accreditation,and provide guidance for the prevention and treatment of cardiovas-cular diseases.Methods A retrospective descriptive epidemiological approach was adopted to analyze the data of 2115 inpatients at the department of cardiovascular medicine in a tertiary hospital from 2022 to 2024 following chest pain center accreditation.Re-sults The number of the inpatients in 2022,2023,and 2024 was 582 cases(27.52％),684 cases(32.34％),and 849 cases(40.14％),respectively,with the total rising year by year.The proportion of males was higher than that of females,with a male-to-female sex ratio of 1.45∶1.The group aged 40 to 79 years accounted for the highest percentage(80.90％).The top three diseases categorized by percentage were coronary heart disease(754 cases,35.64％),hypertension(479 cases,22.64％),and arrhythmia(167 cases,7.89％).Epidemiological characterization exhibited a statistically significant difference in the disease composition of hospitalized cardiovascular patients in years,genders,ages,and seasons(x2=155.40,36.591,900.597,856.659,P＜0.05).Specific classification showed significant differences in hypertension and other conditions by age(P＜0.05);coronary heart disease and valvular heart disease by gender(P＜0.05);and significant differences across ages in coronary heart disease,hypertension,heart failure,pericardial disease,peripheral vascular disease,congenital heart disease,and others(all P＜0.05).Seasonal differences in coronary heart disease,hypertension,arrhythmia,cardiomyopathy,valvular heart disease,heart failure,pericardial disease,and others were also statistically significant(P＜0.05).Conclusion Against the backdrop of chest pain center accreditation in our hospital,inpatients in our department now demonstrate extinct demographic profiles and seasonal patterns among hospitalized cardiovascular patients.We should strengthen the prevention and treatment of coronary heart disease and hypertension,and establish a comprehensive prevention and control system based on these epidemio-logical characteristics.

Objective:To assess the effects of various leisure hobbies on the ability of daily living(ADL)and the quality of life among older adults in China.Methods:A cross-sectional study was conducted using data from the 4th Chinese Urban and Rural Elderly Living Conditions Sample Survey.We categorized community recreation hobbies into two types: dynamic hobbies, which include walking, playing ball games, dancing, and other physical activities, and static hobbies, which encompass activities that do not require physical exertion, such as reading, watching TV, and drawing.The EuroQol five-dimension scale(EQ-5D)-3L was employed to evaluate the quality of life.Older adults who maintained either dynamic or static hobbies for three consecutive years from 2017 to 2019 were initially screened.The relationship between different types of leisure hobbies and ADL scores, as well as quality of life at various time points, was analyzed using repeated-measures ANOVA.Subsequently, propensity scores were matched based on gender, age, ethnicity, marital status, literacy, and chronic diseases, and five machine learning algorithms were utilized to identify the optimal model for predicting fully independent ADL and EQ-5D effect values.Based on the optimal predictive model, we conducted Shapley Additive Explanations(SHAP)and global analysis.Results:The total number of older adults who participated in the survey over the three consecutive years from 2017 to 2019 was 4 912.Among these, 2 594 individuals maintained the same hobby habits throughout this period, comprising 1 362 males and 1 232 females, with an average age of(70.81±6.71)years.Statistically significant differences in ADL scores and EQ-5D scores were observed between the dynamic and static leisure hobby groups(all P<0.05)across various time points, hobby group classifications, and interaction levels.Older adults engaged in dynamic hobbies exhibited superior ADL functioning and higher EQ-5D scores in comparison to those in the static hobby group, with these differences remaining statistically significant following propensity score matching(all P<0.05).In predicting full ADL independence, the SHAP value for dynamic hobbies ranked second, while for predicting an EQ-5D weighted value of 1, the SHAP value for dynamic hobbies ranked ninth.Overall, the type of dynamic hobby demonstrated a positive trend in its effect on the ability to perform daily activities independently and in achieving an EQ-5D weighted value of 1. Conclusions:In comparison to static hobbies, Chinese older adults who engage in dynamic hobbies exhibit improved daily mobility and a higher quality of life.Furthermore, dynamic hobbies positively influence the capacity for full independence in daily activities, as evidenced by an EQ-5D weighted value of 1.

Objective:To assess the effects of various leisure hobbies on the ability of daily living(ADL)and the quality of life among older adults in China.Methods:A cross-sectional study was conducted using data from the 4th Chinese Urban and Rural Elderly Living Conditions Sample Survey.We categorized community recreation hobbies into two types: dynamic hobbies, which include walking, playing ball games, dancing, and other physical activities, and static hobbies, which encompass activities that do not require physical exertion, such as reading, watching TV, and drawing.The EuroQol five-dimension scale(EQ-5D)-3L was employed to evaluate the quality of life.Older adults who maintained either dynamic or static hobbies for three consecutive years from 2017 to 2019 were initially screened.The relationship between different types of leisure hobbies and ADL scores, as well as quality of life at various time points, was analyzed using repeated-measures ANOVA.Subsequently, propensity scores were matched based on gender, age, ethnicity, marital status, literacy, and chronic diseases, and five machine learning algorithms were utilized to identify the optimal model for predicting fully independent ADL and EQ-5D effect values.Based on the optimal predictive model, we conducted Shapley Additive Explanations(SHAP)and global analysis.Results:The total number of older adults who participated in the survey over the three consecutive years from 2017 to 2019 was 4 912.Among these, 2 594 individuals maintained the same hobby habits throughout this period, comprising 1 362 males and 1 232 females, with an average age of(70.81±6.71)years.Statistically significant differences in ADL scores and EQ-5D scores were observed between the dynamic and static leisure hobby groups(all P<0.05)across various time points, hobby group classifications, and interaction levels.Older adults engaged in dynamic hobbies exhibited superior ADL functioning and higher EQ-5D scores in comparison to those in the static hobby group, with these differences remaining statistically significant following propensity score matching(all P<0.05).In predicting full ADL independence, the SHAP value for dynamic hobbies ranked second, while for predicting an EQ-5D weighted value of 1, the SHAP value for dynamic hobbies ranked ninth.Overall, the type of dynamic hobby demonstrated a positive trend in its effect on the ability to perform daily activities independently and in achieving an EQ-5D weighted value of 1. Conclusions:In comparison to static hobbies, Chinese older adults who engage in dynamic hobbies exhibit improved daily mobility and a higher quality of life.Furthermore, dynamic hobbies positively influence the capacity for full independence in daily activities, as evidenced by an EQ-5D weighted value of 1.

Objective:To investigate the effect of using extended trans-dome onlay graft(eTDOG) made of costal cartilage combined with nasal vestibule V-Y advancement flap for correction of alar retraction.Methods:Clinical data of patients diagnosed with alar retraction at Chongqing Huamei Plastic Surgery Hospital between July 2019 and October 2020 were retrospectively analyzed. The 6th or 7th right costal cartilage was harvested, cut into pieces for grafts, including a laminar trans-dome onlay graft, made from cortex part of the rib. Then a V-shaped flap was designed on the vestibular skin. At the end of the rhinoplasty, a pocket was created along the alar rim, and the eTDOG was inserted into the pocket to push down the alar rim. Nasal vestibule V-Y advancement flap provides extra soft tissue for alar retraction correction. Splints were applied to hold the eTDOG and flap in place. Assessment of therapeutic effect was made from three aspects. First of all, therapeutic satisfaction assessment, which was made based on the visual analogue scale(VAS). VAS scoring was conducted by patients and two surgeons who were not involved in surgery. Results were divided into three categories, total satisfaction with scoring 9 or 10, partly satisfaction with scoring 7 or 8, and dissatisfaction with scoring 0-6. Subsequently, the percentage of satisfaction indeed in the total number of cases was counted. Alar symmetry assessment was also included. The percentage of cases with alar symmetry in the total number of cases. Third, the ratio (a/b) of the distance between the line defined by bilateral highest points of alar retraction and the line determined by tip-defining points (a) to that between the line determined by bilateral highest points of alar retraction and the horizontal line defined by the turning point of columella lobule (b) was calculated on frontal view. The value of a and b was measured using Image J, and a/b<1 represented absence of alar retraction. The statistical analysis was performed using SPSS version 20.0. Chi-square test was used to compare the symmetry of alae pre- and post-operation. Values of a/b were expressed as Mean±SD, and was compared using t-test. SNK were used for comparison among and between groups of different types, respectively. P-value less than 0.05 considered to be statistically significant. Results:Forty-three cases were included in this study, including 5 men and 38 women, with mean age of 27.3 years (18-45 yars). Among them, medial, central and lateral type of alar retraction was comprised of 17, 22 and 4 cases, respectively. The median follow-up time was 4 months (range, 1-24 months). During the follow-up, no complications like avascular necrosis of ala, step like deformity or alar contracture were observed, so was the recurrence of alar retraction. A total of 5 complications were observed, including 4 cases of hypertrophic scar at the incision which were improved after injection of Triamcinolone and 1 case of remaining alar asymmetry which was corrected by reoperation. The VAS score of patient was 8.93±1.12, and patients with satisfaction indeed accounted for 81.4% (35/43). The mean VAS score of the two operation-non-participated surgeons was 8.93±1.04; and cases assessed to be satisfaction indeed accounted for 81.4% (70/86). The proportion of symmetric alae significantly improved from 58.1% (25/43) to 93.0% (40/43) ( P<0.01). The ratio of a/b decreased from 0.79±0.06 pre-operation to 1.00±0.04 post-operation( P<0.01). While no significance was found among groups neither pre- nor post-operation ( P>0.05). Conclusions:eTDOG made of costal cartilage combining nasal vestibule V-Y advancement flap is an effective method for correction of all types of alar retraction and improvement of alar symmetry, with high satisfaction of patients and surgeons.

Objective:To investigate the effect of using extended trans-dome onlay graft(eTDOG) made of costal cartilage combined with nasal vestibule V-Y advancement flap for correction of alar retraction.Methods:Clinical data of patients diagnosed with alar retraction at Chongqing Huamei Plastic Surgery Hospital between July 2019 and October 2020 were retrospectively analyzed. The 6th or 7th right costal cartilage was harvested, cut into pieces for grafts, including a laminar trans-dome onlay graft, made from cortex part of the rib. Then a V-shaped flap was designed on the vestibular skin. At the end of the rhinoplasty, a pocket was created along the alar rim, and the eTDOG was inserted into the pocket to push down the alar rim. Nasal vestibule V-Y advancement flap provides extra soft tissue for alar retraction correction. Splints were applied to hold the eTDOG and flap in place. Assessment of therapeutic effect was made from three aspects. First of all, therapeutic satisfaction assessment, which was made based on the visual analogue scale(VAS). VAS scoring was conducted by patients and two surgeons who were not involved in surgery. Results were divided into three categories, total satisfaction with scoring 9 or 10, partly satisfaction with scoring 7 or 8, and dissatisfaction with scoring 0-6. Subsequently, the percentage of satisfaction indeed in the total number of cases was counted. Alar symmetry assessment was also included. The percentage of cases with alar symmetry in the total number of cases. Third, the ratio (a/b) of the distance between the line defined by bilateral highest points of alar retraction and the line determined by tip-defining points (a) to that between the line determined by bilateral highest points of alar retraction and the horizontal line defined by the turning point of columella lobule (b) was calculated on frontal view. The value of a and b was measured using Image J, and a/b<1 represented absence of alar retraction. The statistical analysis was performed using SPSS version 20.0. Chi-square test was used to compare the symmetry of alae pre- and post-operation. Values of a/b were expressed as Mean±SD, and was compared using t-test. SNK were used for comparison among and between groups of different types, respectively. P-value less than 0.05 considered to be statistically significant. Results:Forty-three cases were included in this study, including 5 men and 38 women, with mean age of 27.3 years (18-45 yars). Among them, medial, central and lateral type of alar retraction was comprised of 17, 22 and 4 cases, respectively. The median follow-up time was 4 months (range, 1-24 months). During the follow-up, no complications like avascular necrosis of ala, step like deformity or alar contracture were observed, so was the recurrence of alar retraction. A total of 5 complications were observed, including 4 cases of hypertrophic scar at the incision which were improved after injection of Triamcinolone and 1 case of remaining alar asymmetry which was corrected by reoperation. The VAS score of patient was 8.93±1.12, and patients with satisfaction indeed accounted for 81.4% (35/43). The mean VAS score of the two operation-non-participated surgeons was 8.93±1.04; and cases assessed to be satisfaction indeed accounted for 81.4% (70/86). The proportion of symmetric alae significantly improved from 58.1% (25/43) to 93.0% (40/43) ( P<0.01). The ratio of a/b decreased from 0.79±0.06 pre-operation to 1.00±0.04 post-operation( P<0.01). While no significance was found among groups neither pre- nor post-operation ( P>0.05). Conclusions:eTDOG made of costal cartilage combining nasal vestibule V-Y advancement flap is an effective method for correction of all types of alar retraction and improvement of alar symmetry, with high satisfaction of patients and surgeons.

Abstract Depression is a major public health issue among adolescents. The Ministry of Education of China recently proposed to integrate depression screening into students school health check among adolescents. However, there are inconsistencies regarding the strength of recommendation and implementation details of routine screening for adolescent depression across professional organizations and countries. This paper outlines the epidemiology and risk factors of adolescent depression and summarizes relevant international guidelines and recommendations. We suggest that before the national implementation of school based depression screening, key issues including scientific evidence, execution details, resource allocation and ethical considerations need to be examined in close collaboration with all stakeholders. Systematic piloting followed by rigorous evaluation will also be needed.

OBJECTIVE:To establish a method for simultaneous determination of paeoniflorin,berberine hydrochloride and ammonium glycyrrhizinate in Xiaoer huadu powder.METHODS:HPLC method was adopted.The separation was performed on Waters SunFireTM-C18 column with mobile phase consisted of acetonitrile-0.1％ phosphoric acid (gradient elution) at the flow rate of 1.0 mL/min.The detection wavelength was set at 238 nm,and column temperature was 25 ℃.The sample size was 10 μL.RESULTS:The linear ranges of paeoniflorin,berberine hydrochloride and ammonium glycyrrhizinate were 8.808-88.08 μg/mL(r=0.999 8),1.778-17.78 μg/mL(r=0.999 6),2.533-25.33 μg/mL(r=0.999 9),respectively.LOQ were 4.404,0.889,2.533 μg/mL;LOD were 1.101,0.445,1.267 μg/mL.RSDs of precision,stability and reproducibility tests were all lower than 2％.The recoveries were 95.08％-99.61％ (RSD=1.77％,n =9),96.93％-99.94％ (RSD=0.92％,n=9),98.33％-102.05％ (RSD=1.27％,n=9).CONCLUSIONS:The method is simple,accurate and reproducible,and can be used for simultaneous determination of paeoniflorin,berberine hydrochloride and ammonium glycyrrhizinate in Xiaoer huadu powder.

Objective To investigate the incidence of enteric pathogens causing acute gastroenteritis (AGE) among children to measure the incidence of coinfections,and to compare the clinical characteristics of those infected with one versus multiple agents.Methods A retrospective study was conducted from January 2014 to December 2014.All patients between 1 month and 14 years of age admitted to the Pediatric department with a diagnosis of AGE were eligible for enrollment.Two stool samples for each patient were tested for gastrointestinal pathogens.We summarized the clinical severity of episodes,describing the duration of diarrhea,duration and frequency of vomiting,fever.All patients underwent medical evaluation with estimation of dehydration.Results One or more etiological agents were detected in 3595 out of 4728 patients(76.0％),while we did not detect any etiological agent in 1133 (24.0％).Rotavirus was detected in 1889 (40.0％),adenovirus in 412 (8.7 ％),norovirus in 309 (6.5 ％),verotoxigenic Escherichia coli (VTEC) in 274 (5.8 ％),Salmonella spp.in 276(5.8％),Klebsiella pneumoniae in 123 (2.6％),Shigella spp.in 78 (1.6％),Staphylococcus aureus in 70 (1.5％),C.perfringens in 126(2.7％).In 1370 children out of 4728(29.0％),we found evidence of coinfection.with rotavirus and norovirus was the most common 150 (3.2％),rotavirus and C.perfringens was also common 127(2.7％).Children with coinfection had a more severe clinical presentation.The difference has statistical significance.Conclusion Rotavirus is still the most common pathogen in children with acute diarrhea,followed by NV,adenovirus,Salmonella spp.and VTEC.Rotavirus with norovirus infection was the most common.VTEC combined with three kinds of virus infection had the highest incidence.Children with multiple viral infections were more severe than those of single virus infection in the duration of vomiting and dehydration.There was no significant difference in the duration of fever and diarrhea and the frequency of diarrhea.Children infected by viruses and bacteria had a more severe clinical presentation such as fever,vomiting and diarrhea lasting for a long time,more serious diarrhea and dehydration than those with single bacteria and single virus infection.The difference has no significant difference in degree and duration of diarrhea.

BACKGROUND: Ankle fracture combined with deltoid ligament rupture and distal tibiofibular syndesmosis injury occurs occasionally. Its treatment with distal tibiofibular syndesmosis screw fixation or deltoid ligament repair remains controversial. The former appears with poor reduction, broken nails, secondary surgery and other problems.OBJECTIVE: To observe the clinical effectiveness of suture anchor repair for ankle fracture combined with deltoid ligament injury.METHODS: Twelve patients with ankle fracture combined with deltoid ligament injury were selected from the First Affiliated Hospital of Guangzhou University of Chinese Medicine between January 2013 and December 2015. All patients were treated with open reduction, internal fixation, and anchor repair, but without distal tibiofibular syndesmosis screw fixation. The curative efficacy and joint stability were observed.RESULTS AND CONCLUSION: (1) All patients were followed-up for more than 12 months. (2) The modified Baird-Jackson scoring system showed excellent in nine cases, good in two cases, average in one case, poor in none case, and the excellent and good rate was 92%. (3) At 1 year after internal fixation, the X-ray examination showed the malleolus gap and talus slope angle of the affect side were (3.47±0.12) mm and (0.45±0.18)°, and the malleolus gap and talus slope angle of the healthy side were (3.44±0.05) mm and (0.43±0.14)°, and there was no significant difference between two sides (P > 0.05). (4) These results indicate that the suture anchor can repair the anatomy and biomechanics of deltoid ligament with stable ankle joint, and secondary surgery is unnecessary.