Objective To investigate the efficacy and safety of Linggui Qihua No.2 Prescription(LGQH2)in patients with heart failure with preserved ejection fraction(HFpEF).Methods Totally 60 HFpEF patients were randomly divided into experimental group and control group according to random number table method,with 30 patients in each group.On the basis of standardized treatment for heart failure,the experimental group was given LGQH2 granules,13 g/time,twice a day,orally;the control group was given placebo granules of LGQH2,with the same administration method as the experimental group.The treatment course for both groups was 4 weeks.6-minute walking distance(6MWD),Kansas City Cardiomyopathy Questionnaire(KCCQ)score,TCM syndrome score and serum NT-proBNP levels.Echocardiography was used to detect the ratio of early diastolic blood flow velocity(E)at the mitral valve to early diastolic myocardial motion velocity(e')at the mitral annulus,left atrial diameter(LAD),left ventricular end-diastolic diameter(LVEDD)and interventricular septal thickness(IVST).Adverse reactions and events were also recorded.Results Compared with before treatment,both groups showed significant improvement in 6MWD,KCCQ score,TCM syndrome score,serum NT proBNP,and E/e'after treatment(P<0.05),and there was no statistical significance in LAD,LVEDD and IVST between the two groups(P>0.05);after treatment,the experimental group showed better improvement in 6MWD,KCCQ score,TCM syndrome score and E/e'compared to the control group(P<0.05).During the research process,neither group of patients experienced any adverse reactions or events.Conclusion LGQH2 Prescription can effectively enhance exercise tolerance and cardiac function of HFpEF patients,alleviate symptoms,improve quality of life,and inhibit diastolic dysfunction of the heart,without notable adverse reactions.

Objective:To evaluate the effect of applying function-related grouping model of Changsha medical insurance for patients convalescing from a cerebral infarction using the International Classification of Functioning, Disability and Health′s rehabilitation set (ICF-RS).Methods:Ninety cerebral infarction patients in convalescence were treated according to their functional status, including clinical treatment, rehabilitation, traditional Chinese medicine treatment, and rehabilitation nursing. Within 3 days after admission and at the time of discharge, they were evaluated using a comprehensive assessment system for cerebral infarction based on the ICF-RS. The modified Ashworth scale (MAS), Fugl-Meyer assessment (FMA), the mini-mental state examination (MMSE) and the Boston diagnostic aphasia examination (BDAE) were also employed.Results:With the exception of ICF-RS item b280 (pain perception) and item x005 of the MAS, all of the remaining assessments indicated significant enhancements compared to the pre-treatment levels. Functional severity grading also improved significantly after the treatment. Thirteen of the ICF-RS categories indicated more favorable therapeutic outcomes after the treatment. That was accompanied by improvements in the FMA upper limb, lower limb and total scores, and in the MMSE scores. However, no significant disparity was detected in the MAS scores or the BDAE grades before and after treatment.Conclusions:The comprehensive evaluation system based on the ICF-RS effectively evaluates the effectiveness of rehabilitation after cerebral infarction in a way suitable for medical insurance purposes.

Objective To investigate the prevalence of metabolic associated fatty liver disease(MAFLD)and its correlation with metabolic components among personnel on tropical islands.Methods The data of personnel who received health examination on islands in 2024 were analyzed,and they were grouped with the age limit of 30 years old to compare the detection rates of MAFLD and metabolic components in different age groups.In people aged≥ 30 years old,the age,gender,body mass index(BMI),waist circumference(WC),fasting blood glucose,blood lipids,liver function,kidney function and other indexes were compared between MAFLD and non-MAFLD groups.Univariate and multivariate logistic regression models were conducted to analyze the factors affecting the occurrence of MAFLD.The effects of various metabolic components on the risk of MAFLD in different age groups were analyzed by subgroup analyses.Results Among 1213 personnel,175(14.4％)cases had MAFLD,of which 141(80.6％)cases were mild,32(18.3％)were moderate,and 2(1.1％)were severe.The detection rates of MAFLD(25.6％[74/289]vs 10.9％[101/924])and overweight/obesity(55.7％[161/289]vs 37.7％[348/924])in age ≥ 30 years old were significantly higher than those in age＜30 years old(both P＜0.001).In people aged≥ 30 years old,compared with the non-MAFLD group,the BMI,WC,systolic blood pressure,diastolic blood pressure,triglyceride(TG),low density lipoprotein-cholesterol,alanine transaminase,aspartate transaminase,gamma glutamyltransferase and uric acid(UA)in the MAFLD group were significantly higher(all P＜0.05),and the high density lipoprotein-cholesterol(HDL-C)was significantly lower(P＜0.05).There were no significant differences in age,gender,fast blood glucose,total cholesterol,alkaline phosphatase,total bilirubin,serum creatinine,or blood urea nitrogen(all P＞0.05).Logistic regression analysis showed that WC was an independent risk factor for MAFLD(odds ratio[OR]=1.101,95％confidence interval[95％CI]1.030-1.176,P=0.004);HDL-C was an independent protective factor for MAFLD(OR=0.071,95％CI0.016-0.323,P=0.001);and BMI ≥24.0 kg/m2 and WC≥90 cm were positively correlated with MAFLD(both P＜0.01).In people aged≥30 years old,the risk of MAFLD was increased in those with overweight/obesity,arterial blood pressure≥ 130/85 mmHg(1 mmHg=0.133 kPa),TG≥1.7 mmol/L,HDL-C≤1.0 mmol/L and UA＞420 μmol/L(all P＜0.05),and the risk of MAFLD was most significantly increased in overweight/obesity people(hazard ratio[HR]=5.088,95％CI 2.724-9.504,P＜0.001).Among people aged＜30 years old,the risk of MAFLD was increased in those with overweight/obesity and UA＞420 μmol/L(both P＜0.01),and the risk of MAFLD was most significantly increased in overweight/obesity individuals(HR=6.305,95％CI3.973-10.006,P＜0.001).Conclusion The detection rates of MAFLD and various metabolic components are higher in the personnel on tropical islands,and the risk of MAFLD is higher in those with overweight/obesity,TG≥1.7 mmol/L and hyperuricemia.

Objective To investigate the relationship between 9 immunoinflammatory indicators derived from complete blood count and the severity of Mycoplasma pneumoniae pneumonia(MPP)in children of different ages.Methods Totally 2 132 children with MPP who were hospitalized in the Department of Pediatrics of The First Affiliated Hospital of Naval Medical University from Jul.1,2023,to Dec.31,2024 were enrolled,and were assigned to severe MPP(SMPP)or non-severe MPP(NSMPP)groups.According to age and gender 1∶1 matching,the children were assigned to 2 subgroups according to age(1-6 years old and＞6-16 years old).The basic data,laboratory examination and immunoinflammatory indicators from complete blood count of each group were collected and compared.The influencing factors of SMPP were analyzed by univariate and multivariate Cox proportional hazards regression models.Receiver operating characteristic curves were used to analyze the predictive value of indicators that showed statistically significant differences for SMPP.Results There were 220 patients with SMPP,accounting for 10.3%of MPP.In children aged 1-6 years,compared with the NSMPP group,the SMPP group had a longer hospital stay,higher platelet(PLT)count,platelet-to-lymphocyte ratio(PLR),neutrophil-to-lymphocyte ratio,derived neutrophil-to-lymphocyte ratio and systemic immune-inflammation index(all P＜0.05).PLR was an independent risk factor for SMPP(odds ratio=1.010,95%confidence interval[CI]1.003-1.018,P=0.007).The area under curve predicted by PLR for SMPP was 0.635(95%CI 0.560-0.711,P＜0.001),the best cut-off value was 125.04,and the corresponding sensitivity and specificity were 57.7%and 70.2%,respectively.All the children were assigned to low PLR group or high PLR group using the best cut-offvalue as the boundary,and the severe disease rate in the high PLR group was significantly higher than that in the low PLR group(65.9%[60/91]vs 37.6%[44/117],P＜0.001).All the children were assigned to Q1-Q4 groups by quartile,and the severe disease rate of the Q4 group(71.2%,37/52)was significantly higher than that of the Q1-Q3 group(all P＜0.05).In children aged＞6-16 years,compared with the NSMPP group,the PLT and PLR in the SMPP group were higher(both P＜0.05),but neither was an independent risk factor.All the children were assigned to low PLR group or high PLR group using the best cut-offvalue(137.03)as the boundary,and the severe disease rate in the high PLR group was significantly higher than that in the low PLR group(57.0%[77/135]vs 40.2%[39/97],P=0.011).All the children were assigned to Q1-Q4 groups by quartile,and the severe disease rate of the Q4 group(65.5%,38/58)was significantly higher than that of the Q1-Q3 group(all P＜0.05).Conclusion The immunoinflammatory indicators derived from complete blood count,especially PLR,have certain application value in predicting the severity of MPP children in different ages.

Objective To investigate the effects and mechanism of Linggui Qihua Prescription against myocardial inflammation and fibrosis in heart failure with preserved ejection fraction(HFpEF).Methods Totally 40 spontaneously hypertensive rats(SHR)were equally divided into model group,Entresto group(18 mg/kg)and Linggui Qihua Prescription low-and high-dosage groups(3.87,7.74 g/kg),the HFpEF model was induced using a 16-week high fat-salt-sugar diet and 8-week streptozotocin intraperitoneal injection.Ten WKY rats(WKY group)and 10 SHR(SHR group)served as control.After successful modeling,the groups were subjected to a 6-week corresponding intervention.Left ventricular end diastolic diameter(LVEDD),left ventricular end-diastolic volume(LVEDV),relative ventricular wall thickness(RWT),left ventricular fractional shortening(LVFS),isovolumic relaxation time(IVRT),mitral annular early and late diastolic velocities of motion(e? and a?),global longitudinal strain(GLS)and global longitudinal strain rate(GLSr)were measured by echocardiography;serum tumor necrosis factor-α(TNF-α)and soluble growth stimulation expressed gene 2 protein(sST2)contents were detected by ELISA;the morphology of myocardial tissue was observed by HE staining;myocardial fibrosis was assessed by Masson staining;the mRNA and protein expressions of myocardial tissue vascular cell adhesion molecule-1(VCAM-1),intercellular adhesion molecule-1(ICAM-1),growth differentiation factor-15(GDF-15)and sST2 were detected by qPCR and Western blot.Results Compared with the WKY group and SHR group,the model group exhibited significant increase in LVEDV,RWT,IVRT,along with significant decrease in e?,a? and absolute values of GLS and GLSr(P<0.05,P<0.01),the serum contents of TNF-α and sST2 significantly increased(P<0.01);there was pronounced myocardial inflammatory infiltration and collagen fiber deposition,while the mRNA and protein expression of VCAM-1,ICAM-1,GDF-15 and sST2 significantly increased(P<0.05,P<0.01).Compared with the model group,Entresto group and Linggui Qihua Prescription low-and high-dosage groups demonstrated significant decrease in LVEDV,RWT,IVRT,along with significant increases in e?,a? and absolute values of GLS and GLSr(P<0.05,P<0.01),the serum contents of TNF-α and sST2 significantly decreased(P<0.01);myocardial inflammatory infiltration and collagen fiber deposition were reduced,the mRNA and protein expressions of ICAM-1,GDF-15 and sST2 decreased in Linggui Qihua Prescription high-dosage group(P<0.01).Conclusion Linggui Qihua Prescription may inhibit chronic inflammation and fibrosis of the myocardium in HFpEF rats by regulating the expressions of ICAM-1,VCAM-1,GDF-15 and sST2,improving cardiac remodeling and functional impairment.

Objective To develop a core outcome set(COS)for clinical effectiveness trials of heart failure with preserved ejection fraction(HFpEF).Methods Outcome measures were collected through database literatures search,clinical experts questionnaire survey and semi-structured patients interview.Then,the outcome measures pool was constructed and domains were divided.Candidate outcome measures of COS were screened through two rounds of Delphi survey.Finally,a consensus meeting was held to determine COS and reach a consensus.Results A total of 317 outcome measures which could be divided into 6 domains were collected through literature research,questionnaire survey and semi-structured interview.15 candidate outcome measures of COS were screened through two rounds of Delphi survey.Finally,the consensus meeting reached consensus on a COS with 6 entries.Conclusion In this study,a COS for clinical effectiveness trials of HFpEF was developed,which is conducive to the standardization of efficacy evaluation.

Objective:To evaluate the effect of applying function-related grouping model of Changsha medical insurance for patients convalescing from a cerebral infarction using the International Classification of Functioning, Disability and Health′s rehabilitation set (ICF-RS).Methods:Ninety cerebral infarction patients in convalescence were treated according to their functional status, including clinical treatment, rehabilitation, traditional Chinese medicine treatment, and rehabilitation nursing. Within 3 days after admission and at the time of discharge, they were evaluated using a comprehensive assessment system for cerebral infarction based on the ICF-RS. The modified Ashworth scale (MAS), Fugl-Meyer assessment (FMA), the mini-mental state examination (MMSE) and the Boston diagnostic aphasia examination (BDAE) were also employed.Results:With the exception of ICF-RS item b280 (pain perception) and item x005 of the MAS, all of the remaining assessments indicated significant enhancements compared to the pre-treatment levels. Functional severity grading also improved significantly after the treatment. Thirteen of the ICF-RS categories indicated more favorable therapeutic outcomes after the treatment. That was accompanied by improvements in the FMA upper limb, lower limb and total scores, and in the MMSE scores. However, no significant disparity was detected in the MAS scores or the BDAE grades before and after treatment.Conclusions:The comprehensive evaluation system based on the ICF-RS effectively evaluates the effectiveness of rehabilitation after cerebral infarction in a way suitable for medical insurance purposes.

Objective To investigate the effects and mechanism of Linggui Qihua Prescription against myocardial inflammation and fibrosis in heart failure with preserved ejection fraction(HFpEF).Methods Totally 40 spontaneously hypertensive rats(SHR)were equally divided into model group,Entresto group(18 mg/kg)and Linggui Qihua Prescription low-and high-dosage groups(3.87,7.74 g/kg),the HFpEF model was induced using a 16-week high fat-salt-sugar diet and 8-week streptozotocin intraperitoneal injection.Ten WKY rats(WKY group)and 10 SHR(SHR group)served as control.After successful modeling,the groups were subjected to a 6-week corresponding intervention.Left ventricular end diastolic diameter(LVEDD),left ventricular end-diastolic volume(LVEDV),relative ventricular wall thickness(RWT),left ventricular fractional shortening(LVFS),isovolumic relaxation time(IVRT),mitral annular early and late diastolic velocities of motion(e? and a?),global longitudinal strain(GLS)and global longitudinal strain rate(GLSr)were measured by echocardiography;serum tumor necrosis factor-α(TNF-α)and soluble growth stimulation expressed gene 2 protein(sST2)contents were detected by ELISA;the morphology of myocardial tissue was observed by HE staining;myocardial fibrosis was assessed by Masson staining;the mRNA and protein expressions of myocardial tissue vascular cell adhesion molecule-1(VCAM-1),intercellular adhesion molecule-1(ICAM-1),growth differentiation factor-15(GDF-15)and sST2 were detected by qPCR and Western blot.Results Compared with the WKY group and SHR group,the model group exhibited significant increase in LVEDV,RWT,IVRT,along with significant decrease in e?,a? and absolute values of GLS and GLSr(P<0.05,P<0.01),the serum contents of TNF-α and sST2 significantly increased(P<0.01);there was pronounced myocardial inflammatory infiltration and collagen fiber deposition,while the mRNA and protein expression of VCAM-1,ICAM-1,GDF-15 and sST2 significantly increased(P<0.05,P<0.01).Compared with the model group,Entresto group and Linggui Qihua Prescription low-and high-dosage groups demonstrated significant decrease in LVEDV,RWT,IVRT,along with significant increases in e?,a? and absolute values of GLS and GLSr(P<0.05,P<0.01),the serum contents of TNF-α and sST2 significantly decreased(P<0.01);myocardial inflammatory infiltration and collagen fiber deposition were reduced,the mRNA and protein expressions of ICAM-1,GDF-15 and sST2 decreased in Linggui Qihua Prescription high-dosage group(P<0.01).Conclusion Linggui Qihua Prescription may inhibit chronic inflammation and fibrosis of the myocardium in HFpEF rats by regulating the expressions of ICAM-1,VCAM-1,GDF-15 and sST2,improving cardiac remodeling and functional impairment.

Objective To investigate the efficacy and safety of Linggui Qihua No.2 Prescription(LGQH2)in patients with heart failure with preserved ejection fraction(HFpEF).Methods Totally 60 HFpEF patients were randomly divided into experimental group and control group according to random number table method,with 30 patients in each group.On the basis of standardized treatment for heart failure,the experimental group was given LGQH2 granules,13 g/time,twice a day,orally;the control group was given placebo granules of LGQH2,with the same administration method as the experimental group.The treatment course for both groups was 4 weeks.6-minute walking distance(6MWD),Kansas City Cardiomyopathy Questionnaire(KCCQ)score,TCM syndrome score and serum NT-proBNP levels.Echocardiography was used to detect the ratio of early diastolic blood flow velocity(E)at the mitral valve to early diastolic myocardial motion velocity(e')at the mitral annulus,left atrial diameter(LAD),left ventricular end-diastolic diameter(LVEDD)and interventricular septal thickness(IVST).Adverse reactions and events were also recorded.Results Compared with before treatment,both groups showed significant improvement in 6MWD,KCCQ score,TCM syndrome score,serum NT proBNP,and E/e'after treatment(P<0.05),and there was no statistical significance in LAD,LVEDD and IVST between the two groups(P>0.05);after treatment,the experimental group showed better improvement in 6MWD,KCCQ score,TCM syndrome score and E/e'compared to the control group(P<0.05).During the research process,neither group of patients experienced any adverse reactions or events.Conclusion LGQH2 Prescription can effectively enhance exercise tolerance and cardiac function of HFpEF patients,alleviate symptoms,improve quality of life,and inhibit diastolic dysfunction of the heart,without notable adverse reactions.

Objective To construct an XGBoost predictive model using clinical characteristic data from patients with chronic obstructive pulmonary disease(COPD)and evaluate the efficacy of the predictive model in early risk prediction of lung cancer occurrence in COPD patients.Methods In this retrospective cross-sectional study,cluster sampling was used.We selected clinically diagnosed COPD patients admitted to The Second Affiliated Hospital of Xi'an Jiaotong University from January 1,2018,to December 31,2022.A total of 4 008 patients with complete data were included.First,the baseline of each characteristic was analyzed,and then XGBoost was used to construct the lung cancer risk prediction model for COPD patients,and SHAP(SHapley Additive exPlanation)value was used to quantify and attribute the importance of each characteristic.DC A curve was used to evaluate the clinical application value.Results After constructing a lung cancer risk model for COPD patients using 28 variables,eight variables were selected according to the importance of the variables and clinical experience,and the prediction model was reconstructed.The model efficacy in the training set and the test set was 0.948(0.938,0.958)and 0.797(0.738,0.856),respectively.SHAP diagram showed that elevated CEA,CA125,FIB,eosinophils,PLT and D-dimer and reduced TT all contributed to an increased risk of lung cancer in COPD patients.DCA curve showed that the prediction model had clinical application value,which could help doctors make more accurate prognosis prediction and treatment decisions.Conclusion The successful establishment of an XGBoost predictive model,utilizing a subset of features,enables early prediction of lung cancer occurrence in COPD patients.