Objective To analyze the reasons and influencing factors of ambiguous medical records,and propose targe-ted intervention strategies.Methods The medical records discharged from the Department of Otolaryngology,Head and Neck Surgery of a large Class Ⅲ hospital in Xi'an from January 2023 to December 2023 were retrospectively collected,and the medical records groups and ambiguous medical records were screened through the DRG information platform.The clinical features,defect causes and risk factors of ambiguous cases were analyzed statistically.Results There were 4 124 discharged cases in the year,of which 77 were ambiguous cases,accounting for 1.87％.Compared with the non-ambiguous group,more patients in the ambig-uous group adopted a self-funded approach,experienced a transfer and a longer hospital stay.The proportion of surgery and trau-ma in ambiguous group was higher,but the proportion of tumor patients was lower.Due to DRG grouping rules,64 cases(83.1％)were divided into ambiguous groups,which was the primary direct cause.Binary Logistic regression indicated that self-paid medical treatment(OR=2.2),transfer(OR=4.8),hospitalization ≥7 days(OR=3.1),trauma(OR=15.0),and total cost＞20 000 yuan(OR=1.7)were the risk factors for ambiguous disease cases(P＜0.05),while tumor disease was the pro-tective factor(OR=0.6,P＜0.05).Conclusion The emergence of ambiguous medical records involves many aspects such as clinical diagnosis and treatment,hospital management,health policy and so on,which has an important impact on hospital per-formance and medical insurance fund.Only by strengthening the level of hospital management,improving the quality of informa-tion system,and promoting the coordination and communication between doctors,management and patients,can we effectively re-duce the occurrence of ambiguous medical records.

Objective:To understand the current situation of the ability to screen health information of the elderly in rural areas and analyze its influencing factors, so as to provide a basis for taking targeted measures.Methods:A cross-sectional survey was adopted, and rural elderly people in Yonghe Town, Dahu Town and Dayao Town of Liuyang City, Hunan Province were selected as the survey subjects by the convenience sampling method. The investigation was conducted using the general information Questionnaire, the Health Information Discrimination Ability Scale, the filial Piety Expectation Scale and the two-way Social Support Scale.Results:A total of 228 questionnaires were distributed, and 215 valid questionnaires were retrieved, with an effective recovery rate of 94.30%. Among the 215 rural elderly people surveyed, 86 were male and 129 were female. The ability to discriminate health information was (69.19 ± 13.41) points, the expectation of filial piety was (37.67 ± 6.12) points, and the two-way social support was (46.82 ± 8.11) points. The ability of rural elderly people to discriminate health information was positively correlated with filial piety expectations and two-way social support ( r = 0.340, 0.456; both P<0.01). The results of hierarchical regression analysis showed that educational level, filial piety expectations and two-way social support were the influencing factors of the current status of health information discrimination ability of rural elderly people ( t values were 2.60 to 5.35, all P<0.05). Conclusions:The ability of discriminating health information of the elderly in rural areas is affected by the educational level, filial piety expectation and two-way social support. The health information of rural elderly people with low education level should be screened and targeted, so as to enrich their cultural life and combine education with fun. Actively build a filial piety culture to promote children′s attention to their parents. In addition to providing social support for the elderly, we should promote their interpersonal and social communication and exert their self-value, so as to improve the health information screening ability of the elderly in rural areas.

BACKGROUND: The effect of the interval between previous Helicobacter pylori (H. pylori) eradication and rescue treatment on therapeutic outcomes remains unknown. The aim of this study was to investigate the association between eradication rates and treatment interval durations in H. pylori infections. METHODS: This prospective observational study was conducted from December 2021 to February 2023 at six tertiary hospitals in Shandong, China. We recruited patients who were positive for H. pylori infection and required rescue treatment. Demographic information, previous times of eradication therapy, last eradication therapy date, and history of antibiotic use data were collected. The patients were divided into four groups based on the rescue treatment interval length: Group A, ≥4 weeks and ≤3 months; Group B, >3 and ≤6 months; Group C, >6 and ≤12 months; and Group D, >12 months. The primary outcome was the eradication rate of H. pylori . Drug compliance and adverse events (AEs) were also assessed. Pearson's χ2 test or Fisher's exact test was used to compare eradication rates between groups. RESULTS: A total of 670 patients were enrolled in this study. The intention-to-treat (ITT) eradication rates were 88.3% (158/179) in Group A, 89.6% (120/134) in Group B, 89.1% (123/138) in Group C, and 87.7% (192/219) in Group D. The per-protocol (PP) eradication rates were 92.9% (156/168) in Group A, 94.5% (120/127) in Group B, 94.5% (121/128) in Group C, and 93.6% (190/203) in Group D. There was no statistically significant difference in the eradication rates between groups in either the ITT ( P = 0.949) or PP analysis ( P = 0.921). No significant differences were observed in the incidence of AEs ( P = 0.934) or drug compliance ( P = 0.849) between groups. CONCLUSION: The interval duration of rescue treatment had no significant effect on H. pylori eradication rates or the incidence of AEs. REGISTRATION ClinicalTrials.gov , NCT05173493.
Humans ; Helicobacter Infections/drug therapy* ; Helicobacter pylori/pathogenicity* ; Male ; Female ; Prospective Studies ; Middle Aged ; Anti-Bacterial Agents/adverse effects* ; Adult ; Aged ; Treatment Outcome ; Proton Pump Inhibitors/therapeutic use*

Objective:To investigate the protection effect of a new 360-degree radiation protection and position fixation device on the pelvic cavity during chest CT examination.Methods:Three shielding methods were applied to the pelvic cavity of the standard simu-lated human model,i.e.,no shielding(group A),traditional 180-degree front protection with a lead square towel(group B),and 360-degree protection with a new protection device(group C).Philips IQon Spectral CT was used to perform chest CT scan at a tube voltage of 80 kVp,100 kVp,and 120 kVp,respectively,and the cumulative radiation doses from the front,side,and back of the pelvic cavity were measured and analyzed statistically.Results:Compared with groups A and B,group C had significantly lower cumulative radiation doses of the front,side,and back of the pelvic cavity in the simulated human model(all P<0.05);at the tube voltages of 80,100,and 120 kVp,the cumulative dose of the pelvic cavity in group C was reduced by 85%,84%,and 67%,respectively,compared with that in group B,and was reduced by 88%,87%,and 76%,respectively,compared with that in group A.Compared with group A,group B had significant reductions in the radiation doses of the side and back of the pelvic cavity(P<0.05)and a significantly higher radiation dose of the front of the pelvic cavity,which was increased by 19%,23%,and 10%,respectively,at the tube voltages of 80,100,and 120 kVp,and there were significant differences in all tube voltage conditions(P<0.05)except under the tube voltage condition of 120 kVp(P=0.190).In addition,after the application of the device for protection,the reduction rate of pelvic radiation dose under the tube voltages of 80 and 100 kVp was higher than that under the tube voltage of 120 kVp.Conclusion:The new 360-degree radiation protection and position fixation device can significantly reduce the cumulative radiation dose of pelvic organs during chest CT scan,and it holds promise for clinical application due to its characteristics of conve-nient wearing and fixed patient position.

Objective To investigate the population composition,seasonal dynamics,and infestation levels of cockroaches in Lanzhou,China,and to provide information for the scientific development of cockroach control strategies.Methods Monitoring was conducted at three locations using the sticky trap method.Habitats included farm product markets,catering establishments,hotels,hospitals,and residential areas.Results From 2016 to 2023,the average cockroach density was 0.77 insects per board,with an average infestation rate of 10.84%.Blattella germanica was the dominant species.Seasonal density of cockroaches showed an approximately unimodal distribution,peaking in September.The highest average density and infestation rates were observed in farm product markets.Conclusions Cockroach density and infestation levels in Lanzhou remained relatively low.A comprehensive prevention and control strategy focusing on environmental management in key areas should be implemented according to the seasonal fluctuations.

Objective To investigate the expression of E6-associated protein(E6AP)and BRG1-associated factor 155(BAF155)in patients with hepatitis B virus-related hepatocellular carcinoma(HBV-HCC)and its clinical prognostic significance.Methods A total of 126 patients with HBV-HCC diagnosed and treated in the First Affiliated Hospital of Harbin Medical University from January 2019 to February 2021 were retrospec-tively collected as the research subjects.The expressions of E6AP and BAF155 in cancer tissues and adjacent tissues of HBV-HCC patients were detected by real-time fluorescence quantitative PCR and immunohisto-chemistry.To analyze the relationship between the levels of E6AP mRNA and BAF155 mRNA and the clini-copathological characteristics of patients with HBV-HCC.The survival curve was plotted using the Kaplan-Meier method to analyze the effects of E6AP mRNA and BAF155 mRNA levels on the survival prognosis of patients with HBV-HCC.COX regression analysis was conducted to analyze the factors influencing the surviv-al prognosis of patients with HBV-HCC.Results Compared with adjacent tissues,the positive rates of E6AP mRNA and protein in cancer tissues of HBV-HCC patients were lower,while the positive rates of BAF155 mRNA and protein were higher,and the differences were statistically significant(P<0.05).Compared with the stage I of the China Liver Cancer Staging(CNLC),the maximum tumor diameter<5 cm and HBV-DNA negative,the E6AP mRNA was lower and the BAF155 mRNA was higher in the HBV-HCC cancer tissues of the CNLC stage Ⅱ—Ⅲ,the maximum tumor diameter≥5 cm and the HBV-DNA positive,the difference was statistically significant(P<0.05).The 3-year survival rates of the high-expression group and the low-expres-sion group of E6AP mRNA were 67.19%(43/64)and 38.71%(24/62),respectively,and the difference was statistically significant(Log rank χ2=10.540,P=0.001).The 3-year survival rates of the high-expression group and the low-expression group of BAF155 mRNA were 42.62%(26/61)and 63.08%(41/65),respec-tively,and the difference was statistically significant(Log rank χ2=6.876,P=0.009).The results of multi-variate COX analysis showed that CNLC stage Ⅱ—Ⅲ and BAF155 mRNA were risk factors affecting the prognosis of HBV-HCC,while E6AP mRNA was a protective factor.Conclusion The expression of E6AP is down-regulated and the expression of BAF155 is up-regulated in patients with HBV-HCC.Detecting the ex-pressions of E6AP and BAF155 is helpful for evaluating the prognosis of patients with HBV-HCC.

Objective To analyze the reasons and influencing factors of ambiguous medical records,and propose targe-ted intervention strategies.Methods The medical records discharged from the Department of Otolaryngology,Head and Neck Surgery of a large Class Ⅲ hospital in Xi'an from January 2023 to December 2023 were retrospectively collected,and the medical records groups and ambiguous medical records were screened through the DRG information platform.The clinical features,defect causes and risk factors of ambiguous cases were analyzed statistically.Results There were 4 124 discharged cases in the year,of which 77 were ambiguous cases,accounting for 1.87％.Compared with the non-ambiguous group,more patients in the ambig-uous group adopted a self-funded approach,experienced a transfer and a longer hospital stay.The proportion of surgery and trau-ma in ambiguous group was higher,but the proportion of tumor patients was lower.Due to DRG grouping rules,64 cases(83.1％)were divided into ambiguous groups,which was the primary direct cause.Binary Logistic regression indicated that self-paid medical treatment(OR=2.2),transfer(OR=4.8),hospitalization ≥7 days(OR=3.1),trauma(OR=15.0),and total cost＞20 000 yuan(OR=1.7)were the risk factors for ambiguous disease cases(P＜0.05),while tumor disease was the pro-tective factor(OR=0.6,P＜0.05).Conclusion The emergence of ambiguous medical records involves many aspects such as clinical diagnosis and treatment,hospital management,health policy and so on,which has an important impact on hospital per-formance and medical insurance fund.Only by strengthening the level of hospital management,improving the quality of informa-tion system,and promoting the coordination and communication between doctors,management and patients,can we effectively re-duce the occurrence of ambiguous medical records.

Objective:To understand the current situation of the ability to screen health information of the elderly in rural areas and analyze its influencing factors, so as to provide a basis for taking targeted measures.Methods:A cross-sectional survey was adopted, and rural elderly people in Yonghe Town, Dahu Town and Dayao Town of Liuyang City, Hunan Province were selected as the survey subjects by the convenience sampling method. The investigation was conducted using the general information Questionnaire, the Health Information Discrimination Ability Scale, the filial Piety Expectation Scale and the two-way Social Support Scale.Results:A total of 228 questionnaires were distributed, and 215 valid questionnaires were retrieved, with an effective recovery rate of 94.30%. Among the 215 rural elderly people surveyed, 86 were male and 129 were female. The ability to discriminate health information was (69.19 ± 13.41) points, the expectation of filial piety was (37.67 ± 6.12) points, and the two-way social support was (46.82 ± 8.11) points. The ability of rural elderly people to discriminate health information was positively correlated with filial piety expectations and two-way social support ( r = 0.340, 0.456; both P<0.01). The results of hierarchical regression analysis showed that educational level, filial piety expectations and two-way social support were the influencing factors of the current status of health information discrimination ability of rural elderly people ( t values were 2.60 to 5.35, all P<0.05). Conclusions:The ability of discriminating health information of the elderly in rural areas is affected by the educational level, filial piety expectation and two-way social support. The health information of rural elderly people with low education level should be screened and targeted, so as to enrich their cultural life and combine education with fun. Actively build a filial piety culture to promote children′s attention to their parents. In addition to providing social support for the elderly, we should promote their interpersonal and social communication and exert their self-value, so as to improve the health information screening ability of the elderly in rural areas.

Amantadine(AMD)residue can accumulate in organisms through the food chain and cause serious harm to human body.AMD can specifically bind to AMD specific aptamer and cause its conformation to change from a random single strand to a stem-loop structure.To avoid the influence of excess nucleotides on binding of aptamer to AMD,the truncation of the AMD original aptamer J was optimized by retaining an appropriate stem-loop structure,and a new type of truncation aptamers was developed in this work.By comparing the truncated aptamer with the original aptamer,it was found that the truncated aptamer J-7 had better affinity and specificity with AMD.The detection limit of AMD was 0.11 ng/mL by using J-7 as specific recognition element and molybdenum disulfide nanosheet(MoS2Ns)as signal amplification element.The developed method base on truncated aptamer J-7 was used for detection of AMD in milk,yogurt and SD rat serum samples for the first time with recoveries of 86.6%-108.2%.This study provided a reference for truncating other long sequence aptamers and provided a more sensitive detection method for monitoring AMD residues in food.

Objective This study aimed to evaluate the associations of serum folate and/or vitamin B12 concentrations with obesity among Chinese children and adolescents. Methods A cross-sectional study was conducted including 3,079 Chinese children and adolescents,aged 6 to 17 years,from Jiangsu,China.Anthropometric indices,such as,children's body mass index(BMI),BMI z-scores,waist circumference,and waist-to-height ratio were utilized.Multivariable linear regression and generalized additive models were used to investigate the associations of serum folate and vitamin B12 levels with anthropometric indices and odds of obesity. Results We observed that serum vitamin B12 concentrations were inversely associated with all anthropometric indices and the odds of general obesity[odds ratio(OR)= 0.68;95%confidence interval(CI)= 0.59,0.78]and abdominal obesity(OR = 0.68;95%CI = 0.60,0.77).When compared to participants with both serum vitamin levels in the two middle quartiles,those with both serum folate and vitamin B12 levels in the highest quartile were less prone to general(OR = 0.31,95%CI = 0.19,0.50)or abdominal obesity(OR = 0.46,95%CI = 0.31,0.67).Conversely,participants with vitamin B12 levels in the lowest quartile alongside folate levels in the highest quartile had higher odds of abdominal obesity(OR = 2.06,95%CI = 1.09,3.91). Conclusion Higher serum vitamin B12 concentrations,but not serum folate concentrations,were associated with lower odds of childhood obesity.Children and adolescents with high levels of vitamin B12 and folate were less likely to be obese.