Objective To investigate the association between lifestyle and risk of heart disease and diabetes in the elderly population in Xi'an City. Methods From January 2021 to January 2024, a staged cluster sampling method was used to investigate the lifestyle and the occurrence of heart disease and diabetes in elderly population aged 60 years and above in the communities of Xi'an. Multivariate logistic regression was used to analyze the relationship between lifestyle and the risk of heart disease and diabetes. Results A total of 413 elderly people were investigated, of which 31.96% had heart disease, 27.12% had diabetes, and 10.90% had diabetes with heart disease. Multivariate logistic regression analysis revealed that age, BMI, family history, sweet food preference, smoking, and sitting and lying for a long time were risk factors for diabetes in the elderly population (P<0.05). Age, BMI, family history, history of diabetes, preference for salted products, smoking, drinking, and sitting and lying for a long time were risk factors for heart disease in the elderly population (P<0.05). Conclusion The incidence rates of heart disease and diabetes are high in the elderly population in Xi'an City. The risk of diabetes is related to unhealthy lifestyles such as sweet food preference, smoking, and sitting and lying for a long time, while heart disease is related to unhealthy lifestyles such as preference for salted products, smoking, drinking, and sitting and lying for a long time.

Objective To investigate the association between lifestyle and risk of heart disease and diabetes in the elderly population in Xi'an City. Methods From January 2021 to January 2024, a staged cluster sampling method was used to investigate the lifestyle and the occurrence of heart disease and diabetes in elderly population aged 60 years and above in the communities of Xi'an. Multivariate logistic regression was used to analyze the relationship between lifestyle and the risk of heart disease and diabetes. Results A total of 413 elderly people were investigated, of which 31.96% had heart disease, 27.12% had diabetes, and 10.90% had diabetes with heart disease. Multivariate logistic regression analysis revealed that age, BMI, family history, sweet food preference, smoking, and sitting and lying for a long time were risk factors for diabetes in the elderly population (P<0.05). Age, BMI, family history, history of diabetes, preference for salted products, smoking, drinking, and sitting and lying for a long time were risk factors for heart disease in the elderly population (P<0.05). Conclusion The incidence rates of heart disease and diabetes are high in the elderly population in Xi'an City. The risk of diabetes is related to unhealthy lifestyles such as sweet food preference, smoking, and sitting and lying for a long time, while heart disease is related to unhealthy lifestyles such as preference for salted products, smoking, drinking, and sitting and lying for a long time.

Objective Based on sentinel symptoms,a nursing intervention program for gastrointestinal symptom group of postoperative chemotherapy for lung cancer was constructed and its application effect was evaluated.Methods The nursing intervention program of gastrointestinal symptom group was constructed on the basis of ref-erence guidelines,qualitative interview and expert consultation.From January 2021 to January 2022,a total of 330 patients with postoperative chemotherapy for lung cancer in a tertiary hospital in Shenyang were selected as re-search subjects.The experimental group received the gastrointestinal symptoms group nursing intervention program on the basis of routine nursing,and the control group received routine care.Patients were investigated with the M.D.Anderson Symptom Inventory and the MOS 36-Item Short-Form Health Survey before 1st chemotherapy(T1),3rd chemotherapy(T2)and 5th chemotherapy(T3).Results After the intervention,the total scores of the 2 groups and the total scores of each symptom in T2 and T3 were statistically significant(P＜0.05),and the score of the experi-mental group was lower than that of the control group.For the scores of 6 dimensions of physiological function,physical pain,overall health,vitality,emotional function,mental health in 2 groups between different time points,the differences are statistically significant(P＜0.05).Conclusion The nursing intervention program of the gastroin-testinal symptom group based on sentinel symptoms is beneficial to reduce the severity of the gastrointestinal symp-tom group and improve the quality of life for postoperative chemotherapy for lung cancer patients.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To observe multiple locus variable-number tandem repeat analysis (MLVA) typing of Brucella isolated from Himalayan marmot in Qinghai-Tibet Plateau of Qinghai Province, and to explore the relationship between the strains and strains previous isolated from Qinghai Province. Methods:Blood samples of Himalayan marmot were collected in Qinghai-Tibet Plateau of Qinghai Province from March 2019 to October 2020. Pathogens were isolated and cultured from Brucella antibody positive samples identified by using the rose bengal test (RBT). Conventional biological methods and molecular biological methods (BCSP31-PCR and AMOS-PCR) were used for strain identification. At the same time, MLVA method was used to genotype the isolated strains, and cluster analysis was used to analyze the genetic relationships between the strains based on the genotype of 70 Brucella isolated from different hosts in Qinghai Province. Results:A total of 1 466 blood samples of Himalayan marmot were collected from Qinghai-Tibet Plateau. Two strains of Brucella were isolated and cultured from 64 RBT-positive samples, named QH2013054 and QH2013062, respectively. They were identified as Brucella ovis biotype Ⅲ by conventional and molecular biological methods. The MLVA genotyping results showed that QH2013054 and QH2013062 were different at the Bru16 locus, indicating different MLVA genotypes. Cluster analysis showed that strain QH2013054 had the same MLVA genotype as 7 strains, among which 6 strains were from 3 farmers and 3 sheep from the same family in Gonghe County, and 1 strain was from a farmer in Menyuan Hui Autonomous County. The strain QH2013062 had the same MLVA genotype as 4 strains, including 3 strains from 3 farmers in Menyuan Hui Autonomous County and 1 strain from a farmer in Tu Autonomous County of Huzhu. Conclusions:The strains of Brucella isolated from Himalayan marmot in Qinghai-Tibet Plateau of Qinghai Province have the same MLVA genotype as some strains of Brucella isolated from humans and sheep in Qinghai Province. It is speculated that the host humans, sheep and Himalayan marmot in Qinghai-Tibet Plateau may have a common source of infection.

Humans ; Neutrophils ; Receptors, Cell Surface ; GPI-Linked Proteins ; HIV Infections ; Isoantigens

Objective:To investigate the long-term survival and safety in patients with muscle-invasive bladder cancer (MIBC) who experienced a noninvasive down-staging (≤pT 1)after transurethral resection of bladder tumor (TURBT) plus systemic chemotherapy and received bladder-sparing treatment. Methods:The records of patients with MIBC who underwent maximal TURBT plus systemic chemotherapy-guided bladder-sparing treatment were reviewed retrospectively from Dec 2013 to Dec 2020. Eventually, 22 patients who achieved noninvasive down-staging underwent conservative management. The total patient cohort contained 10 males and 12 females. A majority of patients had single lesion and stage T2 disease. The median age of the patients was 66 years and the median tumor size was 3.0 cm. All patients underwent maximal TURBT to resect all visible diseases and followed by 3-4 cycles platinum-based systemic chemotherapy. After achieving noninvasive down-staging, 14 patients received concurrent chemoradiotherapy, and the other 8 patients underwent surveillance. Overactive bladder symptom score (OABSS) was used to assess the bladder function after treatment.Results:Twelve patients achieved pT 0 and 10 patients were down-staged to cT a-T 1. At a median follow-up of 36.7 months, 90.9%(20/22) patients retained their bladder function successfully. Among the 14 patients who received concurrent chemoradiotherapy, 4 had grade 3 or 4 adverse events. Among the 8 patients who underwent surveillance, 3 had grade 3 or 4 adverse events after systemic chemotherapy.Nine patients experienced tumor recurrence in the bladder, and 2 patients died of bladder cancer. Seven (31.8%) patients experienced Ⅲ/Ⅳ grade complications. The 5-year recurrence-free survival (RFS) and overall survival (OS) in patients achieved pT0 were 66.7% and 100.0%, respectively. The 5-year RFS and OS in patients achieved cTa-T1 were 40% and 72%, respectively. The OABSS score of 20 patients who retained their bladder successfully was (1.00±1.03). Conclusions:MIBC patients who achieved noninvasive down-staging might be candidates for the bladder-sparing treatment with maximum TURBT followed by systemic chemotherapy.The patients who achieved pT 0 might have better prognosis with functional bladder.

Objective:To investigate the efficacy and safety of DOS regimen in adjuvant chemotherapy after D2 radical resection for advanced gastric adenocarcinoma.Methods:The clinical data of 130 patients who received adjuvant chemotherapy after D2 radical resection for advanced gastric adenocarcinoma in Jincheng People's Hospital from January 2017 to January 2019 were retrospectively analyzed. According to treatment regimens, the patients were divided into DOS regimen chemotherapy group (DOS group, 63 cases) and SOX (oxaliplatin, S-1) regimen chemotherapy group (SOX group, 67 cases). The short-term efficacy and adverse reactions of the two groups were compared.Results:Due to the irregular treatment time, 2 cases in each group were removed. Finally, there were 61 cases in DOS group and 65 cases in SOX group. The 1-, 2- and 3-year disease-free survival (DFS) rates of the DOS group were 80.33%, 73.77% and 62.30%, and the DFS rates of the SOX group were 73.85%, 55.38% and 41.54%. The difference in DFS between the two groups was statistically significant ( χ2 = 5.43, P = 0.022). The 1-, 2- and 3-year overall survival (OS) rates of the DOS group were 93.44%, 80.33% and 70.50%, and the OS rates of the SOX group were 96.92%, 73.85% and 52.31%. The difference in OS between the two groups was statistically significant ( χ2 = 4.38, P = 0.045). There were no statistical differences in the incidence rates of grade Ⅰ-Ⅱ nausea, vomiting, diarrhea, bone marrow suppression and fatigue between the two groups (all P > 0.05). There were no statistical differences in the incidence rates of grade Ⅲ-Ⅳ nausea, vomiting and fatigue (both P > 0.05), but there were statistical significances in the incidence rates of grade Ⅲ-Ⅳ diarrhea and bone marrow suppression (both P < 0.05). Conclusions:Adjuvant DOS regimen in the treatment of advanced gastric adenocarcinoma after D2 radical resection has good curative efficacy and can improve the survival of patients, and the adverse reactions can be tolerated.

Objective: To investigate the association between lifestyle risk factors and comorbidity of chronic diseases among male elderly populations in Oroqen Autonomous Banner, Inner Mongolia Autonomous Region, so as to provide insights into improvements of lifestyles and prevention of comorbidity of chronic diseases among male elderly populations. Methods: Male residents at ages of 65 years and older that participated in community healthy examinations were sampled from 16 villages (communities) in Oroqen Autonomous Banner using a multi-stage cluster random sampling method from July to December, 2020. Participants' demographic data, lifestyle risk factors and disease history were collected using questionnaire surveys, and healthy examinations data were collected through the grassroots healthcare service information system for community health service centers, including waist circumference, blood pressure, fasting blood glucose and blood lipid. The correlation between lifestyle risk factors and comorbidity of chronic diseases were examined among males at ages of 65 years and older using a multivariable ordered logistic regression model. Results: Totally 761 male elderly populations were included, with a mean age of (73.61±6.74) years. There were 216 participants with central obesity (28.38%), 179 with smoking (23.52%), 194 with alcohol consumption (25.49%), 412 with a low frequency of physical activities (54.14%), 347 with one type of lifestyle risk factor (45.60%) and 268 with two and more types of lifestyle risk factors (35.22%), 404 with hypertension, 170 with diabetes and 321 with dyslipidemia. There were 347 participants with one type of chronic disease (45.60%), 199 with two types of chronic diseases (26.15%) and 50 with three types of chronic diseases (6.57%), and the prevalence of comorbidity of chronic diseases was 32.72% among the participants. Multivariable ordered logistic regression analysis showed an increased risk of developing comorbidity of chronic diseases among participants with central obesity (OR=2.442, 95%CI: 1.804-3.307), and a reduced risk of comorbidity of chronic diseases among participants with less than two types of lifestyle risk factors (one type, OR=0.607, 95%CI: 0.451-0.820; none, OR=0.675, 95%CI: 0.460-0.990). Conclusions Central obesity and number of lifestyle risk factors are factors affecting comorbidity of chronic diseases among the male elderly populations at ages of 65 years and older in Oroqen Autonomous Banner.

In recent years, immune checkpoint inhibitors are a milestone in the treatment of lung cancer. There are many kinds of immune checkpoints, which are closely related to the efficacy and drug resis-tance of immunotherapy, including programmed death-1 (PD-1), programmed death ligand-1 (PD-L1), cytotoxic T-lymphocyte antigen 4 (CTLA-4), killer cell immunoglobulin-like receptor (KIR), T cell immunoglobulin and ITIM domain (TIGIT), T-cell immunoglobulin and mucin domain-containing protein 3 (TIM-3), etc. PD-1/PD-L1 inhibitors have been approved by China National Medical Products Administration and U. S. Food and Drug Administration for the first-line treatment of lung cancer, which can improve overall survival and progression-free survival of patients. The double immunotherapies of CTLA-4 inhibitors or TIGIT inhibitors combined with PD-1/PD-L1 inhibitors also achieve good results, however, more serious adverse events may occur.The KIR and TIM-3 targets are closely related to the drug resistance of immunotherapy.