Objective To explore the difference in efficacy of metoprolol versus ivabradine in the treatment of postural orthostatic tachycardia syndrome(POTS)in the elderly after COVID-19 infection.Methods A total of 110 patients diagnosed with POTS at our department from Decem-ber 1,2022 to January 31,2023 were included.According to their drug regimen,they were divided into metoprolol group(62 patients)and ivabradine group(48 patients).On the 28th day of out-patient follow-up,the resting heart rate,heart rate of 10 min of standing,symptom disappearance rate,hospitalization rate,and mortality rate were compared between the two groups.Results On the 28th day of treatment,the resting heart rate and postural heart rate for 10 min were decreased in both groups when compared with the levels at initial diagnosis(P＜0.01).And there were no significant differences in the two types of heart rate between the two groups on the 28th day(71.0±7.0 vs 72.1±7.0,P=0.401;76.5±7.2 vs 77.4±7.6,P=0.573).No obvious differences were observed between the two groups in symptom disappearance rate,hospitalization rate,or mortality rate(88.7％vs 89.6％,3.2％vs2.1％,0％vs 0％,P＞0.05).Conclusion Metoprolol and ivabradine can effectively treat POTS in the elderly patients after COVID-19 infection.

Hip fractures are among the most common fractures in the elderly, presenting to be a leading cause of disability and mortality. Surgical treatment is currently the main treatment method for hip fractures. The incidence of perioperative malnutrition is increased after hip fractures in the elderly due to the comorbidities, decreased basal metabolic rate, accelerated protein breakdown, weakened anabolism and surgical stress. However, malnutrition not only increases the incidence of postoperative complications, but also leads to increased mortality, indicating an important role of perioperative nursing management of nutrition for the elderly patients with hip fractures. At present, there still lacks scientific guidance and application standards on perioperative nursing management of nutrition for the elderly patients with hip fractures. Therefore, the Orthopedic Nursing Committee of Chinese Nursing Association and the Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures ( version 2023) according to evidence-based medical evidences and their clinical experiences. Fourteen recommendations were made from aspects of nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention and nutrition monitoring to provide guidance for perioperative nursing management of nutrition in elderly patients with hip fractures.

Abstract: Objective To evaluate the application of TB laboratory detection technology in Liaoning Province from 2016 to 2022, and to provide scientific basis for further improving the detection rate of Mycobacterium tuberculosis in the province. Methods The medical records of registered tuberculosis patients in Liaoning Province from 2016 to 2022 were collected from the "Tuberculosis Information Management System" in the "China Disease Prevention and Control Information System" subsystem. Statistical analysis was performed for sputum coating, sputum culture, and molecular biology testing. Results From 2016 to 2022, a total of 152 778 patients with pulmonary tuberculosis were registered in Liaoning Province. The detection rate of sputum smear microscopy was 98.03% (149 775/152 778), the detection rate of sputum culture was 20.72% (31 661/152 778), and the detection rate of molecular biology testing was 20.21% (30 737/152 778). From 2018 to 2022, the rate of molecular biological detection showed an increasing trend (χ2trend=7 104.466, P<0.01), while from 2016 to 2021, the detection rate of sputum culture showed an increasing trend, with statistical significance (χ2trend=3,068.701, P<0.01). The sputum smear detection rate showed a downward trend（χ2trend=689.913, P<0.01). . There were significant differences in the results of sputum smear microscopy, sputum culture, and molecular biology testing, as confirmed by the McNemar test (P<0.01). The positive rate of pathogenic academics increased from 26.27% in 2016 to 51.55% in 2022, showing a yearly upward trend (χ2trend=5 262.863, P<0.01), with significant differences between each year (χ2=5 686.935, P<0.01). Among pulmonary tuberculosis patients with positive pathogenic microorganisms, the proportion of sputum smear-positive cases decreased from 94.32% to 52.36%, showing a downward trend (χ2trend=5 010.104, P<0.01). The proportion of culture-positive cases increased from 5.68% in 2016 to 12.83% in 2022, showing an upward trend (χ2trend=122.501, P<0.01). In Liaoning Province, molecular biology testing has been carried out since 2018, and the proportion of molecular biology-positive cases increased from 11.51% to 34.81%, showing an increasing trend (χ2trend=1 969.326, P<0.01). The number of positive patients in molecular biological tests in municipal hospitals accounted for 18.69% (8 386/44 778) of etiological positive patients, while the number of positive patients in county-level hospitals accounted for 13.61% (2 439/17 924) of etiological positive patients, with significant differences (χ2=231.594, P<0.01). Conclusions The implementation of molecular biology testing for tuberculosis in Liaoning Province is one of the main measures to improve the positive rate of etiology, and it helps to diagnose tuberculosis patients timely and accurately

Abstract: Objective　To analyze the epidemic characteristics of etiologically positive pulmonary tuberculosis, and the outcome of treatment in Liaoning Province from 2016 to 2022, aiming to provide a scientific basis for the formulation of tuberculosis prevention and control measures in Liaoning Province. Methods　The medical records information of registered pulmonary tuberculosis patients in Liaoning Province from 2016 to 2022 was collected from the "Tuberculosis Information Management System", a subsystem of the "China Disease Prevention and Control Information System". A descriptive analysis was performed on the epidemiological characteristics and treatment outcomes of cases of pathogen-positive pulmonary tuberculosis. Results　From 2016 to 2022, a total of 152 778 cases of active pulmonary tuberculosis were registered in Liaoning Province. Registration rates decreased from 54.48/100 000 in 2016 to 39.12/100 000 in 2022, displaying a downward trend (χ2trend=1 921.17, P<0.001). The etiological positive rate increased from 26.70% in 2016 to 51.21% in 2022, indicating an upward trend (χ2trend=5 203.00, P<0.001). The etiological positive registration rate increased from 14.54/100 000 in 2016 to 20.03/100 000 in 2022, showing an upward trend (χ2trend=647.97, P<0.001). The male-female ratio of etiological positive was 3.35∶1. The age group of 55-<65 had the highest incidence rate at 25.45% (16 127/63 376) among pathogen-positive pulmonary tuberculosis cases. Patients over 45 years of age accounted for 71.27% (41 570/63 376) of total cases, pointing towards an aging trend. The main occupations of the patients were household and unemployed, making up 41.78% (26 477/63 376) of total cases and showed an increasing year-on-year trend (χ2trend=17.404, P<0.001). Direct medical consultation was the primary mode of patient source at 50.28%(31 864/63 376), while 64.54%(40 904/63 376) cases reported a delay in seeking treatment. Seasonality was observed in the occurrence of pathogen-positive pulmonary tuberculosis, with February and September being the months of lowest incidence, while May and June witnessed peak incidences. The etiological positive patients were mainly in Shenyang, Dalian, Jinzhou and other regions. The proportion of successful treatment of etiologically positive decreased from 91.15% in 2016 to 85.88% in 2022, manifesting a downward trend (χ2trend=35.892, P<0.001). Conclusions　From 2016 to 2022, the incidence and registration rates of pathogen-positive pulmonary tuberculosis in Liaoning Province displayed an upward trend. Several characteristics were observed including seasonal variations, delayed treatment, regional distribution differences, and a decline in successful treatment rates. Targeted prevention and control measures should be formulated according to the actual situation in Liaoning Province.

In clinic, intima and media thickness are the main indicators for evaluating the development of atherosclerosis. At present, these indicators are measured by professional doctors manually marking the boundaries of the inner and media on B-mode images, which is complicated, time-consuming and affected by many artificial factors. A grayscale threshold method based on Gaussian Mixture Model (GMM) clustering is therefore proposed to detect the intima and media thickness in carotid arteries from B-mode images in this paper. Firstly, the B-mode images are clustered based on the GMM, and the boundary between the intima and media of the vessel wall is then detected by the gray threshold method, and finally the thickness of the two is measured. Compared with the measurement technique using the gray threshold method directly, the clustering of B-mode images of carotid artery solves the problem of gray boundary blurring of inner and middle membrane, thereby improving the stability and detection accuracy of the gray threshold method. In the clinical trials of 120 healthy carotid arteries, means of 4 manual measurements obtained by two experts are used as reference values. Experimental results show that the normalized root mean square errors (NRMSEs) of the estimated intima and media thickness after GMM clustering were 0.104 7 ± 0.076 2 and 0.097 4 ± 0.068 3, respectively. Compared with the results of the direct gray threshold estimation, means of NRMSEs are reduced by 19.6% and 22.4%, respectively, which indicates that the proposed method has higher measurement accuracy. The standard deviations are reduced by 17.0% and 21.7%, respectively, which indicates that the proposed method has better stability. In summary, this method is helpful for early diagnosis and monitoring of vascular diseases, such as atherosclerosis.
Carotid Arteries/diagnostic imaging* ; Carotid Intima-Media Thickness ; Normal Distribution ; Ultrasonography

OBJECTIVE: To detect potential variant in an ethical Han Chinese pedigree affected with breast cancer. METHODS: The proband and her relatives were subjected to next-generation sequencing using a target capture sequencing kit containing 121 cancer-related genes. Candidate variants were selected by analysis of their type, frequency in population, and segregation with the phenotype. Candidate variant was verified by Sanger sequencing and TA cloning. RESULTS: A c.2013_2014ins GT variant was detected in the BRCA1 gene among all breast cancer patients from this pedigree but not among healthy females. The variant was not recorded in the 1000 Genome Project database or the Exome Aggregation Consortium (ExAC) database. The frameshifting insertion was predicted to form an premature stop codon in gene transcript and can give rise to a truncated protein. CONCLUSION The BRCA1 c.2013_2014ins GT variant probably underlies the pathogenesis of breast cancer in this Chinese pedigree.
Asian Continental Ancestry Group ; BRCA1 Protein ; genetics ; Breast Neoplasms ; genetics ; Exome ; Female ; High-Throughput Nucleotide Sequencing ; Humans ; Pedigree ; Phenotype

Objective To evaluate the predictive value of posttreatment whole body scan (RxWBS) for radiation damage to the salivary glands in patients with differentiated thyroid carcinoma (DTC).Methods From April 2015 to June 2015,24 patients (8 males,16 females;age:26-64 years) with DTC,who accepted 131I therapy only one time and underwent Rx-WBS 2-4 d after 131I treatment,were recruited from the First Hospital of China Medical University.All patients had normal salivary glands function on salivary gland scintigraphy (SGS) performed on the day before 131I treatment,and 21 patients underwent SGS again 3 months after 131I treatment.The SGS results and clinical manifestations were used to evaluate the function of salivary glands after 131I therapy.Rx-WBS was analyzed by visual analysis and quantitative analysis (salivary gland to background uptake ratios,SUR).The SUR was compared between patient groups with different function of salivary glands.Mann-Whitney u test was used.Receiver operating characteristic (ROC) curve analysis was used to calculate the sensitivity of SUR for predicting the salivary gland damage.Results The SUR in dysfunctional parotid glands (n =12) was significantly higher than that in other glands with normal function (n=30;3.60(2.55,4.33) vs 2.75(2.33,3.29);z=-2.005,P＜0.05).The SUR was not different between submandibular glands with lower function (n =15) and those with normal function (n=27;z=-0.144,P＞0.05).The SUR of parotid glands (n =32) in patients with parotitis was significantly higher than that in others (n=16;3.16(2.53,4.01) vs 2.49(206,2 81);z=-3.073,P＜0.05).The SUR of submandibular glands (n=28) in patients with sialadenitis was significantly higher than that in others (n=20;4.43(2.67,7.61) vs 2.93(1.92,4.65);z=-2.740,P＜0.05).When 2.97 and 3.66 were selected as cutoff values,the sensitivities of SUR for predicting parotitis and sialadenitis were 59％(19/32) and 64％ (18/ 28),respectively.Conclusion Rx-WBS may play a role in predicting radiation damage to the salivary glands.

Objective To explore the effect of transitional care model on health recovery in discharged elderly patients with angiocardiopathy.Methods A group of transitional care of geriatric department was formed by physicians and nurses of geriatric department, physicians and therapists of rehabilitation department and so on. A total of 81 discharged patients with angiocardiopathy of geriatric department in the Second People's Hospital of Nantong were selected as research group from July 2015 to February 2016 using purposive sampling. They accepted transitional care. A total of 85 elderly patients with angiocardiopathy were recruited as control between December 2015 to June 2016 with routine health education. The effect and the patients' satisfaction were compared between two groups.Results The compliance rate of medication of patients was 93.6% in research group and 65.8% in control group in the second week after leaving hospital with a significant difference (χ2=20.447,P<0.05). There was a statistically significant difference in satisfaction between research group [(95.21±1.98)%] and control group [(88.34±1.84)%] (t=32.7470,P<0.05).Conclusions The transitional care can improve the medication compliance in discharged elderly patients with angiocardiopathy, help them build up health lifestyle and improve the quality of life of patients.

Objective To explore appropriate management of cancer report for general hospital and analyze the effect.Methods Based on the requirements of cancer report for general hospital that formulated by the health administrative departments,we set the rule and process of malignancy report.We clear the responsibilities of reporting and the management,strengthen the training of malignancies report,make regular supervision and evaluation,and gradually use information live system to monitor malignancies report.Results In 2006-2010,the number of reports of malignancy in our general hospital has a upward trend.The false negative rate and delaying rate decreased year by year.The pass rate of the report card increased year by year,and the difference was statistically significant (＜0.05).With the increase of the rate of training for malignancies report,rate of timely report increased significantly.Conclusion General hospitals should use their own conditions to the development of scientific and operational report management systems and processes for malignancies.Attention should be paid to the combine of training and management and the gradual standardizing of the malignancies reporting.

Objective To study the clinical effect and value of the combination of dexamethasone and calcium agent assisted oxytocin on preventing postpartum hemorrhage.Methods 128 cases of maternal of clinical information were reviewed,and which were divided into control group and observation group randomly.The control group was immediately infused muscle note 20IU of Oxytocin and the observation group(n =64) was given 5％ of glucose and 100ml 10％ of glucose acid 10ml calcium.And then give 20IU oxytocin after pending.Lastly,give the two groups comparison of blood-producing capacity and the number of cases of blood-producing.Results Ater observation groups in fetal foetus blood-producing capacity of 2h and 24h,the number of cases of blood-producing less than the control group,and both have significant statistical differences (all P ＜ 0.01).Conclusion The combination of dexamethasone and calcium agent-assisted application of oxytocin can prevent postpartum hemorrhage,better clinical effect,which should be promot in clinical application.