Background::Understanding willingness to undergo pulmonary function tests (PFTs) and the factors associated with poor uptake of PFTs is crucial for improving early detection and treatment of chronic obstructive pulmonary disease (COPD). This study aimed to understand willingness to undergo PFTs among high-risk populations and identify any barriers that may contribute to low uptake of PFTs.Methods::We collected data from participants in the "Happy Breathing Program" in China. Participants who did not follow physicians’ recommendations to undergo PFTs were invited to complete a survey regarding their willingness to undergo PFTs and their reasons for not undergoing PFTs. We estimated the proportion of participants who were willing to undergo PFTs and examined the various reasons for participants to not undergo PFTs. We conducted univariable and multivariable logistic regressions to analyze the impact of individual-level factors on willingness to undergo PFTs.Results::A total of 8475 participants who had completed the survey on willingness to undergo PFTs were included in this study. Out of these participants, 7660 (90.4%) were willing to undergo PFTs. Among those who were willing to undergo PFTs but actually did not, the main reasons for not doing so were geographical inaccessibility ( n = 3304, 43.1%) and a lack of trust in primary healthcare institutions ( n = 2809, 36.7%). Among the 815 participants who were unwilling to undergo PFTs, over half ( n = 447, 54.8%) believed that they did not have health problems and would only consider PFTs when they felt unwell. In the multivariable regression, individuals who were ≤54 years old, residing in rural townships, with a secondary educational level, with medical reimbursement, still working, with occupational exposure to dust, and aware of the abbreviation "COPD" were more willing to undergo PFTs. Conclusions::Willingness to undergo PFTs was high among high-risk populations. Policymakers may consider implementing strategies such as providing financial incentives, promoting education, and establishing community-based programs to enhance the utilization of PFTs.

Patients with acute heart failure (AHF) often experience dyspnea, and monitoring and quantifying their breathing patterns can provide reference information for disease and prognosis assessment. In this study, 39 AHF patients and 24 healthy subjects were included. Nighttime chest-abdominal respiratory signals were collected using wearable devices, and the differences in nocturnal breathing patterns between the two groups were quantitatively analyzed. Compared with the healthy group, the AHF group showed a higher mean breathing rate (BR_mean) [(21.03 ± 3.84) beat/min vs. (15.95 ± 3.08) beat/min, P < 0.001], and larger R_RSBI_cv [70.96% (54.34%-104.28)% vs. 58.48% (45.34%-65.95)%, P = 0.005], greater AB_ratio_cv [(22.52 ± 7.14)% vs. (17.10 ± 6.83)%, P = 0.004], and smaller SampEn (0.67 ± 0.37 vs. 1.01 ± 0.29, P < 0.001). Additionally, the mean inspiratory time (TI_mean) and expiration time (TE_mean) were shorter, TI_cv and TE_cv were greater. Furthermore, the LBI_cv was greater, while SD1 and SD2 on the Poincare plot were larger in the AHF group, all of which showed statistically significant differences. Logistic regression calibration revealed that the TI_mean reduction was a risk factor for AHF. The BR_ mean demonstrated the strongest ability to distinguish between the two groups, with an area under the curve (AUC) of 0.846. Parameters such as breathing period, amplitude, coordination, and nonlinear parameters effectively quantify abnormal breathing patterns in AHF patients. Specifically, the reduction in TI_mean serves as a risk factor for AHF, while the BR_mean distinguishes between the two groups. These findings have the potential to provide new information for the assessment of AHF patients.
Humans ; Heart Failure/diagnosis* ; Prognosis ; Respiration ; Wearable Electronic Devices ; Acute Disease

Objective:To visualize and analyze the literature related to the treatment of extremity lymphedema (EL) over the years 2012 to 2022 and to explore future research directions.Methods:Taking "lymphedema" and "treatment" as the themes, the study searched the Chinese and English literature related to EL treatment reported by Chinese scholars from 2012 to 2022 in Chinese National Knowledge Infrastructure (CNKI) and Web of Science (WOS) databases, and used CiteSpace software to visualize the literature, draw maps of authors, research institutes, keywords, etc., and carry out clustering and emergent word analysis on the keywords.Results:A total of 1 007 Chinese articles with 16 core authors and 236 English articles with 8 core Chinese authors were included. The author with the largest number of publications in Chinese was Liu Ningfei from the Ninth People’s Hospital of Shanghai Jiao Tong University School of Medicine (16 articles), and the author with the largest number of publications in WOS was Cheng Ming-Huei from Chang Gung Memorial Hospital Lin Kou Campus (Taiwan Province of China) (33 articles). The institution with the largest number of articles in Chinese was Sun Yat-sen University Cancer Center (16 articles), and the institution with the largest number of articles in English was Chang Gung University (Taiwan Province of China) (45 articles). "Breast cancer" "nursing care" and "quality of life" were the top 3 keywords in CNKI ; "breast cancer" "diagnosis" and "lower extremity" were the top 3 keywords in WOS. Cluster analysis of the keywords showed that 16 clusters in CNKI and 11 clusters in WOS covering evaluation indexes, treatment method and mechanism studies. The result of CNKI keyword emergence analysis showed that the top 10 emergent keywords were "postoperative breast cancer" "upper limb" "rehabilitation" "nursing care" "rehabilitation therapy" "intramuscular effect patch" "acupuncture therapy" "cervical cancer" "upper limb function" "lymphatic drainage". The result of WOS keyword emergence analysis showed that the top 10 emergent keywords were "prevalence" "extremity lymphedema" "therapy" "postmastectomy lymphedema" "transplantation" "cancer" "flap transfer" "mechanism" "surgical treatment" "reconstruction" .Conclusion:Surgical treatment, preventive nursing and lymphangiogenesis are the key research directions of EL treatment. Both traditional Chinese medicine and Western medicine have their own advantages in the treatment of EL, and the combination of traditional Chinese medicine and Western medicine can play a better role in the treatment. Multidisciplinary team can develop personalized solutions for patients.

Objective:To visualize and analyze the literature related to the treatment of extremity lymphedema (EL) over the years 2012 to 2022 and to explore future research directions.Methods:Taking "lymphedema" and "treatment" as the themes, the study searched the Chinese and English literature related to EL treatment reported by Chinese scholars from 2012 to 2022 in Chinese National Knowledge Infrastructure (CNKI) and Web of Science (WOS) databases, and used CiteSpace software to visualize the literature, draw maps of authors, research institutes, keywords, etc., and carry out clustering and emergent word analysis on the keywords.Results:A total of 1 007 Chinese articles with 16 core authors and 236 English articles with 8 core Chinese authors were included. The author with the largest number of publications in Chinese was Liu Ningfei from the Ninth People’s Hospital of Shanghai Jiao Tong University School of Medicine (16 articles), and the author with the largest number of publications in WOS was Cheng Ming-Huei from Chang Gung Memorial Hospital Lin Kou Campus (Taiwan Province of China) (33 articles). The institution with the largest number of articles in Chinese was Sun Yat-sen University Cancer Center (16 articles), and the institution with the largest number of articles in English was Chang Gung University (Taiwan Province of China) (45 articles). "Breast cancer" "nursing care" and "quality of life" were the top 3 keywords in CNKI ; "breast cancer" "diagnosis" and "lower extremity" were the top 3 keywords in WOS. Cluster analysis of the keywords showed that 16 clusters in CNKI and 11 clusters in WOS covering evaluation indexes, treatment method and mechanism studies. The result of CNKI keyword emergence analysis showed that the top 10 emergent keywords were "postoperative breast cancer" "upper limb" "rehabilitation" "nursing care" "rehabilitation therapy" "intramuscular effect patch" "acupuncture therapy" "cervical cancer" "upper limb function" "lymphatic drainage". The result of WOS keyword emergence analysis showed that the top 10 emergent keywords were "prevalence" "extremity lymphedema" "therapy" "postmastectomy lymphedema" "transplantation" "cancer" "flap transfer" "mechanism" "surgical treatment" "reconstruction" .Conclusion:Surgical treatment, preventive nursing and lymphangiogenesis are the key research directions of EL treatment. Both traditional Chinese medicine and Western medicine have their own advantages in the treatment of EL, and the combination of traditional Chinese medicine and Western medicine can play a better role in the treatment. Multidisciplinary team can develop personalized solutions for patients.

Objective:To explore the association of the total gestational weight gain (GWG) and GWG in different trimesters with adverse pregnancy outcomes during the second pregnancy in women with history of gestational diabetes mellitus (GDM).Methods:This retrospective cohort study recruited 441 singleton pregnant women with a history of GDM who gave birth at Beijing Obstetrics and Gynecology Hospital of Capital Medical University from January 2017 to December 2018 as the GDM history group. Another 1 637 singleton pregnant women without a history of GDM who gave birth at the same period were selected through the mechanical sampling method as the control group. Independent sample t-test and Chi-square test were used to compare the differences in general conditions, GWG and perinatal outcomes between the two groups. Based on the Institute of Medicine guidelines for GWG, the subjects were further divided into three subgroups: inadequate GWG, adequate GWG and excessive GWG groups. Multivariate logistic regression analysis was used to compare the pregnancy outcome in women with the same GWG in different periods of pregnancy between the two groups. Results:(1) Women with GDM history had lower GWG before and after oral glucose tolerance test (OGTT) and the whole pregnancy than those without [(6.3±3.3) vs (7.9±3.7) kg, (4.8±2.6) vs (5.6± 2.6) kg, (11.8±4.6) vs (14.4± 4.6) kg; t=8.074, 5.183, 10.277; all P<0.001]. The incidence of GDM, gestational hypertension, and large for gestational age (LGA) in the GDM history group were higher than those in the control group [46.5% (205/441) vs 18.1% (296/1 637), 8.4% (37/441) vs 5.4% (88/1 637), 12.9% (57/441) vs 9.7% (158/1 637); χ2=153.181, 5.583, 4.013; all P<0.05]. (2) Before OGTT: pregnant women with GDM history of different GWG categories had a higher risk of developing GDM [ OR and 95% CI for inadequate, adequate and excessive GWG were 4.02 (2.35-6.88), 3.92 (2.65-5.79) and 3.33 (2.11-5.25), respectively, all P<0.001]. Except for women with inadequate GWG, pregnancy with a history of GDM also had a higher risk of preeclampsia [ OR and 95% CI were 3.62 (1.47-9.23) and 2.22 (1.07-5.57) for adequate and excessive GWG, respectively, both P<0.05]. After OGTT: pregnant women with GDM history of different GWG categories had a higher risk of developing GDM [ OR and 95% CI for inadequate, adequate and excessive GWG were 2.48 (1.60-3.84), 4.63 (2.92-7.35) and 4.22 (2.73-6.51), respectively, all P<0.001]. Pregnant women with a history of GDM with excessive GWG had an increased risk of preeclampsia ( OR=2.46, 95% CI: 1.10-5.51, P<0.05). During pregnancy: pregnant women with GDM history of different GWG categories had a higher risk of developing GDM [ OR and 95% CI were 3.02(2.00-4.59), 4.08(2.76-6.04) and 2.66(1.54-4.59) for inadequate, adequate and excessive GWG, respectively, all P<0.001]. Women with GDM history had an increased risk of large for gestational age (LGA) in those with inadequate GWG and postpartum hemorrhage in those with excessive GWG [ OR and 95% CI were 1.94 (1.09-4.21) and 2.93 (1.31-6.55), respectively, both P<0.05]. Conclusions:The total GWG and GWG in different periods during the second pregnancy in women with a history of GDM are lower than those without, but with a higher risk of adverse outcomes. Even in women with the same range of GWG, GDM history still increases the risk of adverse pregnancy outcomes.

Objective: To analyze the characteristics of the "Interner Plus-based AIDS Comprehensive Prevention Service System" among MSM who frequently using the Internet in Guangzhou. Methods: An online survey was conducted among MSM who were recruited through gay-website portals between August and September, 2018 in Guangzhou, to collect information regarding the use of and attitudes on the "Interner Plus-based AIDS Comprehensive Prevention Service System" . Logistic regression was used to explore the association between the use of Internet intervention tools and related behavioral characteristics. Information on the awareness of AIDS, HIV testing, and condomless anal sex behavior were compared between the core or non-core services users. Results: A total of 777 Internet-based MSM were recruited as participants including 638 men (82.1%) as core service users. MSM were satisfied in using the the "Interner Plus-based AIDS Comprehensive Prevention Service System" while more than 80.0% of the users felt that the tools were helpful in: increasing the HIV awareness, promoting test uptake, and reducing those related risk behavior. Comparing with those who did not use the tools, the users showed higher rates in practising condomless anal intercourse (1.50-1.86 times), commercial sex with men (11.60-21.21 times), and unprotected vaginal intercourse (13.62-20.67 times), in the last 6 months. Proportions of core service users appeared as: [96.6% vs. 74.8%, aOR (95%CI): 8.80 (4.85-15.97)] on HIV testing, [56.4% vs. 22.3%, aOR (95%CI): 4.54 (2.94-7.02)] on regular HIV testing and [86.2% vs. 80.6%, aOR (95%CI): 1.75 (1.06-2.89)] on awareness of HIV knowledge respectively, which were all significantly higher than the non-core service users. Conclusions The frequent Internet using MSM in Guangzhou claimed to have had high acceptance and satisfaction on the local Internet HIV intervention service tools. The "Internet Plus-based AIDS Comprehensive Prevention Service System" had effectively reached the high-risk subgroups of MSM, increasing the awareness on related risk and promoting testing on HIV.

Objective To investigate the status of body weight,total body fat and skeletal muscle in elderly patients with diabetes.Methods A total of 71 elderly diabetic patients (study group) who met entry criteria and signed informed consent were consecutively enrolled,and 70 healthy subjects (control group) matched for age and gender were selected into the study.Body weight,body mass index (BMI),waist-to-hip ratio (WHR),total body fat (TBF),abdominal fat (AF),visceral fat (VF),visceral fat area (VFA),fatfree mass (FFM),total body muscle (TBM),skeletal muscle (SM),skeletal muscle height index (SMHI) and grip strength (GS) were measured by anthropometry and multi-frequency bioelectric impedance analysis.The rate of low weight,overweight and obesity was judged by BMI;the rate of abdominal obesity by WHR;and the status of muscle by TBM,SM,MHI and GS.Results The two groups were comparable at baseline.Compared to the control group,the rate of low weight [36.6％ (26/71) vs.20.0％ (14/70),x2 =4.791,P=0.039],weight loss [(1.37± 1.57) kg vs.(0.82± 1.12) kg,t=2.402,P =0.018],ratio of people whoexperienced weight loss＞5％ in 3 months [22.5％ (16/71) vs.8.6％ (6/70),x2 =5.219,P=0.035],TBF％ [(32.3±5.0)％ vs.(30.3±5.2)％,t=2.294,P=0.023],WHR (0.91±0.55vs.0.87±0.51,t =2.661,P =0.009),the rate of abdominal obesity [49.3％ (35/71) vs.25.7％ (18/70),x2 =8.355,P=0.005],AF [(12.1±3.4) kg vs.(10.3±3.6) kg,t=2.981,P=0.003],VF [(2.9±0.8) kg vs.(2.5±0.9) kg,t=2.853,P=0.005] andVFA [(99.8±26.3) cm2 vs.(84.9±31.1) cm2,t=3.045,P=0.003] were increased significantly in study group,while the FFM [(34.9±7.5) kg vs.(37.9±5.6) kg,t=-2.691,P=0.008],SM [(25.8±4.5) kgvs.(27.3±3.5) kg,t=-2.140,P=0.034],SMHI [(9.4±1.8) kg/m2 vs.(10.2±1.5) kg/m2,t=-3.081,P=0.002] andGS [(29.3±6.6) kg vs.(31.8±5.7) kg,t=-2.406,P=0.017] were decreased significantly in study group.Conclusion Abnormal weight,abdominal obesity and loss of skeletal muscle were more likely to be observed in elderly patients with diabetes.

Objective To systematically evaluate the clinical effect of prone position mechanical ventilation on the improvement of oxygenation in patients with severe pneumonia. Methods Pubmed, Embase, Cochrane Library, CNKI, Wanfang Data and VIP database were searched from the time of database built up until December 10th, 2017. All the published randomized controlled trials (RCTs) about the effects of prone position ventilation on the oxygenation of severe pneumonia patients were screened, and were confirmed by the literature reference citation retrieval. Inclusion and exclusion criteria had been used to review and rank the literature. After evaluating the quality of included studies, the data was extracted from RCTs and given a Meta-analysis using RevMen 5.1. Results Twelve RCTs with 650 cases were included. Eleven of them were Chinese literature while 1 was in English. Ten studies showed that the prone position ventilation had a significant influence on improving partial pressure of oxygen [weighted mean difference (WMD) =9.93, 95% confidence interval (95%CI) = 2.92-16.95, P = 0.006], publication bias was found in these studies. Seven studies showed that the prone position ventilation had a significant influence on partial pressure of carbon dioxide (WMD =9.99, 95%CI = 1.81-18.18, P = 0.02), publication bias was found in these studies. Seven studies showed that the prone position ventilation had a significant influence on oxygenation index (WMD = 31.22, 95%CI = 26.06-36.39, P < 0.000 01), publication bias was found in these studies. Two studies showed that the prone position ventilation had a significant influence on oxygen saturation of blood (WMD = 2.12, 95%CI = 1.24-3.00, P < 0.000 01), no publication bias was found in these studies. Conclusion Prone position ventilation can effectively improve the patients' oxygenation index, partial pressure of oxygen, and oxygen saturation of blood, and reduce the partial pressure of carbon dioxide.

Diagnosis of Parkinson's disease (PD) based on speech data has been proved to be an effective way in recent years. However, current researches just care about the feature extraction and classifier design, and do not consider the instance selection. Former research by authors showed that the instance selection can lead to improvement on classification accuracy. However, no attention is paid on the relationship between speech sample and feature until now. Therefore, a new diagnosis algorithm of PD is proposed in this paper by simultaneously selecting speech sample and feature based on relevant feature weighting algorithm and multiple kernel method, so as to find their synergy effects, thereby improving classification accuracy. Experimental results showed that this proposed algorithm obtained apparent improvement on classification accuracy. It can obtain mean classification accuracy of 82.5%, which was 30.5% higher than the relevant algorithm. Besides, the proposed algorithm detected the synergy effects of speech sample and feature, which is valuable for speech marker extraction.

Objective To observe the influence of phentolamine on N terminal B-type natriuretic peptide precursor(NT-proBNP),blood gas analysis,hypersensitive c-reactive protein and plasma D-dimer in patients with chronic cor pulmonale Methods One hundred and one cases patients with chronic cor pulmonale were randomly divided into two groups,51 patients in the treatment group,50 patients in the control group.All patients were treated with normal anti-infection,eliminating phlegm to smooth wheezing antithrombotic for one week,as the same time patients in the treatment group were treated with phentolamine for one week.Through observed the treatment effect of phentolamine to chronic cor pulmonale,the level of NT-proBNP,blood gas analysis,hypersensitive c-reactive protein and plasma D-dimer in patients with chronic cor pulmonale before and after the treatment were analyzed.Results Compared with before treatment,the levels of NT-proBNP,PCO2,hypersensitive c-reactive protein,plasma D dimer were lower than after one week in two groups,while the level of PO2 was higher.Treatment group:NT-proBNP (1 712.76±572.32) ng/L vs.(271.59±163.05) ng/L,t=20.42,P<0.05,PCO2 (66.34±5.81) mmHg vs.(52.58±5.82) mmHg,t=16.46,P<0.05,PO2 (59.28±6.13) mmHg vs.(73.64±6.10) mmHg,t=23.02,P<0.05,hypersensitive c-reactive protein 86.0(28.0) mg/L vs.23.0(12.0) mg/L,Z=-6.22,P<0.05 mg/L,plasma D-dimer (4 953.37±1 654.09) μg/L vs.(1 847.90±838.66) μg/L,t=17.11,P<0.05.Control group:NT-proBNP (1 527.24±658.70) ng/L vs.(612.58±357.59) ng/L,t=14.52,P<0.05,PCO2 (65.41±5.23) mmHg vs.(56.46±5.65) mmHg,t=13.04,P<0.05,PO2(60.57±5.84) mmHg vs.(67.21±5.19) mmHg,t=-10.06,P<0.05,hypersensitive c-reactive protein 79.0(29.0) mg/L vs.43.0(20.0) mg/L,Z=-6.16,,P<0.05,plasma D-dimer (4 408.02±1 682.83) μg/L vs.(2 598.28±1 242.73) μg/L,t=12.15,P<0.05.But the levels of NT-proBNP,PCO2,hypersensitive c-reactive protein and plasma D-dimer reduced significantly,the level of PO2 increased more significantly in treatment group(t(z)=-6.19,-3.39,-7.16,-3.56,5.70,all P<0.05).Conclusion Phentolamine can reduce the level of NT-proBNP,PCO2,hypersensitive c-reactive protein and plasma D-dimer and increased the level of PO2 in patients with chronic cor pulmonale.Phentolamine combined with routine treatment can improve the clinical efficacy of patients with chronic cor pulmonale.