Objective:To describe the distribution of lipoprotein (a) [Lp(a)] levels in non-arteriosclerotic cardiovascular disease (ASCVD) population in China and explore its influencing factors.Methods:This study was based on a nested case-control study in the CKB study measured plasma biomarkers. Lp(a) levels was measured using a polyclonal antibody-based turbidimetric assay certified by the reference laboratory and ≥75.0 nmol/L defined as high Lp(a). Multiple logistic regression model was used to examine the factors related to Lp(a) levels.Results:Among the 5 870 non-ASCVD population included in the analysis, Lp(a) levels showed a right-skewed distribution, with a M ( Q1, Q3) of 17.5 (8.8, 43.5) nmol/L. The multiple logistic regression analysis found that female was associated with high Lp(a) ( OR=1.23, 95% CI: 1.05-1.43). The risk of increased Lp(a) levels in subjects with abdominal obesity was significantly reduced ( OR=0.68, 95% CI: 0.52-0.89). As TC, LDL-C, apolipoprotein A1(Apo A1), and apolipoprotein B(Apo B) levels increased, the risk of high Lp(a) increased, with OR (95% CI) for each elevated group was 2.40 (1.76-3.24), 2.68 (1.36-4.93), 1.29 (1.03-1.61), and 1.65 (1.27-2.13), respectively. The risk of high Lp(a) was reduced in the HDL-C lowering group with an OR (95% CI) of 0.76 (0.61-0.94). In contrast, an increase in TG levels and the ratio of Apo A1/Apo B(Apo A1/B) was negatively correlated with the risk of high Lp(a), with OR (95% CI) of 0.73 (0.60-0.89) for elevated triglyceride group, and OR (95% CI) of 0.60 (0.50-0.72) for the Apo A1/B ratio increase group (linear trend test P≤0.001 except for Apo A1). However, no correlation was found between Lp(a) levels and lifestyle factors such as diet, smoking, and physical activity. Conclusions:Lp(a) levels were associated with sex and abdominal obesity, but less with lifestyle behaviors.

Purpose: We aimed to identify effectiveness-associated indicators and evaluate the optimal tumor reduction rate (TRR) after two cycles of neoadjuvant chemotherapy (NAC) in patients with invasive breast cancer. Methods: This retrospective case-control study included patients who underwent at least four cycles of NAC at the Department of Breast Surgery between February 2013 and February 2020. A regression nomogram model for predicting pathological responses was constructed based on potential indicators. Results: A total of 784 patients were included, of whom 170 (21.68%) reported pathological complete response (pCR) after NAC and 614 (78.32%) had residual invasive tumors. The clinical T stage, clinical N stage, molecular subtype, and TRR were identified as independent predictors of pCR. Patients with a TRR > 35% were more likely to achieve pCR (odds ratio, 5.396; 95% confidence interval [CI], 3.299–8.825). The receiver operating characteristic (ROC) curve was plotted using the probability value, and the area under the ROC curve was 0.892 (95% CI, 0.863–0.922). Conclusion TRR > 35% is predictive of pCR after two cycles of NAC, and an early evaluation model using a nomogram based on five indicators, age, clinical T stage, clinical N stage, molecular subtype, and TRR, is applicable in patients with invasive breast cancer.

Objective:To investigate the status quo of professional identity of nursing undergraduates in Beijing and analyze its influencing factors and to provide basis for carrying out professional identity education of nursing undergraduates.Methods:Using the convenient sampling method, a total of 726 nursing undergraduates from four undergraduate colleges in Beijing from June to September 2020 were selected as research objects. General information questionnaire, Professional Identity Questionnaire for Nurse Students (PIQNS) and Professional Self-efficacy Questionnaire for Nurse Students (PSQNS) were used to investigate them. A total of 726 questionnaires were distributed and 615 valid questionnaires were recovered.Results:The total scores of PIQNS and PSQNS among 615 nursing undergraduates in Beijing were respectively 55.00 (36.00, 66.00) and 86.00 (60.00, 101.00) . There was a positive correlation between PIQNS total score and PSQNS total score of nursing undergraduates ( r=0.928, P<0.01) . The results of multiple linear regression analysis showed that gender, whether there was a class tenure, whether he was an only child, reasons for attending nursing major and whether he had clinical practice or internship experience were the influencing factors of professional identity of nursing undergraduates in Beijing ( P<0.01) , which could explain 17.6% of the total variation. Conclusions:The professional identity of nursing undergraduates in Beijing is at the medium level and still needs to be improved. Nursing educators should pay attention to the emotional and psychological status of nursing undergraduates and take appropriate measures to provide vocational education for nursing undergraduates, so as to further improve their professional identity.

Objective:To explore a medical big data algorithm to screen the core indicators in clinical database that can be used to evaluate the prognosis of elderly patients with pneumonia.Methods:Based on the clinical database of a Beijing Chaoyang Hospital Consortium Chaoyang Emergency Ward in Beijing Chaoyang Hospital, Capital Medical University, patients with pulmonary infection were selected through the big data retrieval technology. According to the prognosis at the time of discharge, they were divided into death group and survival group. The general data of patients were collected, including gender, age, blood gas and laboratory indices. A computer language called Python was used to make batch calculations of key indicators that affect mortality in elderly patients with pneumonia. Logistic regression analysis was used to analyze the relationship between laboratory indicators and patients' prognosis. Receiver operating characteristic curve (ROC curve) was drawn to analyze the predictive value of screening method for patients' prognosis.Results:A total of 265 patients were included in the study, 64 died and 201 survived. The data of the first detection indexes of each patient after admission were collected, and 23 key indicators with significant differences were selected from 472 indicators: blood routine indicators ( n = 7), blood gas indicators ( n = 3), tumor markers indicators ( n = 3),coagulation related indicators ( n = 4), and nutrition and organ function indicators ( n = 6). ① The key indicators of blood gas in patients died of pneumonia: Cl - was 97-111 mmol/L in 51.6% (33 cases) of patients, lactic acid (Lac) was 0.5-2.5 mmol/L in 81.2% (52 cases) of patients, and H + was 0-46 mmol/L in 87.5% (56 cases) of patients. ② The key indicators of blood routine of patients died of pneumonia: hemoglobin count (Hb) of 46.9% (30 cases) patients was 80-109 g/L, the eosinophils proportions (EOS%) in 67.2% (43 cases) patients was 0.000-0.009, the lymphocytes proportions (LYM%) in 51.6% (33 cases) patients was 0.00-0.09, the red blood cell count (RBC) in 50.0% (32 cases) patients was (3.0-3.9)×10 12/L, the white blood cell count (WBC) in 54.7% (35 cases) patients was (0.0-9.9)×10 9/L, and the red blood cell volume distribution width coefficientof variability (RDW-CV) in 48.4% (31 cases) patients was 10.0%-14.9%, serum C-reactive protein (CRP) was 0.0-49.9 mg/L in 48.4% (31 cases) patients. ③ The key indicators of tumor markers in patients died of pneumonia: 76.6% (49 cases) of patients had negative free prostate specific antigen/total prostate specific antigen (FPSA/TPSA, the ratio was 0), 92.2% (59 cases) had cytokeratin 19 fragment (CYFRA21-1) between 0.0-11.0 μg/L, and 75.0% (48 cases) had carbohydrate antigen 125 (CA125) between 0-104 kU/L.④ The key coagulation indexes of patients died of pneumonia: 68.8% (44 cases) of patients had activated partial thromboplastin time (APTT) of 57-96 s, 73.4% (47 cases) of patients had D-dimer of 0-6 mg/L, 93.8% (60 cases) of patients had thrombin time (TT) of 14-22 s, and 89.1% (57 cases) of patients had adenosine diphosphate (ADP) inhibition rate of 0%-53%. ⑤ Nutrition and organ function key indicatorsin patients died of pneumonia: 92.2% (59 cases) of brain natriuretic peptide (BNP) in patients with 0, 46.9% (30 cases) of patients had prealbumin (PA) of 71-140 mg/L, 90.6% (58 cases) of the patients with uric acid (UA) for 21-41 μmol/L, 75.0% (48 cases) of the patients with albumin (Alb) to 10-20 g/L, 93.5% (60 cases) of patients had albumin/globulin ratio (A/G ratio) of 0-0.9, 84.4% (54 cases) of the patients with lactate dehydrogenase (LDH) from 0-6.68 μmol/L·s -1·L -1. ⑥ Logistic regression analysis and ROC curve analysis: Logistic regression analysis showed that PA and Lac were the prognostic factors. PA could reduce the risk of death by 0.9%, Lac could increase the risk of death by 69.4%; the area under ROC curve (AUC) between laboratory indicators and the prediction effect of death prediction model for patients' prognosis was 0.80, which showed that the classification effect was better, and this study model could better predict the prognosis of elderly patients with pneumonia. Conclusion:By using big data technology, 23 core indicators for evaluating the prognosis of elderly patients with pneumonia can be screened from the clinical database of emergency ward, which provides a new perspective and method for clinical evaluation of the prognosis of elderly patients with pneumonia.

Objective:To analysis effectiveness of the "14 plus 7 day quarantine" and "nucleic acid plus total antibody testing" strategy (combined screening strategy) for screenin the imported patients with COVID-19 in Xiamen.Methods:The study populations were overseas travelers arriving in Xiamen from March 17 to December 31, 2020, and overseas travelers who had quarantine outside Xiamen for less than 21 days from July 18 to December 31, 2020. Data were collected and analyzed on the timing of detection, pathways, and test results of the imported patients with COVID-19 after implementing combined screening strategy.Results:A total of 304 imported patients with COVID-19 were found from 174 628 overseas travelers and 943 overseas travelers from other cities. A total of 163 cases (53.6%) were diagnosed by multitime, multisite intensive nucleic acid testing after positive finding in total antibody testing. Among them, 27 (8.9%) were first positive for nucleic acid in 14 plus 7 day quarantine and 136 were first positive for nucleic acid in 14-day quarantine. Only 8 of these individuals were tested positive for nucleic acid after positive total antibody testing. The other 128 individuals were tested positive for nucleic acid after being negative for average 2.3 times (maximum of 6 times). Aditional 155 cases might be detected by using the combined "14 plus 7 day quarantine" and " nucleic acid plus total antibody testing" strategy compared with "14-day quarantine and nucleic acid testing" strategy, accounting for 51.0% of the total inbound infections. So the combined screening strategy doubled the detection rate for imported patients with COVID-19. No second-generation case caused by overseas travelers had been reported in Xiamen as of February 26, 2021.Conclusions:Xiamen's combined screening strategy can effectively screen the imported patients with COVID-19 who were first positive for nucleic acid after 14 day quarantine. Compared with "14 day quarantine and nucleic acid testing", the combined screening strategy improved detection rate and further reduced the risk of the secondary transmission caused by the imported patients with COVID-19.

OBJECTIVE: To investigate the prevalence and risk factors of multi-site work-related musculoskeletal disorders(WMSDs) among workers in the industry of electronic equipment manufacturing. METHODS: A total of 815 workers in three factories of electronic equipment manufacturing in Guangdong Province were selected as study subjects by convenience sampling. The prevalence of multi-site WMSDs in the past year was investigated using Musculoskeletal Disorders Investigating Questionnaire and the influencing factors were analyzed. RESULTS: The total prevalence of WMSDs was 69.4%(566/815). The prevalence of multi-site WMSDs was 54.5%(444/815), and the prevalence of one-site WMSDs was 15.0%(122/815). Multiple logistic regression showed that female workers had higher prevalence of multi-site WMSDs than males [odds radio(OR) and 95% confidence interval(CI): 1.59(1.12-2.26), P<0.05]. The prevalence of multi-site WMSDs in left-handed workers was lower than that of right-handed workers [OR(95% CI): 0.42(0.19-0.91), P<0.05]. The longer service of current position and the more neck forward movement, the higher prevalence of multi-site WMSDs [OR(95% CI) were 1.33(1.09-1.63) and 1.62(1.23-2.15), P<0.01]. The workers who had long-time sitting at work, adopted uncomfortable working posture, could decide when to work on their own, kept head down for a long time, or often bending wrists up/down had higher prevalence of multi-site WMSDs [OR(95% CI) were 1.41(1.16-1.73), 1.82(1.40-2.38), 1.79(1.16-2.75), 1.92(1.38-2.69) and 1.60(1.14-2.24), respectively, P<0.01]. The workers who could take turns with colleagues to finish work or had enough rest time had lower prevalence of multi-site WMSDs [OR(95% CI): 0.57(0.41-0.78) and 0.67(0.48-0.92), P<0.05]. The workers who worked >10 h per day had lower prevalence of multi-site WMSDs than those who worked ≤8 h per day [OR(95% CI): 0.57(0.37-0.87), P<0.05]. CONCLUSION: Multi-site WMSDs were more common than one-site WMSDs among workers in the industry of electronic equipment manufacturing, and the prevalence of multi-site WMSDs was high. The risk factors include personal factors, work organization and adverse ergonomic factors.

Objective: To assess the enhancement characteristics of plaques in patients with intracranial atherosclerotic stenosis using three-dimensional high-resolution magnetic resonance imaging (3D HR MRI), and to analyze the correlation between the enhancement characteristics of plaques and the time from onset of stroke symptoms to MRI examination. Methods: The enhancement characteristics of plaques were retrospectively analyzed in 61 patients with cerebral infarction who were scanned in MRI room of the Affiliated Hospital of Yangzhou University from January 2014 to January 2016. According to the elapsed time between symptom onset and MR examination, 61 patients were classified into early stage group (<4 weeks, n=26), middle stage group (4-12 weeks, n=20) and late stage group (>12 weeks, n=15). All cases underwent three-dimensional sampling perfection with application optimized contrast using different angle evolutions (3D-SPACE) T₁WI and enhanced 3D-SPACE T₁WI sequence scans, as well as routine head MRI examinations. The signal intensities of plaques before and after enhancement scanning were compared on the 3D-SPACE T₁WI sequence. The degrees of plaque enhancement were qualitatively analyzed, and the enhancement rates of plaques were quantitatively calculated. The correlation between the enhancement characteristics of plaques and time of symptom onset of stroke was analyzed. Results: Sixty-one intracranial atherosclerotic plaques on the 3D HR MRI showed eccentric thickening or annular thickening of the vessel wall, and slightly higher signals on the T₁WI. They showed different degrees of enhancement or no enhancement after enhancement scans. The characteristics of plaque enhancement in 61 patients with cerebral infarction were analyzed. The results showed that 26 plaques in the early stage group were obviously enhanced for 21 cases (80.8%), mildly enhanced for 4 cases (15.4%), no enhancement for 1 case (3.8%), and the enhancement rate was 80.49%±18.64%. Twenty plaques in the middle stage group were obviously enhanced for 2 cases (10.0%), mildly enhanced for 14 cases (70.0%), no enhancement for 4 cases (20.0%), and the enhancement rate was 52.09%±18.17%. Fifteen plaques in the late stage group were mildly enhanced for 2 cases (2/15), no enhancement for 13 cases (13/15), and the enhancement rate was 12.16%±10.44%. There were statistically significant differences in the degrees of plaque enhancement and plaque enhancement rates among the three groups (χ²=22.834, P<0.01; F=78.403, P<0.01). Further analysis showed that there was a statistically significant difference in the degree of enhancement and enhancement rate of plaques between the early stage group and the middle stage group (χ²=-4.177, P<0.01; t=5.179, P<0.01), and there was a statistically significant difference between the middle stage group and the late stage group (χ²=-2.484, P<0.05; t′=8.189, P<0.01), and the difference between the early stage group and the late stage group was also statistically significant (χ²=-3.796, P<0.01; t′=15.044, P<0.01). There was a significant negative correlation between the time from onset of stroke symptoms to MRI examination and the enhancement rate of plaques (r=-0.903, P<0.01). Conclusions Enhanced HR MRI scanning can clearly show the enhancement of intracranial atherosclerotic plaques. With the prolongation of the onset time interval, the enhancement of intracranial atherosclerotic plaques gradually weakens, which can assess the vulnerability of plaques and has important guiding significance for secondary prevention of ischemic stroke.

Biomarkers ; Breast Neoplasms ; Breast ; Drug Therapy ; Humans ; Neoadjuvant Therapy ; Neoplasm, Residual ; Pathology ; Prognosis ; United States Food and Drug Administration

Objective: To observe distribution and morphological characteristics of symptomatic atherosclerotic plaques in the middle cerebral artery (MCA) using high-resolution magnetic resonance imaging (HR-MRI), and to investigate HR-MRI characteristics of atherosclerotic plaques in the MCA in patients with acute cerebral infarction. Methods: A total of 57 symptomatic patients with MCA atherosclerotic plaques recruited in the Affiliated Hospital of Yangzhou University from January 2014 to January 2016 were imaged with diffusion weighted imaging (DWI), three dimensional time of flight magnetic resonance angiography (3D TOF-MRA) and HR-MRI scanning for plaque on a 3.0 T MRI scanner. According to the results of DWI examination, the 57 patients were divided into transient ischemic attack (TIA) group (27 cases) and acute cerebral infarction group (30 cases). The distribution of the narrowest lumen plaque was evaluated by cross-section division into four equal arcs (superior, inferior, ventral, dorsal arcs). For quantitative analysis, lumen area (LA_MLN), vessel area (VA_MLN) at maximal lumen narrow (MLN) and LA_reference, VA_reference were measured, then wall area (WA), plaque area (PA), percentage of plaque burden, rate of lumen stenosis and remodeling index (RI) were calculated. The data of each group were compared and analyzed. Results: The location and morphological analysis of the 57 patients with symptomatic MCA atherosclerotic plaques revealed that plaques were located in the ventral wall in 19 cases (33.3%), the upper wall in 15 cases (26.3%), the dorsal wall in 10 cases (17.5%), and the lower wall in 13 cases (22.8%). For the location variations in ventral wall, upper wall, dorsal wall and lower wall, the TIA group was shown as six cases (22.2%), five cases (18.5%), seven cases (25.9%) and nine cases (33.3%), and the acute cerebral infarction group was shown as 13 cases (43.3%), 10 cases (33.3%), three cases (10.0%) and four cases (13.3%), respectively. There was no statistically significant difference in the distribution of each side wall between the two groups (P>0.05). VA_reference, LA_reference, VA_MLN and RI of the TIA group and the acute cerebral infarction group were (19.89±1.34) mm², (15.19±2.04) mm², (20.78±1.78) mm², 1.09±0.11 and (19.70±1.34) mm², (14.60±2.33) mm², (21.53±2.34) mm², 1.10±0.11, respectively. There was no statistically significant difference between the two groups (P>0.05). The remodeling patterns of both groups were mainly positive remodeling, with a total of 44 cases (77.2%). In the TIA group and the acute cerebral infarction group, the WA_MLN, PA, stenosis rate and plaque load percentages were (8.85±1.92) mm², (4.00±3.00) mm², 20.92%±9.18%, 19.05%±14.93% and (11.10±1.88) mm², (6.00±2.25) mm², 28.56%±8.67%, 27.30%±7.69%, respectively. The differences between the two groups were statistically significant (t=-4.466, t=-2.865, t=-3.231, t=-2.580, P<0.01). There were eight patients (29.6%) with unsmooth plaque surface in the TIA group and 19 patients (63.3%) in the acute cerebral infarction group. The differences between the two groups were statistically significant (χ²=6.475, P<0.05). LA_MLN in the TIA group and the acute cerebral infarction group was (11.93±1.59) mm² and (10.43±2.08) mm² respectively, and the difference between the two groups was statistically significant (t=3.033, P<0.01). Conclusions Symptomatic atherosclerotic plaques in MCA in the acute cerebral infarction group have higher plaque load, thicker vascular wall at the maximum stenosis and more unsmooth plaque surface. This indicates the characteristics of high-risk plaques to a certain extent.

Objective To observe distribution and morphological characteristics of symptomatic atherosclerotic plaques in the middle cerebral artery (MCA) using high?resolution magnetic resonance imaging (HR?MRI), and to investigate HR?MRI characteristics of atherosclerotic plaques in the MCA in patients with acute cerebral infarction. Methods A total of 57 symptomatic patients with MCA atherosclerotic plaques recruited in the Affiliated Hospital of Yangzhou University from January 2014 to January 2016 were imaged with diffusion weighted imaging (DWI), three dimensional time of flight magnetic resonance angiography (3D TOF?MRA) and HR?MRI scanning for plaque on a 3.0 T MRI scanner. According to the results of DWI examination, the 57 patients were divided into transient ischemic attack (TIA) group (27 cases) and acute cerebral infarction group (30 cases). The distribution of the narrowest lumen plaque was evaluated by cross?section division into four equal arcs (superior, inferior, ventral, dorsal arcs). For quantitative analysis, lumen area (LAMLN), vessel area (VAMLN) at maximal lumen narrow (MLN) and LAreference, VAreference were measured, then wall area (WA), plaque area (PA), percentage of plaque burden, rate of lumen stenosis and remodeling index (RI) were calculated. The data of each group were compared and analyzed. Results The location and morphological analysis of the 57 patients with symptomatic MCA atherosclerotic plaques revealed that plaques were located in the ventral wall in 19 cases (33.3%), the upper wall in 15 cases (26.3%), the dorsal wall in 10 cases (17.5%), and the lower wall in 13 cases (22.8%). For the location variations in ventral wall, upper wall, dorsal wall and lower wall, the TIA group was shown as six cases (22.2%), five cases (18.5%), seven cases (25.9%) and nine cases (33.3%), and the acute cerebral infarction group was shown as 13 cases (43.3%), 10 cases (33.3%), three cases (10.0%) and four cases (13.3%), respectively. There was no statistically significant difference in the distribution of each side wall between the two groups (P>0.05). VAreference, LAreference, VAMLN and RI of the TIA group and the acute cerebral infarction group were (19.89 ± 1.34) mm2, (15.19 ± 2.04) mm2, (20.78 ± 1.78) mm2, 1.09 ± 0.11 and (19.70 ± 1.34) mm2, (14.60 ± 2.33) mm2, (21.53 ± 2.34) mm2, 1.10 ± 0.11, respectively. There was no statistically significant difference between the two groups (P>0.05). The remodeling patterns of both groups were mainly positive remodeling, with a total of 44 cases (77.2%). In the TIA group and the acute cerebral infarction group, the WAMLN, PA, stenosis rate and plaque load percentages were (8.85±1.92) mm2, (4.00±3.00) mm2, 20.92%± 9.18%, 19.05% ± 14.93% and (11.10 ± 1.88) mm2, (6.00 ± 2.25) mm2, 28.56% ± 8.67%, 27.30% ± 7.69%, respectively. The differences between the two groups were statistically significant (t=-4.466, t=-2.865, t=-3.231, t=-2.580, P<0.01). There were eight patients (29.6%) with unsmooth plaque surface in the TIA group and 19 patients (63.3%) in the acute cerebral infarction group. The differences between the two groups were statistically significant (χ2=6.475, P<0.05). LAMLN in the TIA group and the acute cerebral infarction group was (11.93±1.59) mm2 and (10.43±2.08) mm2 respectively, and the difference between the two groups was statistically significant (t=3.033, P<0.01). Conclusions Symptomatic atherosclerotic plaques in MCA in the acute cerebral infarction group have higher plaque load, thicker vascular wall at the maximum stenosis and more unsmooth plaque surface. This indicates the characteristics of high?risk plaques to a certain extent.