Background::Cerebrovascular disease (CVD) ranks among the foremost factors responsible for mortality on a global scale. The mortality patterns of CVDs and temporal trends in China need to be well-illustrated and updated.Methods::We collected mortality data on patients with CVD from Chinese Center for Disease Control and Prevention’s Disease Surveillance Points (CDC-DSP) system. The mortality of CVD in 2020 was described by age, sex, residence, and region. The temporal trend from 2013 to 2019 was evaluated using joinpoint regression, and estimated rates of decline were extrapolated until 2030 using time series models.Results::In 2019, the age-standardized mortality in China (ASMRC) per 100,000 individuals was 113.2. The ASMRC for males (137.7/10 5) and rural areas (123.0/10 5) were both higher when stratified by gender and urban/rural residence. The central region had the highest mortality (126.5/10 5), the western region had a slightly lower mortality (123.5/10 5), and the eastern region had the lowest mortality (97.3/10 5). The age-specific mortality showed an accelerated upward trend from aged 55-59 years, with maximum mortality observed in individuals over 85 years of age. The age-standardized mortality of CVD decreased by 2.43% (95% confidence interval, 1.02-3.81%) annually from 2013 to 2019. Notably, the age-specific mortality of CVD increased from 2013 to 2019 for the age group of over 85 years. In 2020, both the absolute number of CVD cases and the crude mortality of CVD have increased compared to their values in 2019. The estimated total deaths due to CVD were estimated to reach 2.3 million in 2025 and 2.4 million in 2030. Conclusion::The heightened focus on the burden of CVD among males, rural areas, the central and western of China, and individuals aged 75 years and above has emerged as a pivotal determinant in further decreasing mortalities, consequently presenting novel challenges to strategies for disease prevention and control.

Objective:To investigate the perioperative efficacy of robot surgical system assisted anatomic and non-anatomic hepatectomy.Methods:The propensity score matching and retrospective cohort study was conducted. The clinical data of 103 patients who underwent robot surgical system assisted hepatectomy in Sir Run Run Shaw Hospital, Affiliated with the Zhejiang University School of Medicine from March 2016 to December 2021 were collected. There were 54 males and 49 females, aged 56(range, 44?64)years. Of the 103 patients, 55 cases undergoing robot surgical system assisted anatomic hepatectomy were divided into the anatomic group, and 48 cases undergoing robot surgical system assisted non-anatomic hepatectomy were divided into the non-anatomic group. Observation indicators: (1) propensity score matching and comparison of general data of patients between the two groups after matching; (2) intraoperative conditions; (3) perioperative complications. Propensity score matching was done by the 1:1 nearest neighbor matching method. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were expressed as M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data was conducted using the rank sum test. Results:(1) Propensity score matching and compari-son of general data of patients between the two groups after matching. Of the 103 patients, 94 cases were successfully matched, including 47 cases in the anatomic group and 47 cases in the non-anatomic group. The elimination of preoperative body mass index, preoperative platelet and preoperative albumin confounding bias ensured comparability between the two groups after propensity score matching. (2) Intraoperative conditions. After propensity score matching, the operation time and volume of intraoperative blood loss were 175(range, 120?240)minutes and 50(range, 50?100)mL in patients of the anatomic group, versus 155(range, 105?190)minutes and 100(range, 50?200)mL in patients of the non-anatomic group, showing significant differences in the above indicators between the two groups ( Z=1.97, 2.49, P<0.05). (3) Perioperative complications. After propensity score matching, cases with pleural fluid and/or ascites, case with biliary fistula, case with thrombosis, case with peritoneal infection, case with incision infection were 11, 1, 2, 4, 1 in patients of the anatomic group, versus 12, 0, 4, 1, 0 in patients of the non-anatomic group, showing no significant difference in the above indicators between the two groups ( P>0.05). Cases with complications classified as grade Ⅰ, grade Ⅱ, grade Ⅲ, grade Ⅳ of the Clavien-Dindo classification were 33, 14, 0, 0 in patients of the anatomic group, versus 28, 14, 3, 2 in patients of the non-anatomic group, showing no significant difference in the above indicators between the two groups ( Z=?1.38, P>0.05). Conclusions:Robotic surgical system assisted anatomic and non-anatomic hepatectomy are safe and feasible for clinical application. Compared with robot surgical system assisted non-anatomic hepatectomy, patients under-going robot surgical system assisted anatomic hepatectomy have long operation time and less volume of intraoperative blood loss.

Objective:To investigate the association between CITP/MMP-1 ratio and the severity of Myocardial fibrosis (MF) in patients with Chronic Heart failure (CHF) and its diagnostic and prognostic value in patients with MF.Methods:A retrospective study was conducted to select 110 cases [86 males, (56.60±11.15) years old;24 females, (60.06±12.02) years old] who were hospitalized in the Department of Cardiology, Teda International Cardiovascular Hospital from May 18, 2021 to February 30, 2022 and underwent magnetic magnetic examination. Serum CITP and MMP-1 were detected by enzyme-linked immunoassay and CITP/MMP-1 ratio was calculated. Plasma brain natriuretic peptide (BNP) was detected by automatic chemiluminescence analyzer. Anova and non-parametric test were used to compare the difference of indexes among all groups. Spearman analysis was used to analyze the correlation between serum collagen metabolites and the severity of myocardial fibrosis. Logistic regression analysis was performed for multivariate analysis, and ROC curve was used to evaluate the auxiliary diagnostic value of related indexes. Major adverse cardiac events within 1 year after discharge were recorded, including cardiogenic death, HF rehospitalization, malignant arrhythmia, and myocardial infarction. The risk factors of poor prognosis were analyzed by Cox regression. Patients were divided by the median value of CITP/MMP-1 ratio or the median value of CITP/MMP-1 ratio and BNP. Survival analysis was performed by Kaplan-Meier and Log Rank test was performed.Results:Serum MMP-1 and BNP in LGE (+) group were higher than those in LGE (-) group (1.79 ng/ml > 0.91 ng/ml, Z=-2.924; 503 pg/ml > 367 pg/ml, Z=-1.932; P<0.05); The CITP/MMP-1 ratio in the LGE (+) group was lower than that in the LGE (-) group (3.84 < 10.85, Z=-3.601, P<0.001). MMP-1 in CHF with arrhythmia group was higher than that in CHF group (1.98 ng/ml > 1.25 ng/ml, Z=-2.016), while CITP/MMP-1 ratio was lower than that in CHF group (3.25 < 5.73, Z=-2.751), all P<0.05. CITP/MMP-1 ratio in CHF patients was negatively correlated with the severity of MF ( r=-0.363, P<0.001), and BNP and MMP-1 were positively correlated with the severity of MF ( r=0.267, r=0.264, P<0.05). Serum BNP was positively correlated with collagen metabolite MMP-1 and negatively correlated with CITP/MMP-1 ratio (all P<0.05). Logistic multivariate regression analysis showed that only CITP/MMP-1 was a predictor of myocardial fibrosis, with an OR value of 0.624 ( P=0.005). ROC curve was used to evaluate serum BNP, MMP-1 and CITP/MMP-1 ratio in the diagnosis of myocardial fibrosis in HF patients, with AUC of 0.653, 0.696 and 0.754, respectively. The accuracy of CITP/MMP-1 ratio in diagnosing fibrosis was better than that of BNP by comparing their AUC, and the difference was statistically significant ( Z=-3.808, P<0.001). Cox regression analysis showed that CITP/MMP-1 ≤3.84 was a risk factor for poor prognosis, OR=2.647 ( P=0.009). Kaplan-Meier survival analysis at 1-year follow-up showed that the survival rate of the group with lower CITP/MMP-1 ratio was significantly lower than that of the group with higher CITP/MMP-1 ratio ( P=0.014). The survival rate of CITP/MMP-1 increased and BNP decreased group was higher than that of CITP/MMP-1 decreased and BNP increased group ( P=0.011). Conclusions:The ratio of CITP/MMP-1 can be used as a negative correlation indicator of the degree of cross-linking, which is better than BNP in the evaluation of MF, and has a good auxiliary diagnostic value for myocardial fibrosis in patients with chronic heart failure, and is expected to become a protective indicator for patients with chronic heart failure and be used in clinical evaluation of myocardial fibrosis. CITP/MMP-1 ratio is associated with the incidence of major adverse cardiac events, and CITP/MMP-1 ≤3.84 can be used as a predictor of prognostic adverse cardiovascular events in CHF patients.

Objective:To explore the effect of training and management based on cognitive conflict on nursing ability and adverse events of nurses in Department of Interventional Therapy.Methods:Using the convenient sampling method, 90 nurses in the Department of Interventional Therapy of three Class Ⅲ Grade A hospitals in Shanxi Province from January to October 2021 and 170 patients with interventional therapy admitted to three Class Ⅲ Grade A hospitals in Shanxi Province from February 2020 to October 2021 were selected as the research object. The patients admitted before the implementation of personnel training and management based on cognitive conflict from February to December 2020 were set as the control group, and the patients admitted after the implementation of personnel training and management based on cognitive conflict from January to October 2021 were set as the research group, with 85 cases each. We compared the theoretical knowledge, nursing skills, clinical strain ability and critical thinking ability of nurses before and after the implementation of personnel training and management based on cognitive conflict, as well as the occurrence of adverse events and nursing satisfaction of patients.Results:Three and six months after the implementation of personnel training and management based on cognitive conflict, the scores of intervention theoretical knowledge, nursing skills, clinical strain ability and critical thinking ability of nurses were higher than those before the implementation, and the scores in six months after the implementation were higher than those in three months after the implementation, with statistically significant differences ( P<0.05) . The total incidence of adverse events in the research group was 11.76% (10/85) , which was lower than 23.53% (20/85) in the control group with a statistical difference ( P<0.05) . The patient satisfaction of the research group was 95.29% (81/85) , which was superior to 85.88% (73/85) of the control group, with a statistically significant difference ( P<0.05) . Conclusions:The implementation of personnel training and management based on cognitive conflict in the Interventional Therapy Department can improve the quality of nursing service of nurses, reduce the risk of adverse events, and increase patient satisfaction, which is worthy of clinical application.

Objective:This article analyzes the epidemic situation and characteristics of Corona virus disease 2019 (COVID-19) in Russian Federation (referred to as Russia), summarizes the effective measures and problems exposed by Russia to deal with COVID-19, so as to provide reference for our country's epidemic prevention and control, and seek the direction of cooperation under the background of Sino Russia scientific and technological innovation in view of public health emergency.Methods:The epidemic characteristics and prevention and control measures were analyzed based on the data released by official authoritative news media such as Sputnik News Agency & Radio and Stopcoronavirus Website.Results:Russia's first confirmed case was on January 31, 2020 and its first peak of epidemic outbreak was on May 10, 2020. Thanks to a series of prevention and control measures and isolation and detection systems established by the Russia government according with national conditions, such as establishment of COVID-19 medical treatment centers, restrictions on alcohol sales, and the accelerating development of the vaccine and test kit the epidemic was basically controlled at the end of August in 2020. In September, Russia saw the second peak of the outbreak of COVID-19.Conclusions:The fatality rate of COVID-19 in Russia has been at a low level. Therefore, its prevention and control measures, experience and even its deficiencies are worth of learning by China. And we should also strengthen cooperation with Russia in the field of vaccine research and development and its clinical trials.

Objective:Understand the status of brushing teeth behavior of preschoolers in Shaanxi Province, to provide basis for oral health of preschoolers.Methods:By adopting the methods of multi-stage, stratified, geometric and cluster sampling, 1 370 kindergarten students at the age of 3-5 in Shaanxi Province were sampled as respondents to implement oral health questionnaire.Results:49.2%(674/1 370) children brushed their teeth every day, including only 14.8%(203/1 370) children brushing their teeth twice or above. Therefore, the difference of the brushing frequency (≥ 1 time/day) between urban and rural areas had obvious statistical significance ( χ2 value was 47.588, P<0.01). 98.7%(741/750) children used toothpaste, including only 6.9% (51/741) using toothpaste with fluoride. Therefore, the use of toothpaste between urban and rural areas has no statistical significance. Only 0.5% (4/751) children started to brush their teeth when their first deciduous tooth erupted. Therefore, the age for children starting to brush their teeth between urban and rural areas had obvious statistical significance ( χ2 value was 24.217, P<0.01). 65.2% (490/751)parents never helped their children to brush teeth, parents in rural areas even reached to 72.8% (227/312). Therefore, the brushing frequency for parents helping their children to brush teeth between urban and rural areas had statistical difference ( χ2 value was 16.192, P<0.01). Conclusions:The status of brushing teeth behavior of preschoolers in Shaanxi Province is lower than the national level, and the level in rural areas is obviously lower that in urban areas. The education and cultivation on brushing teeth behavior should be further strengthened in the future propaganda and education, especially, the power of propaganda on children and parents in rural areas should be strengthened.

Objective: In order to describe the employment status of the first group of targeted admission medical graduates, evaluate the effects of targeted admission medical education program, find out the existing problems and provide relevant policy recommendations.Methods: This study conducted follow-up survey among 305 medical graduates and 315 clinical medical graduates in four medical colleges of the central and western regions.Data analyses of the contract fulfillment, their employment status, and their participation in the standardized residency training are carried out.Results: The contract fulfillment rate of rural-oriented medical graduates is 99.3%, while the percentages of rural-oriented medical graduates and clinical medical graduates are 90.7% and 2.8%, respectively.Their average monthly incomes are respectively 2,011 and 2,774 yuan, and their proportions of participating in standardized residency training are 77.8% and 43.3% respectively.From the findings it can be seen that the employment situation of the first group of targeted admission medical graduates in four medical colleges and universities is quite good, but the policy implementation process in terms of permanent post and income is less satisfactory.However, the way how medical graduates should participate in the standardized residency training is not yet clearly regulated.This paper recommends that medical colleges and universities should well coordinate with local health administrative departments and human resources and social security departments to systematically deploy medical graduates.At the same time, full consultations should be conducted to make appropriate arrangement for medical graduates to participate in standardized residency training.

BACKGROUND:It has been found that cel ular repressor of E1A-stimulated genes (CREG) is a lysosomal protein binding directly to the mannose-6-phosphate (M6P)/insulin-like growth factor II receptor (IGFIIR) and depends on the interaction with M6P receptors for efficient delivery to lysosomes OBJECTIVE:To study the interactions between the exogenous CREG protein and cathepsins and M6P/IGFIIR and to confirm the effect of CREG protein on expression and distribution of M6P/IGFIIR. METHODS:Double-stained immunofluorescence and coimmunoprecipitation were applied to observe the interactions between the exogenous CREG protein and cathepsin B, cathepsin L and M6P/IGFIIR. Using gain-of-function and loss-of-function approaches, the effect of CREG on expression and distribution of M6P/IGFIIR were studied by western blot assay and immunofluorescence staining. RESULTS AND CONCLUSION:Double-stained immunofluorescence and coimmunoprecipitation analyses confirmed the direct interactions between the exogenous CREG protein and cathepsin B, cathepsin L and M6P/IGFIIR. It was verified that CREG plays a critical role not in the expression but in the distribution of M6P/IGFIIR using gain-of-function and loss-of-function approaches. These findings provide evidence that exogenous CREG protein is located in lysosomes and has interactions with cathepsins and M6P/IGFIIR, also CREG plays a critical role in the distribution of M6P/IGFIIR.

Objective To analyze the influential factors of healthy children′s heart rate turbulence (HRT). Methods One hundred and six healthy children with ventricular premature beat (VPB) were selected in this study and the correlation among HTR parameters as turbulence onset (TO) and turbulence lope (TS) and age, gender, basic heart rate, the number of VPBs were analyzed. Results It was observed that among three age groups, TO decreased with the age, and the difference was statistically significant (P < 0.05), but there was no significant gender difference (all P > 0.05). TS increased with the age, and intergroup difference was statistically significant (P < 0.05). In the group of children aged over seven, significantly higher TS was observed among boys (P < 0.05), while in the group of children aged 1 to 3 and the group aged 3 to 7 , there was no significant gender difference (P > 0.05). TO and TS decreased with the decline of heart rate (r = 0.494, P < 0.00; r = -0.569,P < 0.00 respectively), and the correlation between TO and HR, TS and HR was found.The number of VPBs had no significant correlation with TO or TS (r = 0.104,P = 0.290; r = 0.122,P =0.212). Conclusions The results demonstrate that influenced by age and basic heart rate, healthy children′s HRT increases with the age and the decline of heart rate. Therefore, the reference index of children′s HRT should differ from that of adults, which requires further evaluation.

Objective Type 2 diabetes mellitus ( T2DM) as a common disease around the world becomes a great threat to the health of human beings.The cynomolgus T2DM model, which preferably simulates human T2DM onset and progress, can be beneficial to the drug development and clinical treatment.In the present study, 37 of T2DM-susceptibility SNPs and the extended genome sequences were used to obtain corresponding SNPs in the T2DM cynomolgus monkeys. Methods Firstly, DNA pool screening was conducted.Then, using polymerase chain reaction to amplify and to sequence the cynomolgus homologous sequences.Using DNAStar software to analyze the differences between bases.Finally, we used analysis of variance and F test to calculate the frequency of alleles.We also used the GLM models of SAS software to analyze the association of genotype with fasting plasma glucose and glycosylated hemoglobin.Results SNP661A,SNP661B, SNP343A, SNP343B, SNP343C, SNP565A, SNP565B and SNP565C were found to have a significant difference of allele frequencies between spontaneous cases and controls.Conclusions The findings of this study suggest that SNP661A, SNP661B, SNP343A, SNP343B and SNP343C may play an important role in the establishment of cynomolgus T2DM models.