Objective To investigate the influencing factors of malnutrition in hospitalized elderly patients with comorbidities of chronic diseases, and to construct a predictive model. Methods A convenience sampling method was used to select 426 elderly patients with comorbidities of chronic diseases admitted to the Department of Geriatrics of Suzhou Ninth People's Hospital Affiliated to Soochow University from January 2023 to February 2024. Based on a Mini-nutritional Assessment-Short Form (MNA-SF) score < 8 and either an albumin level < 34.0 g/L or a prealbumin level < 200 mg/L as reference of malnutrition, patients were classified into malnutrition group and non-malnutrition group. General characteristics, oral status[assessed using the Oral Health Assessment Tool (OHAT)], dietary inflammatory index (DII, evaluated through a food frequency questionnaire), and activities of daily living[assessed using the Barthel Index (BI)]were compared between the two groups. Multivariable Logistic regression analysis was employed to explore the influencing factors of malnutrition in elderly patients with comorbidities of chronic diseases and to construct a model formula. A gradient boosting machine (GBM) algorithm was implemented using R software to build a GBM predictive model. Receiver Operating Characteristic (ROC) curves were utilized to analyze the predictive performance of both models, and the Delong test was applied to compare the difference of the area under the curve (AUC). Results Ninety-two patients were diagnosed with malnutrition (malnutrition group), while 334 patients had no malnutrition (non-malnutrition group). Statistically significant differences were observed between the malnutrition and non-malnutrition groups in terms of age, the number of chronic comorbidities, the number of medication taken, OHAT scores, DII, and BI scores (P < 0.05). Advanced age, a higher number of chronic comorbidities, a greater number of medication taken, higher OHAT scores, higher DII, and lower BI scores were all influencing factors of malnutrition in elderly patients with comorbidities of chronic diseases (P < 0.05). The ROC curve analysis revealed an AUC of GBM model was 0.901 and 0.874 for the Logistic regression model. The Delong test indicated that the predictive performance of the GBM model was superior to that of the Logistic regression model (P < 0.05). Conclusion Malnutrition in hospitalized elderly patients with chronic multimorbidity is associated with age, the number of chronic comorbidities, the number of medications taken, OHAT scores, DII, and BI scores. The constructed GBM model can effectively assess the risk of malnutrition in these patients.

To investigate the clinical role of T-cell transcription factor (TBX21) and adenylate cyclase 9 antibody (ADCY9) gene polymorphisms in the development of childhood asthma. METHODS: Two hundred Han Chinese wheezing children aged 5 years and younger in Henan region from July 2016 to January 2017 were selected as the study group, and another 100 Han Chinese healthy children aged 5 years and younger in the same period were selected as the control group. Oral mucosal exfoliated cells were collected from both groups, and the genotypes of TBX21 gene rs2240017 polymorphic locus and ADCY9 gene rs2230739 polymorphic locus were detected by real-time fluorescence quantitative polymerase chain reaction (PCR) technique, and the risk level of asthma was assessed based on the test results. The children in the low-risk and high-risk groups were compared in terms of serum immunoglobulin E (IgE) levels, API positivity rate and allergic disease incidence, and the correlation between the risk level of asthma-related genetic polymorphisms and serum IgE levels, API and allergic disease incidence was analyzed. All children were followed up until 6 years of age to confirm the diagnosis of asthma, and the incidence of asthma was compared between the low-risk and high-risk groups. Children with asthma were treated with inhaled glucocorticoids and leukotriene receptor antagonists for 3 months, and the control of asthma and the impairment of lung function were compared between the low-risk and high-risk groups. RESULTS: The genotype detection results of rs2240017 polymorphic locus of TBX21 gene and rs2230739 polymorphic locus of ADCY9 gene in the study group compared with those in the control group were statistically significant (P<0.001). The percentages of CC, CT, and TT genotypes of rs2240017 polymorphic locus of TBX21 gene were 19.50%, 56.00%, and 24.50%, respectively, and the percentages of CC, CG, and GG genotypes of rs2230739 polymorphic locus of ADCY9 gene were 86.00%, 10.00%, and 4.00%, respectively, in 200 children with wheezing; serum IgE level, API positivity rate and allergic disease incidence were higher in the high-risk group than in the low-risk group (P< 0.001, <0.001, 0.021, respectively). The degree of risk of asthma-related gene polymorphisms in children with wheezing was positively correlated with serum IgE levels, API positivity, and the incidence of allergic diseases (P<0.001); the incidence of asthma (81.48%) and impaired lung function (74.07%) were higher in the high-risk group than in the low-risk group (4.90%, 3.50%) (P<0.001). There was no statistically significant difference between the asthma control rate of children with asthma in the high-risk group (79.55%) compared with the asthma control rate of children with asthma in the low-risk group (100.00%) (P=0.433). CONCLUSION: Gene polymorphisms at rs2240017 locus of TBX21 gene and rs2230739 locus of ADCY9 gene are closely associated with asthma development and impaired lung function in children with wheezing.

Objective    To compare and investigate the efficacy and differences of modified B-T shunt, central shunt and right ventricle-pulmonary artery (RV-PA) connection in the treatment of pulmonary atresia with ventricular septal defect (PA/VSD). Methods    A total of 124 children with PA/VSD underwent initial palliative repair in Shanghai Children's Medical Center from September 2014 to August 2019, including 63 males and 61 females, aged 7 days to 15 years. They were divided into in a modified B-T shunt group (55 patients), a central shunt group (22 patients) and a RV-PA connection group (47 patients). The clinical data of these children were retrospectively analyzed. Results    There were 9 early deaths after palliation, with an early mortality rate of 7.3%. The mean follow-up time was 26.5±20.3 months, with 5 patients lost to follow-up, 5 deaths during the follow-up period, and 105 survivors. The 1-year and 5-year survival rates were both 89.7%. The monthly increased Nakata index was 5.2 (–0.2, 12.3) mm2/m2, 9.2 (0.1, 23.6) mm2/m2, 6.3 (1.8, 23.3) mm2/m2 in the modified B-T shunt group, the central shunt group, and the RV-PA connection group, respectively, with no statistical difference among the three groups. The 1-year survival rate was 85.3%, 78.4%, 95.2%, and the 5-year (4-year in the central shunt group) survival rate was 85.3%, 58.8%, 95.2% in the three groups, respectively, with a statistical difference among them (P<0.05). The complete repair rate was 36.5%, 19.0% and 67.4% in the three groups, respectively, with a statistical difference among the three groups (P<0.001). Conclusion    All these three palliative surgical approaches can effectively promote pulmonary vascular development. But compared with systemic-pulmonary shunt, RV-PA connection has a lower perioperative mortality rate and can achieve a higher complete repair rate at a later stage, which is beneficial for long-term prognosis.

Perilla frutescens, an annual herb of the Labiatae family, has been cultivated in China for more than 2000 years. P. frutescens is the one of the first medicinal and edible plant published by the Ministry of Health. Its leaves, stems and seeds can be used as medicine and edible food. Because of the abundant nutrients and bioactive components in this plant, P. frutescens has been studied extensively in medicine, food, health care and chemical fields with great prospects for development. This paper reviews the cultivation history, chemical compositions and pharmacological activities of P. frutescens, which provides a reference for the development and utilization of P. frutescens resources.

Objective:To explore the effect of self-health monitoring information platform in health management of pregnant women at home, so as to provide a reference for self health management of pregnant women at home.Methods:From January 2020 to January 2021, a total of 1 683 pregnant women in Hangzhou Women's Hospital were selected as the research objects using the convenient sampling method, and divided into the intervention group ( n=815) and the control group ( n=868) . The control group received routine antenatal examination, and the intervention group conducted self-health monitoring information platform and routine antenatal examination. The school attendance rate, sleep quality during pregnancy, detection rate of fetal distress, pregnancy weight gain and premature birth rate were compared between the two groups. Results:The school attendance rate, sleep quality during pregnancy, detection rate of fetal distress of the the intervention group were higher than those of the control group, the number of pregnant women with normal weight gain was higher than that of the control group, premature birth rate of the intervention group was lower than that of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Self-health monitoring information platform can improve the quality of sleep and normal weight gain during pregnancy of pregnant women, reduce the incidence of preterm birth, which has important application value under the background of the national "universal three-child" policy.

School-age children are in a specific development stage corresponding to juvenility, when the white matter of the brain experiences ongoing maturation. Diffusion-weighted magnetic resonance imaging (DWI), especially diffusion tensor imaging (DTI), is extensively used to characterize the maturation by assessing white matter properties in vivo. In the analysis of DWI data, spatial normalization is crucial for conducting inter-subject analyses or linking the individual space with the reference space. Using tensor-based registration with an appropriate diffusion tensor template presents high accuracy regarding spatial normalization. However, there is a lack of a standardized diffusion tensor template dedicated to school-age children with ongoing brain development. Here, we established the school-age children diffusion tensor (SACT) template by optimizing tensor reorientation on high-quality DTI data from a large sample of cognitively normal participants aged 6-12 years. With an age-balanced design, the SACT template represented the entire age range well by showing high similarity to the age-specific templates. Compared with the tensor template of adults, the SACT template revealed significantly higher spatial normalization accuracy and inter-subject coherence upon evaluation of subjects in two different datasets of school-age children. A practical application regarding the age associations with the normalized DTI-derived data was conducted to further compare the SACT template and the adult template. Although similar spatial patterns were found, the SACT template showed significant effects on the distributions of the statistical results, which may be related to the performance of spatial normalization. Looking forward, the SACT template could contribute to future studies of white matter development in both healthy and clinical populations. The SACT template is publicly available now ( https://figshare.com/articles/dataset/SACT_template/14071283 ).

Hydrogen sulfide (H

Objective:To form a nursing standard for shoulder-hand syndrome (SHS) after stroke in accordance with the clinical situation by expert argumentation in the best evidence systematically retrieved and screened for SHS after stroke with the method of Delphi expert consultation.Methods:According to the level of evidence, we systematically retrieved and screened relevant guidelines, evidence summary, systematic reviews, original studies and expert consensus. Two researchers who had received Joanna Briggs Institute (JBI) evidence-based training used the Appraisal of Guidelines for Research & Evaluation (AGREE) Ⅱ, JBI quality evaluation tools for systematic reviews, randomized controlled trials/experimental studies and expert consensus to evaluate the included guidelines, systematic reviews, original studies and expert consensus. The included literature was classified and summarized, and recommendations and conclusions related to SHS after stroke were screened and extracted. According to the results of the literature summary, the first draft of the clinical nursing standard for SHS after stroke was formed. Using the Delphi method, 25 experts in related fields were selected for two rounds of expert consultation to demonstrate the contents of the first draft.Results:This study included 8 guidelines including 1 evidence summary, 2 systematic reviews, 7 original studies and 2 expert consensus. The overall quality of the guidelines was Grade B; one piece of evidence summary was of good quality and was Grade B; the overall quality of two systematic reviews was low, and the overall quality of seven original studies was average. The first draft of the clinical nursing standard for SHS after stroke included 6 content frameworks and 29 recommendations. Two rounds of expert consultation were conducted, the questionnaire response rates were 89.28% and 100%, and the expert authority coefficients were 0.864 and 0.894, respectively. The Kendell's W of important content framework and recommended in the second round of expert consultation were 0.118 ( P<0.05) and 0.188 ( P<0.001) . According to the results of the expert consultation, the clinical nursing standard for SHS after stroke was formed, including 6 content frameworks and a total of 31 recommendations. Conclusions:The clinical nursing standard for SHS after stroke is based on the best available evidence and expert argumentation, which is in line with the clinical situation in my country and can be sed in clinical nursing work.

Objective To study the prevalence trends and etiology of hand,foot,and mouth disease (HFMD) in hospitalized children.Methods The clinical data of 11 510 cases of children hospitalized with HFMD from 2008 to 2017 in Department of Infection Diseases of Kunming Children's Hospital were collected,and to retrospectively analyze the characteristics,time distribution and pathogen distribution of the cases.Results Of the 11 510 children with HFMD,6 100 were male and 5 410 were female.There were 9 814 cases under 3 years old,1 696 over 3 years old.HFMD occurred throughout the year.The peak months of the disease were April to July,with the time distribution of single peak.There were 4 690 severe cases and 3 452 critical cases,accounting for 70.34％.The main pathogens detected were enteroviruses A71 (EV-A71),coxsackievirus A16 (CV-A16) and other enteroviruses (EV),with 3 803 cases (36.02％),1 122 cases (10.63％) and 3 401 cases (32.21％) respectively.EV-A71 and CV-A16 infections dominated from 2008 to 2013,while EV-A71 and other EV infection dominated from 2014 to 2017.Conclusions EV-A71,CV-A16 and other EV are the main pathogens of HFMD in Kunming.Critical HFMD cases are mainly caused by EV-A71 infection.

OBJECTIVETo explore the primary site and pathological feature of neuroendocrine neoplasm (NEN), especially the NEN of digestive system.

METHODSClinicopathological data of NEN patients at China-Japan Friendship Hospital from January 2012 to December 2016 were retrospectively analyzed. Tumor primary sites were summarized. Association between tumor site and pathological grading in gastroenteropancreatic neuroendocrine neoplasm(GEP-NEN) was examined.

RESULTSThere were a total of 903 cases of NEN. Sites of primary tumor included the digestive system in 699 cases(77.4%), the thorax(including lung, thymus and mediastinum) in 87 cases(9.6%), other sites in 60 cases (6.6%), unknown in 57 cases(6.3%). Among 699 GEP-NEN cases, the primary sites included the stomachin in 207 cases (29.6%), pancreas in 201 (28.8%), rectumin in 185 (26.5%), duodenum in 43(6.2%), jejunum and ileum in 18(2.6%), appendix in 15 (2.1%), gallbladder in 11(1.6%), esophagus in 10(1.4%), and the colon in 9 cases (1.3%). Pathologically, the tumor grading was neuroendocrine tumor (NET) G1 in 336 cases(48.1%), NET G2 in 203 cases (29.0%), neuroendocrine carcinoma (NEC) G3 in 139 cases (19.9%). All the esophagus NEN(10/10), most gallbladder NEN(9/11) and colon NEN(6/9) were poorly-differentiated NEC (G3), while all appendix NEN(15/15), most stomach NEN(147/207, 71.0%), pancreas NEN (156/201, 77.6%), rectum NEN (169/185, 91.4%), duodenum NEN (31/43, 72.1%), jejunum and ileum NEN(16/18, 88.9%) were well-differentiated NET G1 or G2.

CONCLUSIONSThe most common primary site of NEN is the digestive system. The stomach, pancreas and rectum are most common primary sitesof GEP-NEN. Difference in pathological grading is quite greatin different primary sites of GEP-NEN. Most NENs fromesophagus, colon and gallbladder are poorly-differentiated NEC.