Objective:To understand the characteristics and trends of acute myocardial infarction (AMI) in Shandong Province and to provide evidence for formulating prevention and control strategies.Methods:Data were derived from the AMI incidence reports of Shandong Province's Chronic Disease Surveillance Information Management System in 2012-2021. The crude and standardized incidence rates were used as indicators to describe the incidence level of AMI. Joinpoint regression analysis was used to analyze the trends in the incidence and age of onset over the years. The contribution of population aging to the increase in AMI incidence was assessed using the rate difference decomposition method. The incidence of AMI in each district (county) in Shandong Province was visualized using ArcGIS 10.8 software, and global and local spatial autocorrelation analysis was performed using DeoDa 1.12 software.Results:From 2012 to 2021, 198 233 cases of AMI were reported from 19 provincial monitoring sites in Shandong Province, of which 53.13% were males and 97.12% were ≥45 years old. The reported crude incidence increased from 90.12 per 100 000 in 2012 to 176.54 per 100 000 in 2021, with an average annual increase of 7.01% ( Z=7.35 , P<0.001). There was no significant upward trend in standardized incidence ( Z=1.64 , P=0.140), but the standardized incidence of male residents showed an increasing trend ( Z=2.76 , P=0.028). Before 2014, the reported crude incidence of males was similar to that of females, but after 2014, the reported crude incidence of males was continuously higher than that of females. However, males' standardized incidence was higher than females in all years. Both crude and standardized incidence rates were higher in rural residents than in urban areas. The median onset of AMI increased from 71.6 years old in 2012 to 73.5 years old in 2021. The median age of onset in males was lower than that in females in all years, and in most years, the median age of onset in urban residents was lower than that in rural residents. The incidence of AMI in males showed a trend in younger age groups. According to the seasonal decomposition, the incidence peak of AMI was in January, and the trough was in September. The contribution of aging population to the increase in crude incidence of AMI increased from 8.63% in 2013 to 52.58% in 2021. The global spatial autocorrelation analysis showed that the incidence of AMI presented an obvious spatial clustering distribution. Local spatial autocorrelation analysis found that the high-incidence areas (counties) were mainly concentrated in Liaocheng City and Dezhou City in the northwest region of Shandong Province and Heze City in the southwest. Conclusions:The incidence of AMI among residents in Shandong Province was rising, with spatial clustering and seasonal clustering characteristics. People aged 45 years and older, male residents, and rural residents were at high risk of developing AMI. There was a certain trend of younger age at onset among men. Targeted prevention and control measures should be taken for high-incidence seasons, high-risk groups, and high-incidence clustering areas in northwestern Shandong Province.

Objective:To systematically analyze and evaluate the predictive performance of 5 assessment scales (Munro Pressure Ulcer Risk Assessment Scale, Norton Scale, Braden Scale, Scott Triggers Scale and Waterlow Scale) for adult intraoperatively acquired pressure injury (IAPI), so as to provide reference for the selection of appropriate assessment scales.Methods:This study is a Meta-analysis. Research on the adult IAPI assessment scale was retrieved through computers in databases such as VIP, WanFang Data, China National Knowledge Infrastructure, China Biology Medicine disc, PubMed, Embase, Web of Science and Cochrane Library. The search time limit was from the establishment of the database to December 2, 2021.Two researchers independently screened the article, conducted quality evaluation and data extraction on the included article, and conducted descriptive analysis on the sensitivity and specificity of each scale. The researchers used RevMan 5.3 software to create a receiver operating characteristic (ROC) curve and calculate the area under the curve.Results:A total of 13 articles were included, with a total of 5 640 cases, and the incidence of IAPI was 8.09% (456/5 640). A Meta-analysis was conducted after merging 8 articles on the Braden scale. After merging, it was found that the sensitivity of the scale was 0.76 [95% confidence interval ( CI) (0.72, 0.81) ], the specificity was 0.53 [95% CI (0.51, 0.54) ], and the area under the ROC curve was 0.70. After a combined analysis of 7 articles on the Munro Pressure Ulcer Risk Assessment Scale, it was found that the sensitivity of the scale was 0.81 [95% CI (0.75, 0.86) ], the specificity was 0.79 [95% CI (0.77, 0.81) ], and the area under the ROC curve was 0.84. After a combined analysis of 4 articles on the Waterlow scale, it was found that the sensitivity of the scale was 0.78 [95% CI (0.69, 0.86) ], the specificity was 0.60 [95% CI (0.58, 0.62) ], and the area under the ROC curve was 0.72. After a combined analysis of 3 articles on the Norton scale, it was found that the sensitivity of the scale was 0.67 [95% CI (0.56, 0.77) ], the specificity was 0.69 [95% CI (0.67, 0.71) ], and the area under the ROC curve was 0.74. After a combined analysis of 3 articles on the Scott Triggers Scale, it was found that the sensitivity of the scale was 0.80 [95% CI (0.68, 0.89) ], the specificity was 0.53 [95% CI (0.50, 0.56) ], and the area under the ROC curve was 0.67. Conclusions:As a special scale for surgical patients, the Munro scale has superior sensitivity, specificity, and area under the ROC curve to other evaluation scales. It is recommended that Operating Room nurses prioritize the Munro scale for assessing the risk of IAPI in adult surgical patients.

Objective:To estimate the deaths and life expectancy losses attributed to diet with high salt in Shandong province.Methods:Based on 24 h urinary sodium and blood pressure levels from the final evaluation survey of Shandong-Ministry of Health Action on Salt and Hypertension Project (SMASH) in 2016 and death cause data from Shandong Mortality Surveillance System, the population attributable fractions (PAF) and the deaths due to high-salt diet were calculated based on the framework of comparative risk assessment and the life expectancy loss was calculated by life table method.Results:A total of 32 987 deaths caused by high-salt diets were reported in 2016, accounting for 11.74% of related disease deaths and 4.95% of all deaths. The proportion of deaths due to high-salt diet in men (13.51%) was higher than that in women (9.17%). Cardiovascular diseases were the major causes of deaths due to high salt diet, accounting for 90.82% of all disease deaths caused by high-salt diets. The other causes were gastric cancer (8.10%) and chronic kidney disease (1.08%). The PAF in urban residents (13.87%) was higher than that in rural residents (10.87%). A loss of 0.58 years of the life expectancy were attributed to the high-salt diet. The different diseases caused by high-salt diet had different effects on life expectancy loss, ischemic heart disease ranked first, followed by cerebral hemorrhage and cerebral infarction.Conclusions:The proportion of deaths attributed to high-salt diets was high in Shandong. Cardiovascular diseases were the most important causes of deaths caused by high-salt diets. High-salt diet is still seriously affecting the health of residents in Shandong, indicating that salt reduction interventions need to be strengthened.

Objective:To investigate the distribution characteristics and trends of mortality and spatial aggregation of gastric cancer in Shandong Province from 1970 to 2013.Methods:The mortality data of gastric cancer from 1970 to 1974, 1990 to 1992 and 2004 to 2005 were collected from the first, second and third retrospective sampling survey of causes of death in Shandong Province, respectively. The mortality data of gastric cancer from 2011 to 2013 were collected from the all-cause surveillance data of Shandong Province. The crude mortality rate and age-standardized mortality rate were used to describe the death level of gastric cancer. The age-standardized mortality rate of Shandong Province was calculated based on Segi′s world standard population, and the age-standardized mortality rate of counties (cities and districts) was calculated based on the Chinese population in 1964.The factors influencing the difference of gastric cancer mortality in different periods were decomposed by using the method of differential decomposition of mortality, and the contributions of population and non-population factors in different periods were estimated.Using ArcGIS 10.2 software, the death level of gastric cancer in different counties (cities and districts) in Shandong province from 1970 to 1974 and 2011 to 2013 were visualized. DeoDa 1.12 software was used for global and local spatial autocorrelation analysis.Results:The crude death rate and age-standardized death rate of gastric cancer in Shandong province increased firstly and then decreased during 1970-2013, and the crude death rate of gastric cancer increased from 18.33/100 000 in 1970-1974 to 28.51/100 000 in 2011-2013. Segi′s age-standardized mortality rate for gastric cancer decreased from 20.94 per 100 000 in 1970-1974 to 18.17 per 100 000 in 2011-2013.From 1990 to 1992, from 2004 to 2005 and from 2011 to 2013, the contribution value of non-population factors to the increase of crude gc mortality was 95.59%, 48.45% and -20.57%, respectively, showing a continuous downward trend. The Moran′s I index of crude mortality of gastric cancer in Shandong province from 1970 to 1974 and from 2011 to 2013 were 0.77 and 0.57, respectively, and the Moran′s I index of age-normalized mortality was 0.75 and 0.44, respectively. Local autocorrelation analysis showed that there were 31 and 19 high aged-mortality areas of gastric cancer in 1970-1974 and 2011-2013 respectively, and 7 overlapping counties (cities and districts), 6 of which were located in Jiaodong area. Conclusion:The crude mortality and age-standardized mortality of gastric cancer in Shandong province increased first and then decreased from 1970 to 2013, and the distribution of gastric cancer mortality had obvious spatial aggregation and changed with time.

Objective:To investigate the distribution characteristics and trends of mortality and spatial aggregation of gastric cancer in Shandong Province from 1970 to 2013.Methods:The mortality data of gastric cancer from 1970 to 1974, 1990 to 1992 and 2004 to 2005 were collected from the first, second and third retrospective sampling survey of causes of death in Shandong Province, respectively. The mortality data of gastric cancer from 2011 to 2013 were collected from the all-cause surveillance data of Shandong Province. The crude mortality rate and age-standardized mortality rate were used to describe the death level of gastric cancer. The age-standardized mortality rate of Shandong Province was calculated based on Segi′s world standard population, and the age-standardized mortality rate of counties (cities and districts) was calculated based on the Chinese population in 1964.The factors influencing the difference of gastric cancer mortality in different periods were decomposed by using the method of differential decomposition of mortality, and the contributions of population and non-population factors in different periods were estimated.Using ArcGIS 10.2 software, the death level of gastric cancer in different counties (cities and districts) in Shandong province from 1970 to 1974 and 2011 to 2013 were visualized. DeoDa 1.12 software was used for global and local spatial autocorrelation analysis.Results:The crude death rate and age-standardized death rate of gastric cancer in Shandong province increased firstly and then decreased during 1970-2013, and the crude death rate of gastric cancer increased from 18.33/100 000 in 1970-1974 to 28.51/100 000 in 2011-2013. Segi′s age-standardized mortality rate for gastric cancer decreased from 20.94 per 100 000 in 1970-1974 to 18.17 per 100 000 in 2011-2013.From 1990 to 1992, from 2004 to 2005 and from 2011 to 2013, the contribution value of non-population factors to the increase of crude gc mortality was 95.59%, 48.45% and -20.57%, respectively, showing a continuous downward trend. The Moran′s I index of crude mortality of gastric cancer in Shandong province from 1970 to 1974 and from 2011 to 2013 were 0.77 and 0.57, respectively, and the Moran′s I index of age-normalized mortality was 0.75 and 0.44, respectively. Local autocorrelation analysis showed that there were 31 and 19 high aged-mortality areas of gastric cancer in 1970-1974 and 2011-2013 respectively, and 7 overlapping counties (cities and districts), 6 of which were located in Jiaodong area. Conclusion:The crude mortality and age-standardized mortality of gastric cancer in Shandong province increased first and then decreased from 1970 to 2013, and the distribution of gastric cancer mortality had obvious spatial aggregation and changed with time.

Objective:To explore the spatial clustering and trend of liver cancer mortality in different counties of Shandong province from 1970 to 2013, and provide scientific basis for the development of liver cancer prevention and control plan.Methods:Cancer mortality data were obtained from Shandong Death Registration System and three national death cause surveys in China. Mortality rate and age adjusted mortality rate were used to describe the trend of liver cancer in different years. Difference decomposing method was applied to estimate the contribution of demographic and non-demographic factors to the change of mortality. Software ArcGIS 10.2 was used for spatial analysis, and software SaTScan 9.4 was used for spatial clustering analysis on liver cancer mortality.Results:From 2011 to 2013, the crude mortality rate of liver cancer (29.89/100 000) in Shandong increased by 208.00 % and 35.37 % respectively compared with that during 1970-1974 (9.72/100 000) and 1990-1992 (22.08/100 000) and was similar to that during 2004-2005 (30.44/100 000). While age standardized mortality rate (ASMR) increased first and then decreased. The ASMR during 2011-2013 (12.62/100 000) increased by 60.97 % compared with that during 1970-1974 and decreased by 22.38 % and 21.81 % compared with that during 1990-1992 and 2004-2005, respectively. According to the difference decomposition analysis on liver cancer mortality in different years, the contribution of population factors to the liver cancer mortality rate increased from 3.38 % during 1990-1992 to 29.36 % during 2004-2005 and 46.16 % during 2011-2013. However, the contribution of non-population factors to the increase of liver cancer mortality decreased. According to the spatial distribution of liver cancer mortality, the crude mortality rate of liver cancer in different counties were quite different, ranging from 9.33/100 000 to 65.33/100 000. Using the spatial scanning statistical software to analyze the spatial clustering of liver cancer mortality, multi areas with high mortality rate of liver cancer were found, and they were mainly distributed in Jiaodong peninsula from 2011 to 2013, covering 20 counties (cities, districts) in Qingdao, Yantai and Weihai. The risk of liver cancer mortality in this area was 1.54 times higher than that in other areas. The spatial clustering distribution of liver cancer mortality during 1970-1974 was significantly different from that during 2011-2013, the areas with high mortality rate during 1970-1974 were mainly distributed in central and western Shandong. Conclusions:There were significant temporal and spatial distribution changes in the mortality rate of liver cancer in Shandong from 1970 to 2013. According to these trends and their geographical and spatial distribution, we should further explore the risk factors of liver cancer, and formulate feasible and area specific prevention and control measures for liver cancer.

Objective To explore associated factors of cerebral microbleeds (CMBs) in patients with intracerebral hemorrhage (ICH).Methods A total of 161 ICH patients were detected by 1.5T magnetic resonance imaging.Patients were divided into different groups according to ICH location (58 cases with lobar ICH,103 cases with non-lobar ICH).Results Eighty-eight (55％) patients hadCMBs at ICH onset,and 76 (47％) had CMBs during follow-up.Predictors of incident CMBs were ≥ 1 CMBs at ICH onset and old radiological macrohemorrhage.In the patients with nonlobar hemorrhage,CMBs was associated with lacunar state and antiplatelet drug use.In patients with lobar hemorrhage,CMBs was associated with large brain hemorrhage showed by imaging display.Conclusion The prognosis and related factors of CMBs are different according to the location of hemorrhage.

Objective To explore associated factors of cerebral microbleeds (CMBs) in patients with intracerebral hemorrhage (ICH).Methods A total of 161 ICH patients were detected by 1.5T magnetic resonance imaging.Patients were divided into different groups according to ICH location (58 cases with lobar ICH,103 cases with non-lobar ICH).Results Eighty-eight (55％) patients hadCMBs at ICH onset,and 76 (47％) had CMBs during follow-up.Predictors of incident CMBs were ≥ 1 CMBs at ICH onset and old radiological macrohemorrhage.In the patients with nonlobar hemorrhage,CMBs was associated with lacunar state and antiplatelet drug use.In patients with lobar hemorrhage,CMBs was associated with large brain hemorrhage showed by imaging display.Conclusion The prognosis and related factors of CMBs are different according to the location of hemorrhage.

ABSTRACT:Objective To study the effects of weight and anteroposterior diameter-to-transverse diameter ratio on establishing a model of acute myocardial infarction (AMI)in rats without artificial ventilation and changes in left ventricular function after infarction.Methods Healthy SD rats were randomly divided into group A (200-250 g),group B (250 - 300 g),group C (> 300 g),and group D (control group).The left anterior descending (LAD)coronary artery was ligated to establish a model of myocardial infarction under spontaneous breathing condition immediately after thoracic lines were measured.And changes of electrocardiography were recorded after model establishment.At 2 and 4 weeks after AMI,we observed ventricular wall thickness and ventricular wall motion and measured the changes of cardiac function.Histomorphological changes and myocardial ultrastructure of the heart were observed under thoracotomy 2 weeks after operation.The above data were analyzed by SPSS13.0 statistics software.Results ① The first AMI rat model was established successfully after 30 times of experiments, and after 100 times the model’s success rate gradually stabilized at about 83%.② Group B and group C had a higher model success rate than group A (P <0.05),but group B and group C did not differ in modeling success rate (P >0.05).③ There was no association between the rate of rat thoracic line and modeling success rate (P >0.05).
④ Two weeks after thoracotomy,ischemic myocardial color was white,and ventricular wall motion decreased.HE staining revealed that cardiomyocytes disappeared and were replaced by fibrous tissues and collagen.Remnant cardiomyocytes were arranged disorderly and myofibers were fractured,with interstitial damage and hyperplasia of fibrous tissue.Visible muscle cells were sparse and dissolved,the mitochondria had darker staining,blurred cristae, and edema under electron microscopy. ⑤ Compared with group D, 2 weeks and 4 weeks after myocardial infarction,left ventricular end-diastolic diameter (LVEDD)and left ventricular end systolic diameter (LVEDs) increased (P <0.05),but EF values and heart rate dropped (P <0.05).Conclusion By this method,a model of AMI in rats can be established successfully and the heart function is changed.Under the condition of non-artificial ventilation,the weight of rats is an important factor for establishing AMI model.However,we have not confirmed the effect of thoracic lines on establishing AMI model yet.

Private cloud is an internal cloud featuring multi-tenant,dynamic configuration and optimization infrastructure,which enables developers to achieve service self-deployment and self-hosting within security coverage of the enterprise data center.This paper introduced the concept of cloud computing.Then it went on to present the private cloud architecture of the hospital by analysis of problems in the hospital including information construction costs,management and maintenance,and information expansion.In the end,the authors analyzed the cloud computing service model,hospital private cloud architecture,along with outcome analysis for hospital private cloud implementations.