Objective To systematically evaluate the predictive models for re-admission in patients with heart failure (HF) in China. Methods Studies related to the risk prediction model for HF patient re-admission published in The Cochrane Library, PubMed, EMbase, CNKI, and other databases were searched from their inception to April 30, 2024. The prediction model risk of bias assessment tool was used to assess the risk of bias and applicability of the included literature, relevant data were extracted to evaluate the model quality. Results Nineteen studies were included, involving a total of 38 predictive models for HF patient re-admission. Comorbidities such as diabetes, N-terminal pro B-type natriuretic peptide/brain natriuretic peptide, chronic renal insufficiency, left ventricular ejection fraction, New York Heart Association cardiac function classification, and medication adherence were identified as primary predictors. The area under the receiver operating characteristic curve ranged from 0.547 to 0.962. Thirteen studies conducted internal validation, one study conducted external validation, and five studies performed both internal and external validation. Seventeen studies evaluated model calibration, while five studies assessed clinical feasibility. The presentation of the models was primarily in the form of nomograms. All studies had a high overall risk of bias. Conclusion Most predictive models for HF patient re-admission in China demonstrate good discrimination and calibration. However, the overall research quality is suboptimal. There is a need to externally validate and calibrate existing models and develop more stable and clinically applicable predictive models to assess the risk of HF patient re-admission and identify relevant patients for early intervention.

Humans ; Aged ; Lung Diseases ; Pneumonia/drug therapy* ; Adrenal Cortex Hormones/therapeutic use* ; Pulmonary Disease, Chronic Obstructive/drug therapy* ; Administration, Inhalation ; Community-Acquired Infections/drug therapy*

Objective:To explore expression of each member of miR17-92 cluster in peripheral blood mononuclear cells(PBMCs)of patients with gout,to predict their possible targets and pathways of action,and to evaluate their possible mechanism and clinical significance in gout.Methods:A total 67 gouty arthritis(GA)patients were selected,including 22 patients with acute gout arthritis(AG)and 45 patients with intermittent gout(IG),and 35 normal health control(HC)were selected in Affiliated Hospital of North Sichuan Medical College.RT-qPCR measured expressions of miR17-92 cluster,IFN-γ,IL-10 and some members of JAK-STAT pathway,and relevant laboratory indicators were collected to analyze correlation between each other.Results:Relative expressions of miR17,miR18a,miR19a,miR20a and miR19b were significantly changed in AG,IG and HC(H=8.753,P<0.05;H=6.338,P<0.05;H=6.523,P<0.05;H=9.061,P<0.05;H=9.729,P<0.01).JAK3 and STAT2 expressions were statistically different in AG,IG and HC groups(H=10.349,P<0.01;H=14.801,P<0.01).Expression of IFN-γ was statistically different among AG,IG and HC groups(H=8.734,P<0.05).In AG patients,miR18a expression was inversely correlated with IBIL,Crea,MO and HGB.miR19a ex-pression was negatively associated and TC,UA and HGB.miR20a expression was negatively associated with Crea.miR19b expression was negatively associated with UA and HGB.In IG patients,miR17 expression was negatively associated with IBIL,WBC,LY and MO.miR18a expression was positively associated with ALP,miR19a expression was negatively associated with TC and UA,and miR20a expression was negatively associated with ADA and UA.Conclusion:miR17-92 cluster may regulate development and partici-pate in clinical pathology of gout by targeting JAK-STAT pathway.

Objective To build a knowledge graph;To visualize the knowledge structure relationships and clinical thinking in the treatment of coronary heart disease by renowned TCM doctors;To provide methodological reference for the inheritance of experience of renowned TCM doctors.Methods Medical records about treatment of coronary heart disease by renowned TCM doctors were retrieved from CNKI from the establishment of the database to 30th,Nov.2022.The characteristics of TCM diagnosis and treatment and the characteristics of the theoretical system of syndrome differentiation and treatment in TCM were analyzed.Concept types and relationships between concepts were sorted out and extracted to form a pattern layer of knowledge graph;based on the characteristics of the pattern layer,Python 3.11(PyCharm 2022.3.2)was used to write rules,and knowledge extraction and data import were implemented through the Pandas library,Openpyxl library and Py2neo library,which were stored in the graph database Neo4j-Community-5.2.0 to complete the construction of the knowledge graph.Implementing query application was realized through Cypher language.Results The data of 643 medical cases of 144 renowned TCM doctors were included,which were entered into the Neo4j graph database,forming a knowledge graph consisting of 2 744 nodes and 23 795 relationships under 8 concepts and 10 relationships,to achieve visual presentation and query application of the diagnosis and treatment process of coronary heart disease by renowned TCM doctors.Conclusion The knowledge graph can intuitively display the relationship of diseases-symptoms-syndromes-treatments-prescriptions-medicine in medical records,develop a knowledge system that is easy to retrieve,and improve the accessibility of domain knowledge,which can provide methodological reference for the inheritance of experience of renowned TCM doctors.

Objective To explore artificial reconstruction vs artificial intelligence reconstruction in coronary artery volume rendering(VR).Methods A total of 110 coronary heart disease(CHD)patients were enrolled in the study,and underwent computed tomography arteriography.Artificial reconstruction(artificial group)and artificial intelligence reconstruction(intelligent group)were conducted in coronary artery VR.The image quality of VR and curved planar reconstruction(CPR),the diagnosis coincidence rate of arterial stenosis,and vascular reconstruction score were compared between two groups.Results The VR image quality of intelligent group was significantly higher than that of artificial group,with excellence rate of 90.91%vs 80.00%;and intelligent group scored higher than artificial group in CPR image quality(P<0.05).The differences in the diagnostic coincidence rates of arterial vessels(RCA,LAD,LCX)with no stenosis,slight stenosis,moderate stenosis,and vascular occlusion between two groups were trivial(P>0.05),while the two groups differed significantly in the diagnosis coincidence rates of mild stenosis and severe stenosis(P<0.05).The mean total score,the median value of the 3 main branches+posterior descending branch+intermediate branch+diagonal branch+blunt margin branch,and the median value of the other vascular branches were all significantly increased in intelligent group as compared with artificial group(P<0.05).Conclusion Artificial intelligence reconstruction has higher application value than artificial reconstruction in coronary artery VR.

OBJECTIVE：To study the intervention eff ects and pot ential m echanism of celastrol on non-alcoholic steatohepatitis （NASH）induced by methionine-choline deficiency （MCD）diet. METHODS ：Male C 57BL/6J mice were randomly divided into normal control group ，model group ，celastrol low-dose and high-dose groups [ 0.5，1 mg/（kg·d）]，with 7 mice in each group. The normal control group was given a methionine-choline sufficient diet ，while the model group and administration groups were fed an MCD diet to induce NASH model. At the same time ，normal control group and model group were given polyoxyethylene castor oil intragastrically；administration groups were given relevant drugs intragastrically ；the volume of gavage was 0.1 mL/g，once a day ， for consecutive 4 weeks. The liver morphology was observed ，and the pathological changes of liver tissue were observed by HE staining and oil red O staining. The levels of serum liver enzymes （AST，ALT），and the levels of lipid indexes （TC，TG）in serum and liver tissue were detected by enzyme method. The protein expression of NF-κB p65，TNF-α and IL-6 in liver tissue were determined by Western blotting assay. RESULTS ：Compared with normal control group ，the volume of the liver was reduced and the color was yellow ，and the surface was rough in model group ；inflammatory cell infiltration ，fat vacuoles and lipid droplets aggregation were found in the liver tissue ；the serum levels of TC and TG were significantly decreased ，the levels of serum liver enzymes and protein expression of NF-κB p65，TNF-α and IL-6 in liver tissue were significantly increased （P＜0.01）. Compared with model group ，the liver surface of each administration group was ruddy and smooth without brown spots ，the inflammatory cells and fat vacuoles in liver tissue were reduced ，and the coverage area of lipid droplets was reduced ；the levels of serum TC and TG were significantly increased ，the levels of serum liver enzymes ，the levels of TG and protein expression of NF-κB，TNF-α and IL-6（except for celastrol low-dose group ）in liver tissue were significantly decreased （P＜0.05 or P＜0.01）. CONCLUSIONS ： Celastrol can improve the liver injury of NASH model mice induced by MCD diet ，which is related to the reduction of TG accumulation in liver tissue and inhibition of the expression of inflammatory related factors.

Objective To investigate the risk factors of heart failure in patients with non-dialysis chronic renal failure,to provide a reference for the prevention and treatment of heart failure.Methods A total of 289 patients in Renmin Hospital of Wuhan University from January 2015 to January 2017 were enrolled in this retrospective study.They were divided into two groups according to the occurrence of heart failure General information,relevant auxili-ary examination and laboratory tests were collected to analyze.Multivariate Logistic regression was used to analyze the risk factors of heart failure in patients with chronic renal failure.Results Univa-riate analysis showed that diabetes,blood pressure,anemia,myocardial damage,albumin,renal function,myocardial hypertrophy,pericardial effusion in the two groups were statistically significant(P ＜ 0.05).Logistic regression analysis showed that diabetes (OR =2.308,P =0.002),hypertension (OR =2.464,P =0.000),elevated creatine kinase (OR =3.065,P =0.000),hypoalbuminaemia (OR =0.845,P =0.000),hypocalcemia (OR =0.062,P =0.000),hyperphosphatemia (OR =2.868,P =0.000) were independently associated with heart failure in patients of chronic renal failure.Conclusion Diabetes mellitus,hypertension,myocardial in-jury,low albumin,imbalance of calcium-phosphorus metabolism are risk factors for heart failure.Paying attention to these factors is of great significance to the prevention and treatment of heart failure.

Objective To investigate the prevalence of iron deficiency(ID)and iron deficiency anemia (IDA) in pregnant women in urban areas of China. Methods The study was a national cross-sectional survey conducted from September 19th, 2016 to November 20th, 2016. According to the classification of the National Bureau of Statistics, all survey sites were set up in 6 regions of the country. Pregnant women were continuously selected using multistage stratified sampling. A total of 12 403 pregnant women were collected and examined for serum ferritin and hemoglobin levels. Results The median serum ferritin level during pregnancy was 20.60 μg/L(11.78-36.98 μg/L), the hemoglobin level was(118±12)g/L. With the progress of pregnancy, the levels of serum ferritin and hemoglobin decreased gradually. The median serum ferritin levels in the first, second trimester and third trimester were 54.30 μg/L(34.48-94.01 μg/L), 28.60 μg/L(16.40-50.52 μg/L), and 16.70 μg/L(10.20-27.00 μg/L)respectively(P<0.01). The mean hemoglobin levels were(127 ± 10)g/L,(119 ± 11)g/L and(117 ± 11)g/L respectively(P<0.01). The prevalence of ID in urban pregnant women was 48.16%(5 973/12 403), and IDA prevalence was 13.87% (1 720/12 403). The prevalence of IDA in the first, second trimester and third trimester were 1.96% (20/1 019), 8.40%(293/3 487)and 17.82%(1 407/7 897), respectively(P<0.01). The prevalence of standardized ID and IDA were significantly different in various regions of China(P<0.01). The standardized prevalence of ID were relatively higher in East China and Northeast China, 57.37% and 53.41% respectively, while it was the lowest in Southwest China, 30.51%. The standardized prevalence of IDA in South Central, Northwest, and East China were relatively high, 21.30%, 16.97% and 17.53% respectively, and the standardized prevalence of IDA in Southwest China was the lowest, 5.44%,the differents in various regions were significant(all P<0.01). Conclusion The current phenomenon of ID and IDA in pregnant women is still very common,and nutrition and health care during pregnancy should be strengthened.

Objective To evaluate the efficacy of erector spinae plane block (ESPB) combined with general anesthesia when used for thoracoscopic radical resection of lung cancer.Methods Forty patients of both sexes,aged 30-64 yr,with body mass index of 18-24 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective thoracoscopic radical resection of lung cancer,were divided into 2 groups (n =20 each) using a random number table method:ESPB combined with general anesthesia group (group EG) and general anesthesia group (group G).ESPB was performed before anesthesia induction,and 20 min later the effect was evaluated by testing the area of block in group EG.Anesthesia was induced with midazolam,propofol,sufentanil and cisatracurium and maintained with sevoflurane and remifentanil to maintain the bispectral index value between 40 and 60.Patient-controlled intravenous analgesia was applied in both groups at the end of operation,flurbiprofen axetil 100 mg was intravenously injected as a remedy for analgesia when necessary,and the visual analog scale score was maintained less than or equal to 3.The intraoperative consumption of sulfentanil and remifentanil,emergence time from anesthesia and time of tracheal extubation were recorded.The development of adverse effects within 48 h after operation,postoperative length of hospital stay,requirement for rescue analgesia and patients' overall satisfaction with postoperative analgesia were also recorded.Results Compared with group G,the intraoperative consumption of sulfentanil and remifentanil was significantly decreased,the emergence time from anesthesia and time of tracheal extubation were shortened,the incidence of nausea and vomiting within 48 h after operation was decreased,the first occurrence time was prolonged,the requirement for rescue analgesia was decreased,postoperative length of hospital stay was shortened,and patients' satisfaction scores were increased in group EG (P＜0.05).Conclusion ESPB combined with general anesthesia can reduce the perioperative consumption of opioids and is helpful in improving prognosis when used for thoracoscopic radical resection of lung cancer.

Objective To study efficacy and prognostic analysis of metoprolol combined with trimetazidine in treating 86 patients with ischemic heart failure.Methods A total of 172 patients with ischemic heart failure in our hospital were randomly divided into experimental group (n =86) and control group (n =86).On the basis of conventional symptomatic treatment,the control group was treated with trimetazidine,while the observation group was combined with metoprolol,continuous treatment was lasted for 12 weeks.The systolic blood pressure (SBP),diastolic blood pressure (DBP),heart rate (HR),ultrasonic cardiogram and clinical efficacy between the two groups were-compared.After 1 year of follow-up,the incidence of cerebral infarction was recorded.Results The results of SBP,DBP,HR and ultrasonic cardiogram in the two groups were significantly improved compared with treatment before (P ＜ 0.05);The SBP,DBP and HR in the experimental group were significantly lower than that of the control group (P ＜ 0.05);The ultrasonic cardiogram,the left ventricular fractional shortening (FS),stroke volume (SV),cardiac output (CO),left ventricular end diastolic volume (LVEDV),left ventricular end systolic volume (LVESV),left ventricular ejection fraction (LEVF) were significantly better than that of the control group,the differences were statistically significant (P ＜ 0.05);The total effective rate in the observation group was significantly higher than that of the control group (P ＜ 0.0 5),the follow-up showed that the incidence of cerebral infarction in the observation group was significantly lower than that of the control group (P ＜ 0.05).Conclusion The effect of metoprolol combined with trimetazidine is significant for ischemic heart failure,and it's helpful for prevention of cerebral infarction.