Objective: To establish a prediction model for high-risk cardiovascular disease (CVD) among residents aged 35 to 75 years, so as to provide the basis for improving CVD prevention and control measures. Methods: Permanent residents aged 35 to 75 years were selected from Dongcheng District, Beijing Municipality using the stratified random sampling method from 2018 to 2023. Demographic information, lifestyle, waist circumference and blood biochemical indicators were collected through questionnaire surveys, physical examinations and laboratory tests. Influencing factors for high-risk CVD among residents aged 35 to 75 years were identified using a multivariable logistic regression model, and a prediction model for high-risk CVD was established. The predictive effect was evaluated using the receiver operating characteristic (ROC) curve. Results: A total of 6 968 individuals were surveyed, including 2 821 males (40.49%) and 4 147 females (59.51%), and had a mean age of (59.92±9.33) years. There were 1 155 high-risk CVD population, with a detection rate of 16.58%. Multivariable logistic regression analysis showed that gender, age, smoking, central obesity, systolic blood pressure, fasting blood glucose, triglyceride and low-density lipoprotein cholesterol were influencing factors for high-risk CVD among residents aged 35 to 75 years (all P<0.05). The area under the ROC curve of the established prediction model was 0.849 (95%CI: 0.834-0.863), with a sensitivity of 0.693 and a specificity of 0.863, indicating good discrimination. Conclusion The model constructed by eight factors including demographic characteristics, lifestyle and blood biochemical indicators has good predictive value for high-risk CVD among residents aged 35 to 75 years.

This paper summarized three developing conditions and five service modes of mental health social work in Shanghai by reading literature and investigating and interviewing the social work service of mental health medical institutions in Shanghai. Three challenges to mental health social work after COVID -19 were identified: firstly, the reduction of direct services led to a decrease in the number of service beneficiaries, and the effectiveness of services could not be guaranteed; secondly, the application of social work methods was forced to adjust, which challenges the service ability of social workers; thirdly, the expansion or increase of the scope of service objects and the insufficient number of social workers led to difficulties in service response. In view of the above challenges and problems, countermeasures are proposed: ensure the continuity of professional relationship and service effectiveness through flexible and diversified service methods; knit for social work online working ability training, increasing network service experience; the scope of service objects expanding gradually and multi-sectoral cooperation to prevent psychological problems in key groups; set up a volunteer team to serve mental health.

The clinical data of a patient with Klinefelter syndrome (KS) complicated by partial androgen insensitivity syndrome (PAIS) was retrospectively analyzed.The patient, a 2-month-and-22-day-old baby, was admitted to Children′s Hospital Affiliated to Zhengzhou University due to abnormal external genitalia in October 2021.Upon birth, the patient exhibited abnormal external genitalia, manifested as clitoral hypertrophy.Hormonal examinations were consistent with those of peers, while chromosomal analysis revealed 47, XXY.Due to the severe undermasculinization, whole exome sequencing was conducted, indicating a heterozygous variant of the AR gene (c.1847G>A, p.Arg616His). The patient was diagnosed with PAIS, and her elder sister was diagnosed with complete androgen insensitivity syndrome.For further treatment, a multidisciplinary comprehensive evaluation is needed.This is a rare case of KS combined with PAIS, suggesting the possibility of AR gene mutations in KS children with severe undermasculinization.

With the transformation of the concept and model of mental health service in China,the participation of social work in multidisciplinary team cooperation in mental health has become an important development trend.In order to explore the mode and path of multidisciplinary treatment involving social work in mental health,this study selected two typical wards of Shanghai Mental Health Center as typical cases through the double-case study method,and conducted in-depth interviews and participatory observation of the medical teams in the wards.The results show that medical social workers can participate in multi-disciplinary comprehensive treatment through the path of"service embedding-relationship embedding-system embedding".In this process,the"resource-demand"response mode,power acquisition,daily interaction,discourse integration,and service mecha-nism reconstruction are important action strategies to achieve the service embeddedness of social workers.Different strategies de-termine the final different service modes.In the future,the participation of medical social work in multidisciplinary comprehen-sive treatment mode should not only strengthen micro-practice,but also form macro-institutional guarantee.

Objective:To investigate the correlations of urinary adverse reactions with dose to the bladder and urethra during external pelvic irradiation for locally advanced cervical cancer.Methods:This study retrospectively collected relevant dosimetric parameters and urinary symptoms, such as frequent, urgent, and painful urination, from locally advanced cervical cancer patients treated with external pelvic irradiation in the Department of Oncology, Affiliated Hospital of Guizhou Medical University. The dosimetric parameters examined in this study included the maximum, minimum, and mean doses to bladder and urethra (i.e., Dmax, Dmin and Dmean), mean doses received in an area of 0.1, 1, and 2 cm 3 around the planning target volume, D0.1 cm 3, D1 cm 3, D2 cm 3, and percentages of irradiated volumes in the whole organ volume under doses of 5, 10, 15, 20, 25, 30, 35, 40, 45, 50 Gy, V5 Gy, V10 Gy, V15 Gy, V20 Gy, V25 Gy, V30 Gy, V35 Gy, V40 Gy, V45 Gy, V50 Gy. Then the correlations between urinary symptoms and these dosimetric parameters were analyzed using the independent-sample t-test and the Logistic regression model. Results:The median volumes of bladder and urethra were 294.8 and 4.71 cm 3, respectively. Patients were divided into two groups based on the median division. The univariate analysis showed that urethral Dmax, Dmin, Dmean, V5 Gy, V10 Gy, V15Gy, V20 Gy, V25 Gy, V30 Gy, V35 Gy, V40 Gy, V45 Gy and V50 Gy correlated with urinary complications ( t = 14.30, 21.65, 32.19, 33.36, 16.62, 17.91, 21.52, 20.11, 12.27, 37.25, 30.18, 36.24 and 21.98, P<0.05). The multivariate analysis further indicates that urethral D2 cm 3, V20 Gy, V40 Gy and Bladder V40 Gy, D1 cm 3, D2 cm 3 were independent predictors of grade 2 urinary adverse reactions ( P<0.05). Conclusions:This study reported the correlations of relevant dosimetric parameters of urethra with urinary toxicity during external pelvic irradiation. It holds that urethral D2 cm 3, V20 Gy and V40 Gy should be restricted to minimize the risks of grade 2 urinary complications.

Objective With the assistance of 3D visualization and real-time navigation technologies,the tumors in the parapharyngeal and lateral skull base should be removed through oral the approach with endoscopy.Methods The preoperative CT data of eight patients with parapharyngeal or lateral skull base soft tissue tumors were modeled,and the anatomical position relationship between the tumor and surrounding blood vessels and other important structures was re-constructed using 3D visualization technology,and preop-erative design was performed.The intraoperative oral ap-proach and real-time navigation guidance were adopted in the endoscopic resection of soft tissue tumors in the parapharyngeal and lateral skull base,and the clinical ap-plication value of this method was evaluated.Results The blood loss during the operation was controlled within 150 mL,and the average blood loss was approximately 125 mL.The incidence of postoperative complications was low,and patients could recover well through functional training.The oral approach did not leave any wounds nor scars on the patient's facial skin after the operation and had no effect on the patient's appearance.Conclusion The combination of 3D visualization technology,intraoperative real-time navigation,and endoscopy provides a beautiful,safe,and minimally invasive surgical method for patients with parapharyngeal or lateral skull base tumors.

Objective: To evaluate the dietary quality of residents in Wenzhou City, Zhejiang Province, so as to provide the basis for future health education and nutrition intervention programs. Methods: A stratified multi-stage random sampling method was used to select residents aged 18 years and older in 6 counties (cities, districts) of Wenzhou City as the study subjects, “24-hour dietary review for 3 consecutive days” was adopted to collect dietary intake, and the diet balance index (DBI_16) scoring method was applied to evaluate the dietary quality. Results: This study analyzed the dietary quality of 406 residents in Wenzhou City, including 197 males (48.52%) and 209 females (51.48%). The majority of the residents were aged 18-44 years (254 residents, 62.56%). The median DBI total score was -31 (interquartile range, 8), and 404 residents had insufficient dietary intake, accounting for 99.51%. The median DBI positive score was 5 (interquartile range, 6), and 288 residents had appropriate dietary intake, accounting for 70.94%. The median DBI negative score was 37 (interquartile range, 6), and 210 residents had a high level of insufficient dietary intake, accounting for 51.72%. Five dietary patterns, namely A, B, C, E and F, were identified, with pattern B being the most dominant, accounting for 75.62% of the total (307 individuals). Patterns D, H, I and G were not observed. Conclusions The dietary quality of the residents surveyed indicates the existence of dietary imbalances, mainly manifesting as inadequate intake. It is recommended to strengthen nutritional and health guidance.

Objective To explore the effects of airflow stimuli on human immunoglobulin concentrations in a warm environment,and to discuss and analyze the correlations between immunoglobulin concentrations and subjective questionnaires results.Methods Dynamic airflow of different modes was created by a modified wind blowing device in the climate chamber.Then the changes of S-IgA and S-IgE concentrations of 12 subjects exposed to different airflow environments were measured,during which the TSV,TCV,draught perception,satisfaction with the airflow,and airflow discomfort symptom polling of the subjects were investigated.Results The S-IgA concentration increased by 56.3%after blowing in the warm environment,but the subsequent high air speed condition resulted in a decrease of S-IgA concentration by 24.8%.Both S-IgA and S-IgE had the highest concentrations when the TSV was neutral,and the S-IgA concentration was 176%higher under comfortable conditions than that under uncomfortable conditions.The S-IgA concentration showed an inverted"U"-shaped relationship with the average wind speed,and the highest S-IgA concentration was observed when the mean air speed was 1.0 m/s.Conclusion Dynamic airflow has a significant effect on S-IgA concentration but little effect on S-IgE concentration.Comfortable airflow in a warm environment could benefit the S-IgA concentration elevation thus the respiratory immunity.However,a strong draught perception caused by high wind speeds and an unsatisfactory airflow environment can lead to lower S-IgA concentrations.

Objective To explore the risk factors for vaginal stump recurrence after early cervical cancer surgery.Methods A total of 243 patients who underwent radical cervical cancer surgery in the First Affiliated Hospital of Henan University of Science and Technology from January 2018 to March 2020 were selected as the research subjects and divided into recurrence group(n=21)and non-recurrence group(n=22)based on whether vaginal stump recurrence occurred within 3 years after surgery.The clinical data of patients in the two groups,including age,pathological type,International Federation of Gynecology and Obstetrics(FIGO)staging of cervical cancer,degree of tissue differentiation,surgical approach,distance between surgical margin and tumor,muscle layer infiltration,presence or absence of lymph node involvement at diagnosis of cervical cancer,number of tumor budding,presence or absence of vascular cancer thrombus,vaginal resection length,and postoperative radiotherapy site were collected.One-way analysis of variance and binary logistic regression were used to analyze the risk factors for vaginal stump recurrence after early cervical cancer surgery.Results The recurrence rate of vaginal stumps within 3 years after early cervical cancer surgery was 8.64％(21/243).There were statistically significant differences in the pathological types,distance between surgical margin and tumor,muscle layer infiltration,number of tumor budding,vaginal resection length,and postoperative radiotherapy site of patients between the recurrence group and non-recurrence group(P＜0.05);there was no statistically significant difference in the age,FIGO stage,degree of tissue differentiation,surgical approach,presence or absence of lymph node involvement at diagnosis of cervical cancer,presence or absence of vascular cancer thrombus of patients between the two groups(P＞0.05).The binary logistic regression analysis showed that the distance between the surgical margin and the tumor≤3.5 mm,the number of tumor budding＞5,and the vaginal resection length≤2 cm were risk factors for vaginal stump recurrence after early cervical cancer surgery(P＜0.05),while postoperative pelvic radiotherapy combined with vaginal brachytherapy was a protective factor for vaginal stump recurrence after early cervical cancer surgery(P＜0.05).Conclusion The risk of vaginal stump recurrence after early cervical cancer surgery is high.The distance between the surgical margin and tumor≤3.5 mm,the number of tumor budding＞5,and the vaginal resection length≤2 cm are risk factors for vaginal stump recurrence after early cervical cancer surgery;pelvic radiotherapy combined with vaginal brachytherapy can reduce the risk of vaginal stump recurrence after early cervical cancer surgery.

Objective:To explore the histopathological factors affecting the stiffness of papillary thyroid carcinoma (PTC).Methods:Ninety-six patients with PTC confirmed by surgery and pathology in Shanxi Bethune Hospital from January 2019 to December 2020 were selected, including 101 nodules. Two-dimensional ultrasound and shear-wave elastography (SWE) were performed before surgery and the average Young's modulus (Emean) of PTC nodules were measured. Histopathological examinations on the nodules were conducted after surgery to decide the lesion size, number of lesions, calcification type, presence or absence of capsular and extracapsular invasion, degree of fibrosis, microvessel density, and number of tumor cells. The correlations between the lesion size, degree of fibrosis, microvessel density, and number of tumor cells and the Emean were analyzed. The Emeans of nodules with different numbers of lesions, presence or absence of capsular and extracapsular invasion, and different pathological calcification types were compared. The multiple linear regression analysis was used to evaluate the histopathological factors influencing the Emean.Results:The ranges of the lesion sizes, degrees of fibrosis, microvascular density, numbers of tumor cells, and the Emeans of the 101 investigated PTC nodules were (1.29±0.95) cm, (30.64±18.37)%, (101.64±30.7) vessels per high power field, (373.52±149.87) cells per high power field, and (36.47±19.62) kPa, respectively. Correlation analysis showed that the lesion size of PTC and the degree of fibrosis were positively correlated with the Emean ( r=0.660, P＜0.001; r=0.789, P＜0.001), while the microvessel density was negatively correlated with the Emean ( r=-0.198, P=0.047). The Emean of the group with capsular and extracapsular invasion was higher than that of the group without ( P=0.014). There were statistical differences in the Emeans among different types of pathological calcification ( P＜0.001). The multiple linear regression analysis showed that the lesion size ( β=0.325, P＜0.001), degree of fibrosis ( β=0.563, P＜0.001), psammoma bodies ( β=0.177, P=0.001), stromal calcification ( β=0.164, P=0.003), and mixed calcification of both psammoma bodies and stroma ( β=0.163, P=0.003) were independent influencing factors for the Emean. The degree of fibrosis had the greatest impact on the Emean. Conclusions:The Emean of PTC lesions was correlated with the histopathological characteristics of PTC. The lesion size, degree of fibrosis, and calcification had significant impact on the Emean, among which the degree of fibrosis had the greatest impact.