Objective To explore the research dynamics and hotspots of project management in the field of hospital man-agement,and analyze the contents that still need to be improved,so as to provide references for the subsequent research,and provide hospital managers with practical experience in hospital management.Methods Based on the PubMed database,we used the citexs data analysis platform to analyze the literature and big data from January 2012 to December 2022 on the application of project management in the field of hospital management.Results The effective literature was retrieved from 4236 articles,and the analysis found thatthe annualnumberofpublicationsinthisfield hasbeenincreasing,2021 sawthe highestannualnumberof 573 articles,and the fastest growth rate was 20.36% in 2017.The country with the most publications is the United States(1 546 articles,36.5% ),the research institution with the most publications is Monash University,Australia,the journal with the most publications is BMJ Open(124 articles),and the key words with the highest frequency of occurrence in the retrieved literature are quality improvement,primary care improvement,covid-19,telemedicine.Conclusion The research in this field has been rapidly developed and is in a fast rising phase.In almost every organization and industry,the share of project management or"projectization"is increasing,and project management has become an important part of hospital management research and prac-tice.In the context of building a modern hospital management system,the application of project management to hospital manage-ment is an effective means of improving the level of fine hospital management.

Purpose To assess the right atrial and right ventricular strain and right ventricular-pulmonary artery(RV-PA)coupling in rheumatoid arthritis(RA)via two-dimensional speckle tracking.Materials and Methods Sixty patients with RA in the General Hospital of Ningxia Medical University from June 2020 to June 2022 were prospectively selected,and all RA patients were divided into three groups according to pulmonary artery systolic pressure(PASP),including group A(n=20 cases)with PASP<33 mmHg,group B(n=20 cases)with PASP 33-39 mmHg as mild ePH,and group C(n=20 cases)PASP≥40 mmHg,twenty healthy individuals were selected as the control group.All subjects underwent transthoracic echocardiography,and right atrial and right ventricular systolic function was assessed by two-dimensional speckle tracking technique,and RV-PA coupling was assessed noninvasively by right ventricular free wall strain/pulmonary artery systolic pressure(RV FWS/PASP),pulmonary function was analyzed by pulmonary function instruments.Spearman's analysis was used to analyze the correlation between right heart function and RV-PA coupling to pulmonary diffusion function.Results There were statistical differences in right ventricular base diameter,right atrium diameter,tricuspid annular plane systolic excursion,inferior vena cava diameter,PASP,right ventricular global strain,RV FWS,right atrium strain-reservoi,right atrium strain-conduit(S-CD),RV FWS/PASP among the four groups(F/H=2.369-74.880,all P<0.05).Right atrium strain-reservoi[(36.0±7.9)%vs.(30.9±7.8)%],right atrium S-CD[(19.9±6.9)%vs.(15.3±4.7)%]and RV FWS/PASP(0.96±0.19 vs.0.56±0.13)in group B were significantly lower than those of group A(t=2.040,2.262,7.704,all P<0.05).There was a good correlation between diffusing capacity of the lung for carbon monoxide single-breathmethod and right ventricular global strain,RV FWS,right atrium S-CD and RV FWS/PASP in RA patients(r=0.392,0.472,0.431,0.572,all P<0.05).Conclusion The more increases of pulmonary artery pressures,the more decreases of right heart function in RA patients,and the more uncoupling in RV-PA.Right heart dysfunction and right ventricle-pulmonary artery uncoupling have developed in RA patients with PASP 33-39 mmHg,with association of pulmonary diffusion dysfunction.

Objective To observe the value of left atrial strain combined with electrocardiogram(ECG)P-wave parameters for predicting recurrence of paroxysmal atrial fibrillation(PAF)after pulmonary vein isolation(PVI)using radiofrequency catheter.Methods Totally 88 PAF patients who planned to receive the first PVI were prospectively enrolled and divided into recurrence group(n=30)and non-recurrence group(n=58)according to results of ECG within 6 months after PVI.The patients'basic data,the transthoracic echocardiography(TTE)parameters,including left atrial reservoir strain(LASr),left atrial conduct strain(LAScd)and left atrial contraction strain(LASct),as well as ECG parameters including P-wave duration,PR interval and P/PR(the ratio of P-wave duration to PR interval)were compared between groups.Multivariate logistic regression analysis was performed of parameters being statistically different between groups to screen independent predictors for recurrence of PAF after PVI.The receiver operating characteristic curve and the area under the curve(AUC)were used to evaluate the predicting efficacy of individual independent predictors alone and their combination,and DeLong test was used for comparison.Results No significant difference of patients'basic data was found between groups(all P＞0.05).Compared with those in non-recurrence group,LASr and LAScd decreased while P/PR increased in recurrent group(all P＜0.05).LASr(OR=0.805),LAScd(OR=0.850)and P/PR(OR=1.119)were all independent predictors for recurrence of PAF after PVI(all P＜0.05),with AUC of 0.755,0.643 and 0.771,respectively,all lower than their combination(AUC=0.869)(all P＜0.05).Conclusion TTE and ECG parameters could be used to predict recurrence of PAF after PVI.The predicting efficacy of the combination of LASr,LAScd and P/PR was better than that of each alone.

Objective: To track and investigate the changes in visual acuity of primary and secondary school students in Henan Province during the COVID-19 pandemic home confinement, so as to provide theoretical basis for the prevention and control of myopia. Methods: A cohort study design was employed for this research. In September 2019, visual acuity tests were conducted among 2 222 primary and secondary school students by Multi stage random cluster sampling method from four cities in Henan Province, including Zhengzhou, Xinxiang, Zhoukou, and Pingdingshan. A follow up study was conducted in June 2020, with on site visual acuity tests and questionnaire surveys. Wilcoxon rank sum test, Kruskal Wallis rank sum test, Chi square test, one way analysis of variance, and multiple linear regression model were used to analyze the changes in visual acuity of primary and secondary school students and the influencing factors from 2019 to 2020. Results: Compared with 2019, the overall myopia rate of students increased in 2020, and the difference was statistically significant (55.7%, 64.9%, χ 2=1 035.91, P <0.01), and the difference between mild, moderate and severe myopia rates occurred at 2 years (2019:32.4%, 18.8%, 4.4%, 2020:36.7%, 22.5%, 5.7%, χ 2= 8.43, 9.23, 3.94, P <0.05). The myopia incidence rate of primary and secondary school students in 2020 was 28.3%. As presented in multiple linear regression analysis, middle school, grade 4th-6th and grade 1st-3rd of primary school, low economic level, using television for online classes, the study desk being not bright on sunny days, without looking far away during breaks, the brightness of the study desk and desktop which was average on sunny days, and using roof lamp only when studying at night were associated with myopia progression among students ( B=-0.16, -0.18, -0.20, -0.06, -0.21, -0.13, -0.11, -0.40, P <0.05). Conclusions During 2019-2020, primary and secondary school students in Henan Province experience a progression towards myopia, which is comprehensively influenced by education stage, economic level, the habit of using eyes, and visual environment. Myopia prevention and control should be actively intervened and strengthened to improve the eye environment for primary and secondary school students, in order to slow down the development of myopia.

Pathological insulin resistance (IR) is closely related to gestational diabetes mellitus (GDM) and adverse pregnancy outcomes in women with GDM. Increasing studies have investigated the efficacy of IR indices, such as quantitative insulin sensitivity index, homeostasis model assessment of insulin resistance, triglyceride-glucose index and sex hormone-binding globulin, in predicting GDM and related complications in recent years. This article reviews the research progress in the above topics.

Objective:To explore the characteristics of echocardiographic parameters among the many parameters of two-dimensional transthoracic echocardiography(2D-TTE) and three-dimensional speckle tracking imaging (3D-STI) that can be used for early identification of familial hypertrophic cardiomyopathy(FHCM) mutation gene carriers, and construct a Nomogram prediction model, in order to provide a diagnostic method for early identification of G+ P- patients for clinical practice.Methods:A total of 15 FHCM families admitted to the General Hospital of Ningxia Medical University from November 2017 to August 2022 were enrolled.Whole exome sequencing and Sanger sequencing technology were used for gene detection, among which 54 were G+ P- and 75 were G-P-. Stratified random sampling was used to divide the subjects into training set ( n=90) and test set ( n=39) according to the ratio of 7∶3. Philips iE33 ultrasonic diagnostic instrument and TomTec offline software were used to obtain relevant ultrasonic parameters. Lasso regression and Logistic regression were used to screen echocardiographic parameters and obtain independent risk factors for early prediction of G+ P-, based on which a Nomogram prediction model was established. Results:①Lasso-Logistic regression showed that global longitudinal strain(GLS) ( OR=1.739, 95% CI=1.305-2.316) and left ventricular outflow trac velocity time integral(LVOT-VTI) ( OR=1.358, 95% CI=1.072-1.722) could be used as independent risk factors for early prediction of G+ P-. ②The Nomogram prediction model was established based on the above indicators. After 1000 internal verifications of Bootstrap self-sampling, the C-indices of the training set and the test set were 0.885 (95% CI=0.816-0.954), 0.878 (95% CI=0.764-0.992), which had good internal consistency. ③The results of the calibration curve showed that the risk of G+ P- predicted by the Nomogram model was basically consistent with the actual risk (training set P=0.990, test set P=0.961); the clinical decision curve shows that under different threshold probabilities, using this prediction model to provide patients with clinical decision-making could bring benefits to patients. Conclusions:Echocardiographic parameters GLS and LVOT-VTI can be used as independent risk factors to predict FHCM mutation gene carriers. The Nomogram prediction model has good discrimination, goodness of fit and clinical benefit in identifying whether the family members of FHCM patients carry the mutation gene, and it can provide a new idea and evaluation method for the early identification of FHCM mutation gene carriers by echocardiography.

Animals ; Mice ; Corticotropin-Releasing Hormone/metabolism* ; Neurons/metabolism* ; Brain/metabolism*

BACKGROUND: Sarcopenia is an age-related progressive skeletal muscle disorder involving the loss of muscle mass or strength and physiological function. Efficient and precise AI algorithms may play a significant role in the diagnosis of sarcopenia. In this study, we aimed to develop a machine learning model for sarcopenia diagnosis using clinical characteristics and laboratory indicators of aging cohorts. METHODS: We developed models of sarcopenia using the baseline data from the West China Health and Aging Trend (WCHAT) study. For external validation, we used the Xiamen Aging Trend (XMAT) cohort. We compared the support vector machine (SVM), random forest (RF), eXtreme Gradient Boosting (XGB), and Wide and Deep (W&D) models. The area under the receiver operating curve (AUC) and accuracy (ACC) were used to evaluate the diagnostic efficiency of the models. RESULTS: The WCHAT cohort, which included a total of 4057 participants for the training and testing datasets, and the XMAT cohort, which consisted of 553 participants for the external validation dataset, were enrolled in this study. Among the four models, W&D had the best performance (AUC = 0.916 ± 0.006, ACC = 0.882 ± 0.006), followed by SVM (AUC =0.907 ± 0.004, ACC = 0.877 ± 0.006), XGB (AUC = 0.877 ± 0.005, ACC = 0.868 ± 0.005), and RF (AUC = 0.843 ± 0.031, ACC = 0.836 ± 0.024) in the training dataset. Meanwhile, in the testing dataset, the diagnostic efficiency of the models from large to small was W&D (AUC = 0.881, ACC = 0.862), XGB (AUC = 0.858, ACC = 0.861), RF (AUC = 0.843, ACC = 0.836), and SVM (AUC = 0.829, ACC = 0.857). In the external validation dataset, the performance of W&D (AUC = 0.970, ACC = 0.911) was the best among the four models, followed by RF (AUC = 0.830, ACC = 0.769), SVM (AUC = 0.766, ACC = 0.738), and XGB (AUC = 0.722, ACC = 0.749). CONCLUSIONS: The W&D model not only had excellent diagnostic performance for sarcopenia but also showed good economic efficiency and timeliness. It could be widely used in primary health care institutions or developing areas with an aging population. TRIAL REGISTRATION Chictr.org, ChiCTR 1800018895.
Humans ; Aged ; Sarcopenia/diagnosis* ; Deep Learning ; Aging ; Algorithms ; Biomarkers

Objective:To evaluate the changes of left ventricular (LV) myocardial systolic strain and twist motion including global longitudinal strain(GLS), global circumferential strain(GCS), global radial strain(GRS), global area strain(GAS), LV basal segment rotation angle (Rotation-basal), LV apical segment rotation angle (Rotation-apical), LV twist angle (Twist), LV torsion(Torsion) by three-dimensional speckle tracking imaging(3D-STI) in adult patients with hypertrophic cardiomyopathy (HCM), and further to analyze the correlations between LV twist and its morphology and global systolic function.Methods:A total of 45 patients with HCM from the General Hospital of Ningxia Medical University from September 2017 to June 2019 were enrolled. In addition, 50 healthy subjects were recruited as a control group. Left atrial dimension(LAD), interventricular septal end-diastole dimension(IVSD), LV posterior wall end-diastole dimension (LVPWD), LV mass index(LVMI) and other parameters were respectively measured by conventional two-dimensional transthoracic echocardiography. LV end-diastole volume(EDV), LV end-systole volume(ESV), calculated stroke volume(SV) and LV ejection fraction (LVEF) were respectively measured by 3D transthoracic echocardiography. Full-volume 3D dynamic images were performed using matrix transducer X5-1. LV Rotation-basal, Rotation-apical, Twist and Torsion, GLS, GCS, GRS and GAS were respectively analyzed by off-line TomTec software. The differences of those parameters between the two groups were compared. The correlations between 3D-Torsion parameters and those parameters by two-dimensional echocardiography was further analyzed.Results:Compared with control group, LAD, IVSD, LVPWD and LVMI of HCM group were increased(all P<0.01), EDV, ESV, SV, LVEF and E/A were decreased(all P<0.01). Compared with control group, GLS, GCS and GRS of HCM group were decreased(all P<0.01). Rotation-basal, Rotation-apical, Twist and Torsion were increased(all P<0.01), and there was no significant difference of GAS between the two groups( P>0.05). In HCM group, IVSD was not correlated with Rotation-basal ( P>0.05), but negatively correlated with Rotation-apical, Twist and Torsion ( r=-0.327, -0.439, -0.374; all P<0.05); LVEF and LVMI were not correlated with Rotation-basal, Rotation-apical, Twist and Torsion (all P>0.05). Conclusions:①3D-STI can detect the earlier subtle changes of left ventricular three-dimensional systolic strain in HCM patients; ②LV three-dimensional Twist inereases considerably in HCM patients; ③LV Twist, Torsion and Rotation-apical are significantly decreased with the increase of IVSD in HCM patients; However, LVEF and LVMI are not significantly correlated with Rotation-basal, Rotation-apical, Twist and Torsion.

Tumor associated macrophage (TAM), as the main type of immune cells in tumor microenvironment, becomes an active participant in the development of breast cancer. MicroRNA (miRNA) can regulate post-transcriptional gene expression, modulation of macrophage function by affecting its polarization typing and transformation, and ultimately contribute to the occurrence and development of breast cancer. It could provide a new diagnosis and clinical treatment strategy for the treatment of breast cancer by summarizing the mechanisms of miRNA in the polarization of TAM.