Objective To explore the effects of air pressure, humidity, wind, and sunshine on the incidence of cardiovascular and cerebrovascular diseases (CVD) in Guiyang, and to provide reference for the prevention of CVD. Methods Using CVD incidence data from September 2021 to August 2022 in Guiyang City and meteorological data including average air pressure, average humidity, wind, and sunshine during the same period, the effects of meteorological factors on CVD incidence were explored and the importance of each factor was analyzed. Results When air pressure was below 868 hPa, above 887 hPa, or between 877 and 883 hPa, and when air pressure dropped less than 5.3 hPa within 24 hours, there was a higher risk of CVD. When the humidity was above 81%, the wind speed was small (<1.2 m/s) or high (>4m/s), and there was less sunlight (less than 3 hours), the risk of CVD was higher. Low humidity (<60%) was not conducive to the onset of CVD. There were highest risks at lag 5~10 days and 4-25 days for high pressure and low sunlight, respectively. When the relative humidity was saturated, there was an immediate effect. When the wind speed was low and high, the immediate effect and hysteresis effects were significant. Among the above meteorological factors, the impact of 24-hour variation of pressure and high or low atmospheric pressure on the incidence of CVD was the most significant, while the impact of sunlight and humidity was the weakest. The impact of diurnal variations in wind and atmospheric pressure was not clear. Conclusion The impact of air pressure on the incidence of CVD does not exhibit a simple linear relationship. The risk of CVD is high in high humidity, low light, and moderate or strong winds. It is necessary to fully consider changes in meteorological factors for CVD prevention and control.

Objective:To explore the risk factors of sepsis in patients with multiple trauma and construct a nomogram prediction model.Methods:The data of patients with multiple injuries admitted to the emergency intensive care unit (EICU) of the General Hospital of Ningxia Medical University from January 2021 to April 2022 were respectively collected. Inclusion criteria: (1) meet the diagnostic criteria for multiple injuries; (2) the time from injury to admission ≤ 24 hours; (3) age>18 years old; (4) all examination or rescue measures were approved by the patient or the patient's family; (5) the patient's clinical data were complete. The patients were divided into sepsis group and non-sepsis group according to the definition of Sepsis 3.0 at the 28-day of EICU hospitalization. The receiver operating characteristic curve was drawn. Logistic regression analysis was applied to determine the independent predictors for sepsis, and the nomogram was constructed.Results:A total of 291 patients were included, including 102 in the sepsis group and 189 in the non-sepsis group. Multivariate logistic analysis revealed that age, acute physiology and chronic health status score (APACHE) Ⅱ, Glasgow Coma Scale (GCS), injury severity score (ISS), sequential organ failure assessment (SOFA) within 24 hours after admission, blood transfusion frequency, the application of norepinephrine, mechanical ventilation, pathogenic culture results, and history of diabetes were independent factors influencing the occurrence of sepsis. A nomogram model was constructed by combining these variables (AUC=0.913, 95% CI: 0.847-0.942), and the model had a good fitting calibration curve. Conclusions:The nomogram constructed by age, APACHE-Ⅱ, GCS score, SOFA score, ISS score, number of blood transfusions, mechanical ventilation, norepinephrine drug use, pathogenic culture and diabetes has a good predictive value for sepsis in patients with multiple trauma in the later stage, which is worth promoting.

BACKGROUND:Due to the mismatch between the design of the proximal femoral nail antirotation Asian version(PFNA-Ⅱ)and Asian population,extrusion of the proximal femoral intertrochanteric nail may occur in the treatment of femoral intertrochanteric fractures.The influence of the protruding length on the curative effect of the operation needs to be further discussed. OBJECTIVE:To quantitatively measure the protruding length of the proximal trochanter of the femur with intramedullary nail after PFNA-Ⅱ,and to analyze the effect of protruding length on the efficacy of PFNA-Ⅱ in the treatment of femoral intertrochanteric fractures. METHODS:Totally 68 patients with femoral intertrochanteric fractures treated with PFNA-Ⅱ internal fixation in the First Affiliated Hospital of Anhui Medical University were selected.The extramedullary process of the proximal trochanter of the femur was quantitatively measured on the anterior and posterior X-ray films of the hip joint within 6 months after operation.According to the existence of extrusion of the proximal trochanter intramedullary nail,the patients were divided into protruding group and non-protruding group.The data of sex,height,fracture type,length and diameter of the intramedullary nail,the position of screw blade in the femoral neck and protruding length of proximal greater trochanter were collected.The postoperative curative effect was judged by visual analog scale pain score and hip joint Harris score at 6 months after operation.The influence of protruding proximal trochanter of the PFNA-Ⅱ intramedullary nail on the operative effect was observed. RESULTS AND CONCLUSION:(1)There were significant differences in sexual characteristics between the protruding group and the non-protruding group(P=0.001).(2)According to AO/OTA classification,there were no significant differences in fracture type between the protruding group and the non-protruding group(P=0.289).(3)There was no significant difference in the length and diameter of the intramedullary nail between the two groups(P=0.067,P=1.000).(4)There was no significant correlation between the height of all patients and the length of the intramedullary nail(P=0.510),but there was a significant correlation between height and protruding length(P=0.034).There was no significant correlation between screw blade position and protruding length(P=0.968).(5)Six months after operation,there was no significant difference in the hip Harris score(P=0.373),but the visual analog scale pain score was significantly higher in the protruding group than that in the non-protruding group(P=0.000).(6)The results suggest that nail extrusion often occurs in the proximal greater trochanter when PFNA-Ⅱ is used in the treatment of intertrochanteric fractures in Asians.When the nail extended into the proximal soft tissue of the greater trochanter,patients complained of proximal greater trochanteric pain and the visual analog scale score of proximal greater trochanter pain in the patient was significantly higher than that in the non-protruding group.To be more suitable for the Asian population,we suggest that the PFNA-Ⅱ should be improved to further shorten the proximal nail end to obtain better clinical results of femoral intertrochanteric fracture fixation.

Objective To assess the effects of temperature and rainfall on the incidence of cardiovascular and cerebrovascular diseases (CVD) in Guiyang. Methods Using daily CVD incidence data and temperature and rainfall data in Guiyang City from September 2021 to August 2022, a distributed lag non-linear model was used to explore the nonlinear relationship between meteorological and environmental factors and CVD incidence. Results The risk of CVD was higher under cold (average, minimum, and maximum temperatures <2.1 ℃, 1.6 ℃, and 4.2 ℃, respectively) and hot (maximum temperature>32.5 ℃) effects, and the cumulative lag effect reached its maximum at 10 and 17 days, respectively. The risk of CVD increased sharply when there was a small diurnal temperature (<6.9 ℃), sudden drop in temperature (over 6.1 ℃), and heating (over 2.4 ℃ in 24 hours). The incidence risk of CVD was high when the daily rainfall exceeded 21.5 mm and the continuous rainy days exceed 5.7 days. The risk in rainstorm was 0.81 higher than that in heavy rain. Continuous absence of rain helped to prevent CVD patients from developing symptoms. Conclusion Meteorological environments such as hot and cold weather, dramatic change in temperature, significant rainfall and continuous rainfall have an impact on the incidence of CVD. It is necessary to consider the changes of the meteorological environment during the prevention and control of CVD.

Objective:To establish and validate a prediction model for the risk of major upper gastrointestinal bleeding in patients with varices of liver cirrhosis.Method:This study retrospectively collected the clinical data of patients with esophageal and gastric variceal bleeding who were admitted to the emergency department of Ningxia Medical University General Hospital from October 2019 to October 2022. The patients were divided into modeling group and validation group according to the ratio of 7:3 by random number table method. The observation index was whether the upper gastrointestinal bleeding occurred within 24 hours after admission. The predictors in the logistic regression model were used to construct a prediction model for the risk of major upper gastrointestinal bleeding in patients with varices with liver cirrhosis, and the area under the receiver operating characteristic curve (AUC), the correction curve and the decision curve were analyzed to evaluate the discriminatory ability, accuracy and clinical utility of the prediction model.Results:A total of 305 patients were included, including 215 and 90 in the modeling and validation groups, respectively, and the clinical data of the two groups were comparable. Multivariate logistic regression showed that systolic blood pressure ( OR=0.918, 95% CI: 0.860-0.980, P=0.010), MAP(ASH) score ( OR=1.993, 95% CI: 1.017-3.907, P=0.045), Child-Pugh score ( OR=1.999, 95% CI: 1.139-3.510, P=0.016) and model for end-stage liver disease (MELD) ( OR=1.398, 95% CI: 1.037-1.886, P=0.028) were independent influencing factors for the occurrence of upper gastrointestinal bleeding in patients with liver cirrhosis varices. The AUC of the prediction model in the modeling group was 0.936 (95% CI: 0.895-0.976), and that of the prediction model in the validation group was 0.891 (95% CI: 0.807-0.975), the prediction model had good identification, calibration, and clinical application value. Conclusions:Systolic blood pressure, MAP (ASH) score, Child-Pugh score, and prediction models constructed by end-stage liver disease models are helpful for early prediction of the risk of upper gastrointestinal bleeding in patients with cirrhosis varices in the emergency department.

Objective:To explore the prognostic factors of elderly patients with community-acquired pneumonia-related sepsis and to construct a prediction model.Methods:The clinical data of elderly patients with community-acquired pneumonia-associated sepsis from October 2020 to October 2022 in the General Hospital of Ningxia Medical University from October 2020 to October 2022 were retrospectively included, and the clinical data of the two groups were divided into the modeling population and the validation population in the ratio of 7:3 by random number table method, and the clinical data of the two groups were compared. According to the 30-day outcomes of admission, the patients were divided into survival group and death group, and the independent risk factors for the prognosis of elderly patients with community-acquired pneumonia-related sepsis were screened out by LASSO regression and multivariate logistic regression analysis, and the nomogram prediction model was constructed by R software. The area under the curve (AUC), calibration curve and decision curve of the receiver operating characteristic curve were used to validate the nomogram prediction model in the modeling population and the validation population to judge its discrimination, calibration and clinical practicability.Results:A total of 472 patients were included, with 331 and 141 models and validations, respectively, indicating that the clinical data were comparable between the modeled and validated populations. LASSO regression and multivariate logistic regression analysis showed that pneumonia severity index (PSI) score and sequential organ failure assessment (SOFA) score were independent risk factors for the prognosis of elderly patients with community-acquired pneumonia-associated sepsis. The AUC of the modeled population prediction model was 0.984 (95% CI: 0.975-0.994), and the AUC of the validated population prediction model was 0.961 (95% CI: 0.926-0.996). The nomogram prediction model has good discrimination, calibration and clinical practicability in both the modeled and validated populations. Conclusions:The nomogram prediction model established in the study has high accuracy for early identification and risk of sepsis in elderly patients with CAP and can guide for clinicians to formulate personalized interventions.

Histone deacetylase 3(HDAC3)is an epigenetic modification enzyme,which participates in the occur-rence and development of atherosclerosis(As).It is significant to search for effective HDAC3 inhibitors for the treatment of atherosclerosis.This article reviews the relationship between HDAC3 and atherosclerosis,the latest research progress of HDAC3 inhibitors,and the therapeutic effects of some traditional Chinese medicine on cardiovascular diseases by inhibi-ting HDAC3.It aims to provide new ideas for developing anti-atherosclerotic drugs targeting HDAC3.

While Mek1/2 and Gsk3β inhibition ("2i") supports the maintenance of murine embryonic stem cells (ESCs) in a homogenous naïve state, prolonged culture in 2i results in aneuploidy and DNA hypomethylation that impairs developmental potential. Additionally, 2i fails to support derivation and culture of fully potent female ESCs. Here we find that mouse ESCs cultured in 2i/LIF supplemented with lipid-rich albumin (AlbuMAX) undergo pluripotency transition yet maintain genomic stability and full potency over long-term culture. Mechanistically, lipids in AlbuMAX impact intracellular metabolism including nucleotide biosynthesis, lipid biogenesis, and TCA cycle intermediates, with enhanced expression of DNMT3s that prevent DNA hypomethylation. Lipids induce a formative-like pluripotent state through direct stimulation of Erk2 phosphorylation, which also alleviates X chromosome loss in female ESCs. Importantly, both male and female "all-ESC" mice can be generated from de novo derived ESCs using AlbuMAX-based media. Our findings underscore the importance of lipids to pluripotency and link nutrient cues to genome integrity in early development.
Male ; Animals ; Female ; Mice ; Mouse Embryonic Stem Cells ; Embryonic Stem Cells ; Genomic Instability ; Lipids ; DNA/metabolism* ; Cell Differentiation

Objective:To explore the prognostic risk factors of patients with multiple injuries and establish a nomogram prediction model.Methods:The clinical data of 291 patients with multiple injuries admitted to the Emergency Intensive Care Unit (EICU) of General Hospital of Ningxia Medical University were collected, including sex, age, open injury, norepinephrine use, mechanical ventilation, time to hospital after injury, distance to hospital, relative lymphocyte value, platelet count, lactic acid, injury severity score (ISS), acute physiology and chronic health evaluationⅡ (APACHE Ⅱ), Glasgow coma scale (GCS), number of blood transfusions, number of operations, and previous history of diabetes, hypertension and smoking within 24 h after admission. According to whether the condition worsened during the hospitalization of EICU, the patients were divided into the deterioration group and improvement group. SPSS26.0 software was used for statistical analysis of the data, univariate and multivariate analysis were used to screen the factors affecting the prognosis of patients with multiple injuries, receiver operating characteristic (ROC) curve and forest chart were drawn, and the influencing factors in binary Logistic regression model were used to make the nomogram.Results:Mechanical ventilation, norepinephrine use, age, relative lymphocyte value, lactic acid, APACHE-II score, GCS score, and number of operations were significant for predicting the prognosis of patients with multiple injuries ( P<0.05). The independent influencing factors obtained by binary Logistic regression model were age, lactic acid, APACHE-Ⅱ score and number of operations. ROC curve analysis showed that the area under the curve was the largest in multi-factor combined prediction, followed by APACHE-Ⅱ score. The diagnostic cut-off value of each index was as follows: age >58 years old, relative lymphocyte value≤ 8.62%, lactic acid >1.72, APACHE-Ⅱ score >16, GCS score≤ 6, and number of operations≤ 0. The R software was used to establish a nomogram of the influencing factors in the binary Logistic regression model, which had good predictive value. Conclusions:The nomogram constructed by age, relative lymphocyte value, lactic acid, APACHE-Ⅱ score, GCS score, number of operations, mechanical ventilation, and norepinephrine use has a good predictive value for the prognosis of patients with multiple injuries, and is worthy of promotion..

Humans ; Data Warehousing ; East Asian People ; Intracranial Hemorrhages/diagnostic imaging* ; Asian People ; Cerebral Hemorrhage/diagnostic imaging*