Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-08-31 Cooperative journals: 《中国全科医学》
Abstract： Background The research related to mHealth technology in chronic disease management has developed rapidly in recent years，however，the research trends，hotspots and cutting-edge issues in this field remain unclear. Objective To systematically review the application and development of mHealth technology in chronic disease management and provide reference for future research. Methods Using Web of Science Core Collection and PubMed as the source of literature data，the relevant literature was searched from 1997 to 2022 by CiteSpace 6.1.R 3 software on October 18，2022，restricting the language to English，and excluding conference papers，conference abstracts，online publications，editorials，letters，book chapters，news，and other non-compliant contents. National regions，disciplinary intersections and keywords were analyzed to grasp the current status and hotspots of related research internationally，and the cutting-edge issues and research trends of mHealth technology in chronic disease management were comprehensively analyzed using keywords clustering analysis，keywords bursting analysis and timeline views. Results A total of 7 622 papers were finally included in the study，with a significant growth trend in the volume of publications starting from 2011，in which the United States contributed the most with a total of 2 645（34.70%）. The journals in which the papers were published were mainly in the fields of medicine，psychology and health；and the top five high-frequency keywords were chronic disease（711 times），nursing（695 times），management（544 times），intervention（502 times） and health（448 times）. A total of 10 meaningful clusters were formed，which can be categorized into 4 dimensions of research tools，research theories and methods，research objects，and research factors；combining with keywords bursting and timeline view，the hot issues mainly focus on telemedicine，telecare，and digital health. Conclusion The international research fervor for the application of mHealth technology in chronic disease management has continued，and the field of research has shifted from medicine to health science，with the focus on intervention research on chronic diseases through mHealth technology and the use of digital technology to provide integrated telehealth services for chronic diseases. It is suggested that our scholars should pay attention to the application of mHealth and digital technologies in chronic disease management，find high-quality health services for patients with chronic diseases in China through intervention studies，and provide strategies and suggestions for the high-quality development of chronic disease services and management in China.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-08-31
Abstract： Abstract Objective To study the effect of information knowledge belief behavior (IKAP) model combined with Otago exercise program (OEP) on fall prevention in elderly patients withdiabetes and myopenia. Methods From May 2021 to May 2022, 108 elderly patients with diabetes complicated with myopenia hospitalized in the Department of Endocrinology and Metabolismof the Second Affiliated Hospital of Nanchang University were selected and divided into control group A and intervention (B+C) group according to whether the patients were willing to carry out OEP exercise training. The intervention (B+C) group was then divided into intervention groupBand intervention group C using random number table method, with 36 cases in each group. Control group A received routine nursing, intervention group B received routine nursing+OEP, and intervention group C received routine nursing+OEP+IKAP mode nursing. The blood glucose levels (FPG, 2hPG, HbA1c), muscle mass and strength (limb skeletal muscle mass index (ASMI) and grip strength), balance Berg balance scale (BBS) score , mobility timed stand and walk test (TUGT) , fall efficacy fall efficacy energy scale (MFES) score , fall incidence and quality of life diabetes specific quality of life scale (DSQL) score were compared among the three groups. Results After intervention, the levels of FPG, 2hPG, and HbA1c in the three groups decreasedwith the extension of intervention time. After 3, 6, and 9 months of intervention, the levels of FPG, 2hPG, and HbA1c in intervention group C were lower than those in intervention group Bandcontrol group A, while those in intervention group B were lower than those in control groupA(P<0.05). After intervention, the ASMI and grip strength of the three groups increased with the extension of intervention time, and after 3, 6, and 9 months of intervention, the ASMI and gripstrength of the intervention group C were higher than those of the intervention group Band the control group A, while the intervention group B was higher than that of the control group A(P<0.05). After intervention, BBS scores in all three groups increased with the extension of intervention time, while TUGT decreased with the extension of intervention time. After 3, 6, and9months of intervention, BBS scores in intervention group C were higher than those in interventiongroup B and control group A, while intervention group B was higher than that in control group A. At the same time, TUGT in intervention group C was shorter than that in intervention group Bandcontrol group A, while intervention group B was shorter than that in control group A (all P<0.05). After intervention, MFES scores in all three groups increased with the extension of interventiontime, while DSQL scores decreased with the extension of intervention time. After 3, 6, and9months of intervention, MFES scores in intervention group C were higher than those inintervention group B and control group A, while intervention group B was higher than that incontrol group A. At the same time, DSQL scores in intervention group C were lower than those inintervention group B and control group A, while intervention group B was lower than that incontrol group A (all P<0.05). During the follow-up period, the incidence of falls in interventiongroup C was 0 lower than 11.11% (4/36) in intervention group B and 30.56% in control group A, and intervention group B was lower than control group A (both P<0.05). Conclusion IKAP mode combined with OEP can steadily reduce blood glucose in elderly patients with diabetes andmyopenia, enhance muscle quality and strength, improve balance and mobility, improve fall efficiency, effectively prevent falls, and thus help to improve the overall quality of life.
Peer Review Status:
Awaiting Review
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-08-31
Abstract：目的 探讨抗阻运动对老年 2 型糖尿病合并肌少症患者血糖控制及活动能力的影响。方法选择我院 2021 年 1 月～2022 年 2 月间收治的 100 例老年 2 型糖尿病合并肌少症患者为对象。采用随机数字法将100 例患者分为对照组和观察组，各 50 例。对照组患者进行常规运动指导，此基础上，观察组实施弹力带抗阻运动干预。比较两组干预前及干预 3 个月、6 个月后空腹血糖（FPG）、餐后2 h 血糖（PBG）、糖化血红蛋白（HbAlc）、 Berg 平衡量表（BBS）及计时起立行走测试（TUG）结果。结果干预前，两组患者FPG、PBG、HbAlc、BBS、TUG 指标水平比较差异无统计学意义（P>0.05）；干预3 个月、6 个月后，两组患者 FPG、PBG、HbAlc、TUG 指标水平均下降并低于干预前，BBS 指标水平升高且均高于干预前（P<0.05）；观察组患者干预 3 个月、6 个月后 FPG、PBG、HbAlc、TUG 指标水平均低于对照组，BBS 指标水平高于对照组，差异均有统计学意义（P<0.05）。结论 抗阻运动有助于对老年 2 型糖尿病合并肌少症患者血糖控制，提高患者日常活动能力，临床干预效果满意，值得进一步推广与应用。
Peer Review Status:Awaiting Review
Subjects: Management Science >> Enterprise Management submitted time 2023-08-31
Abstract： The information disclosure of listed companies can provide investors with more forward-looking information and is an important source of information for investors to make decisions; As an information intermediary in the capital market, securities analysts play a crucial role in alleviating information asymmetry. In order to clarify whether forward-looking information disclosure of listed companies can affect the accuracy of analysts' earnings forecasts, A-share listed companies from 2007 to 2020 were selected as a sample to study the impact of forward-looking information disclosure on the accuracy of analysts' earnings forecasts. The research results show that forward-looking information of listed companies can significantly improve the accuracy of analysts' earnings forecasts. It is further found that listed companies with low financing constraints, high text readability, high institutional shareholding ratio and high stock price synchronization have a more obvious effect of forward-looking information disclosure on the accuracy of analysts' earnings forecasting. This study enriches the relevant research on the accuracy of analysts' earnings forecasting from the perspective of the information content of forward-looking information, and provides policy enlightenment for improving the capital market information disclosure system under the background of comprehensive registration system.
Peer Review Status:Awaiting Review
Subjects: Computer Science >> Other Disciplines of Computer Science submitted time 2023-08-31
Abstract： LLAMA is the most popular open-source Large Language Model(LLM) model in the last few months.
This paper presents its mathematic formulas in detail.
Peer Review Status:Awaiting Review
Subjects: Nursing >> Nursing submitted time 2023-08-31
Abstract： Report on the key points of nursing care for a late stage patient with diffuse large B-cell lymphoma with cancerous wounds. Through emotional care, medication care, dietary care, wound care, and integrated traditional Chinese and Western medicine treatment intervention, pain relief, inflammation control, and promotion of wound healing.
Peer Review Status:Awaiting Review
Subjects: Physics >> General Physics: Statistical and Quantum Mechanics, Quantum Information, etc. submitted time 2023-08-31 Cooperative journals: 《中国全科医学》
Abstract：背景 抗生素滥用导致的耐药问题已成全球重大公共卫生议题，减少公众上呼吸道感染的抗生素不合理使用是我国治理抗生素滥用的重要策略，识别上呼吸道感染疾病病症特点及其对抗生素不合理使用行为的影响有助于临床医生设计更为精准的干预政策。目的 定量分析公众上呼吸道感染症状的潜在模式，探究其对抗生素使用行为的影响。方法 本研究采用整群随机抽样调查，于 2022-07-2008-02 选取重庆市三个县（区）的公众作为调查对象。调查公众上呼吸道感染疾病症状、公众上呼吸道感染抗生素使用行为、公众抗生素使用知识及人口学特征。采用潜在类别分析方法鉴别公众上呼吸道感染疾病症状的潜在模式，采用多因素 Logistic 回归分析探索不同潜在症状模式对抗生素使用行为的影响。结果 815 位公众参与本研究。其中，30.06%（245/815）受访者存在无处方从药店购买抗生素，14.72%（120/815）受访者使用过抗生素自我药疗以应对上呼吸道感染。公众抗生素合理使用知识水平较低〔（2.31.7）分〕。上呼吸道感染疾病发病模式方面，潜在类别分析共识别 4 种症状模式，包括多样症状组 39 例（11.41%）、全身症状组 124 例（15.21%）、鼻咽症状组 282 例（34.60%）和轻微症状组 316 例（38.77%）。多因素 Logistic 回归分析显示：相较于轻微症状组，鼻咽症状组出现无处方购买抗生素行为的概率更高（OR=1.538，P<0.05），结果在调整知识与人口学变量后仍显著。除个体疾病症状潜在模式外，年龄和医保类型也对公众无处方抗生素购药行为有显著影响（P<0.05）。抗生素使用知识水平对抗生素自我药疗行为有显著影响（OR=0.869，P<0.05），对公众无处方抗生素购药行为也有显著影响（OR=1.155，P<0.05）。结论 公众上呼吸道感染症状存在 4 种潜在模式，疾病病症模式显著影响公众抗生素的合理使用，应着重关注出现鼻咽症状患者的抗生素不合理使用行为。
Subjects: Physics >> General Physics: Statistical and Quantum Mechanics, Quantum Information, etc. submitted time 2023-08-31 Cooperative journals: 《中国全科医学》
Abstract： Background Preserved Ratio Impired Spirometry（PRISm）refers to the non-obstructive pulmonary function abnormalities with a decrease forced expiratory volume in one second（FEV1） while the FEV1/forced vital capacity （FVC） remains constant. The PRISm population may be one of the pre-chronic obstructive pulmonary disease（COPD） populations. However，the incidence，characteristics and risk factors of PRISm in the physical examination population in China are still unknown. Objective To analyze the characteristics and influencing factors of PRISm in physical examination population. Methods From January 2017 to December 2019，a total of 970 patients received physical examination in the Third Medical center of PLA General Hospital were selected. The baseline data and physical examination results were collected，pulmonary function was measured for vital capacity（VC），FVC，FEV1，forced expiratory volume in six second（FEV6），FEV1/FVC，peak expiratory flow（PEF），FEF25，FEF50 and FEF75，the relevant indexes were expressed as "%pre" as a percentage of the expected value. The included subjects were divided into the airflow obstruction group with FEV1/FVC<0.7（n=61），PRISm group with FEV1/FVC ≥ 0.7 and FEV1%pre<0.8（n=111），normal lung function group with FEV1/FVC ≥ 0.7 and FEV1%pre ≥ 0.8（n=798） according to FEV1/FVC and FEV1%pre. The incidence of PRISm in physical examination population was calculated，the basic characteristics and the characteristics of lung function indexes were compared，the ordinal logistic regression analysis were used to analyze the influencing factors of lung function impairment. Results The incidence of PRISm was 11.44% and the incidence of airflow obstruction was 6.29% in 970 patients. The proportion of people over 60 years old in the PRISm group and the airflow obstruction group was higher than that the normal lung function group，and the proportion of people between 41 and 60 years old was lower than the normal lung function group（P=0.019）. The proportion of smokers in the PRISm group was significantly higher than the normal lung function group（P<0.001）. The proportion of patients with hypertension in the PRISm group was higher than the normal lung function group （P=0.03）. VC%pre，FVC%pre，FEV1%pre，FEV6%pre， PEF%pre，FEF25%pre，FEF50%pre，FEF75%pre were higher in the normal lung function group than the PRISm group and the airflow obstruction group（P<0.001）；VC%pre，FVC%pre，FEV6%pre，PEF%pre，FEF25%pre，FEF50%pre，and FEF75%pre were higher in the PRISm group than the airflow obstruction group（P<0.05）. FEV1/FVC in the normal lung function group and PRISm group was higher than the airflow obstruction group （P<0.001）. The ordinal logistic regression analysis with different groups of lung function as dependent variables showed that age>60 years〔OR=0.951，95%CI（0.602-1.504），P=0.002〕，smoking history〔OR=2.201，95%CI（1.519-3.187），P<0.001〕 and history of hypertension〔OR=1.673，95%CI（1.106-3.187），P=0.015〕were risk factors for lung function impairment in the physical examination population. Conclusion PRISm is common in physical examination population. Attention should be paid to the changes in lung function in those aged >60 years old，with the history of smoking and hypertension. Early intervention may alleviate the progression of COPD.
Subjects: Astronomy >> Astrophysics Subjects: Astronomy >> Astrophysical processes submitted time 2023-08-31
Abstract： The radiation mechanism of fast radio bursts (FRBs) has been extensively studied but still remains elusive. Coherent radiation is identified as a crucial component in the FRB mechanism, with charged bunches also playing a significant role under specific circumstances. In the present research, we propose a phenomenological model that draws upon the coherent curvature radiation framework and the magnetized neutron star, taking into account the kinetic energy losses of outflow particles due to inverse Compton scattering (ICS) induced by soft photons within the magnetosphere. By integrating the ICS deceleration mechanism for particles, we hypothesize a potential compression effect on the particle number density within a magnetic tube/family, which could facilitate achieving the necessary size for coherent radiation in the radial direction. This mechanism might potentially enable the dynamic formation of bunches capable of emitting coherent curvature radiation along the curved magnetic field. Moreover, we examine the formation of bunches from an energy perspective. Our discussion suggests that within the given parameter space the formation of bunches is feasible. Finally, we apply this model to FRB 20190520B, one of the most active repeating FRBs discovered and monitored by FAST. Several observed phenomena are explained, including basic characteristics, frequency downward drifting, and bright spots within certain dynamic spectral ranges.
Subjects: Physics >> General Physics: Statistical and Quantum Mechanics, Quantum Information, etc. submitted time 2023-08-30
Abstract： Report a patient who underwent VV ECMO after cardiopulmonary resuscitation. The patient experienced cardiac arrest caused by hypokalemia and underwent cardiopulmonary resuscitation and defibrillation. After surgery, the patient regained their autonomous heart rate, but myocardial damage had already occurred. In addition, factors such as hypertension and severe pulmonary infection induced acute left heart failure, increased left heart load led to increased pulmonary circulation pressure, ultimately leading to pulmonary edema. The alveolar epithelium was further damaged on the basis of the original infection damage, ultimately leading to severe cardiopulmonary dysfunction. The ECMO team evaluated the patient and decided to undergo VV ECMO. Scientifically apply nursing procedures to provide treatment care, observation care, daily care, rehabilitation care, psychological care, and other nursing interventions to effectively prevent related complications and successfully recover and discharge from the hospital; Scientific nursing procedures are key to ensuring patient prognosis, successfully improving their quality of life, and returning to normal social life.
Peer Review Status:Awaiting Review
Subjects: Physics >> General Physics: Statistical and Quantum Mechanics, Quantum Information, etc. submitted time 2023-08-30 Cooperative journals: 《中国全科医学》
Abstract： Background Both portal vein thrombosis（PVT） and gastrointestinal bleeding are complications in patients with liver cirrhosis，and PVT can aggravate the risk of gastrointestinal bleeding，but the conflicting treatment of both is another challenge in clinical work. Objective To investigate the clinical characteristics and risk factors of concomitant gastrointestinal bleeding in patients with PVT in liver cirrhosis. Method A total of 279 patients diagnosed with PVT in liver cirrhosis at the First Affiliated Hospital of Kunming Medical University from 2016-10-01 to 2021-09-30 were retrospectively collected and divided into the bleeding group（n=127） and non-bleeding group（n=152） according to the presence of gastrointestinal bleeding symptoms of hematemesis and melena in this admission. The differences in general information，complications，laboratory and imaging tests，surgical history and other relevant information between the two groups were compared. Binary Logistic regression analysis was used to explore the influencing factors of the complications of gastrointestinal bleeding in cirrhotic patients with PVT. Results A total of 5 807 patients were retrospectively investigated in the study， including 350 patients combined with PVT with a incidence of 6.0%. PVT was most common in 279 cirrhotic patients with PVT complicated by liver function Child B grade〔146（52.3%）〕. There were significant differences in etiology，vascular involvement，jaundice，internal diameter of main portal vein，gastroesophageal varices，white blood cell（WBC），blood urea nitrogen（BUN），hemoglobin（Hb），hematocrit（HCT），total bilirubin（TBiL），fibrinogen（FIB），and history of laparotomy between the bleeding group and non-bleeding group（P<0.05）. Binary Logistic regression analysis showed that elevated WBC level〔OR=2.555，95%CI（1.318，6.542）〕，decreased HCT level〔OR=0.511，95%CI（0.247，0.925）〕，decreased FIB level〔OR=0.085，95%CI（0.005，0.661）〕，and involvement of superior mesenteric vein thrombosis〔OR=27.873， 95%CI（1.452，1 335.715）〕 were independent risk factors for concomitant gastrointestinal bleeding in cirrhotic patients with PVT（P<0.05）. Conclusion Elevated WBC level，decreased HCT level，decreased FIB level and involvement of superior mesenteric vein thrombosis are independent risk factors for gastrointestinal bleeding in cirrhotic patients with PVT，and early intervention should be implemented to improve the prognosis.
Subjects: Physics >> General Physics: Statistical and Quantum Mechanics, Quantum Information, etc. submitted time 2023-08-30 Cooperative journals: 《中国全科医学》
Abstract： Background There are various researches about the mode and influencing factors of the integrated elderly care and medical services in China in recent years，but researches about quality of integrated elderly care and medical services in nursing institutions are limited，especially in the comparison of quality of integrated elderly care and medical services in difference types of institutions. Objective To evaluate the quality of integrated elderly care and medical services between public and private nursing institutions. Methods A total of 1 106 older adults from 25 nursing institutions in Baotou，Xi'an，Yichang and Shaoxing were selected by stratified random sampling method from October 2020 to September 2021 to conduct questionnaire survey. The SERVQUAL model was used to construct the Evaluation Index System of Integrated Elderly Care and Medical Services Quality，involving 5 dimensions of reliability，timeliness，supportability，normativity and empathy and 15 secondary indexes，entropy weight method and fuzzy comprehensive evaluation method were used to calculate and compare the service quality scores of integrated elderly care and medical services between public and private nursing institutions. Results The comprehensive evaluation score of integrated elderly care and medical services quality was 41.66 and 38.82 in public and private nursing institutions，respectively，among which the scores of the 15 secondary indexes were all above 40.00 in public institutions， and the scores of 13 secondary indexes were below 40.00 in private institutions. Conclusion There is certain difference in the comprehensive evaluation results of satisfaction on the quality of integrated elderly care and medical services between public and private nursing institutions，among which the differences in the scores of normativity and empathy are higher，while the differences in the scores of reliability，timeliness and supportability are lower，providing a reference for identifying the problems in integrated elderly care and medical services and promoting its high-quality development in nursing institutions.
Subjects: Physics >> General Physics: Statistical and Quantum Mechanics, Quantum Information, etc. submitted time 2023-08-30 Cooperative journals: 《中国全科医学》
Abstract： Background There is growing evidence that pre-hospital use of metformin reduces mortality in patients with diabetes and sepsis；however，the effect of metformin on clinical outcomes in patients with diabetes and sepsis remains controversial. Therefore，there is a need for a systematic review and Meta-analysis of existing studies to further evaluate whether metformin can improve mortality and other clinical outcomes in patients with diabetes and sepsis. Objective To systematicallyevaluate the effects of pre-hospital metformin use on mortality，initial plasma lactate level and organ dysfunction in patients with diabetes and sepsis. Methods PubMed，Embase，Cochrane Library，Web of Science，Scopus，China Biomedical Literature Service System，Wanfang，CNKI and other databases were searched by computer for Chinese and English literature on the effects of pre-hospital metformin use on clinical outcomes in patients with sepsis and diabetes from inception to March 15，2023. The test group（MET group）involved adult patients with diabetes and sepsis received pre-hospital metformin use， and the control group（NM group）involved adult patients with diabetes and sepsis who did not receive pre-hospital metformin use. After screening，data extraction and literature quality evaluation were conducted by two researchers，Meta-analysis was performed using Revman5.3 software. Results A total of 12 papers were included in this study，involving 12 320 patients with diabetes and sepsis，with Newcastle-Ottawa Scale（NOS）scores of 7-8. The results of Meta-analysis showed that the mortality rate（OR=0.61， 95%CI=0.46-0.80，P<0.001）and the use of vasopressors（MD=0.83，95%CI=0.69-0.98，P=0.03）in MET group were lower than those in NM group；there was no significant difference in initial plasma lactate level（MD=0.31，95%CI=-0.12-0.75，P=0.16），serum creatinine level（MD=-0.81，95%CI=-0.48-0.13，P=0.25），initial blood glucose level（MD=32.94，95%CI=-10.12-76.01，P=0.13）and mechanical ventilation（MD=0.90，95%CI=0.77-1.06，P=0.23）between the MET group and NM group. Conclusion The pre-hospital use of metformin can reduce the mortality of patients with diabetes and sepsis，and reduce the use of vasoppressors in corresponding patients，providing updated evidence that metformin can reduce the mortality of patients with diabetes and sepsis. However，whether it can reduce the sepsis severity score and reduce the maximum dose of norepinephrine in patients with diabetes and sepsis remains to be further studied.
Subjects: Physics >> General Physics: Statistical and Quantum Mechanics, Quantum Information, etc. submitted time 2023-08-30 Cooperative journals: 《中国全科医学》
Abstract： Background As one of the most common diseases in the elderly，chronic insomnia is often accompanied by cognitive impairment and seriously affects the quality of life of patients. The biological mechanism of cognitive impairment in elderly patients with chronic insomnia still remains unclear. Objective To investigate the correlation of cognitive function with insomnia severity，serum 25-hydroxy vitamin D3〔25（OH）D3〕，tumor necrosis factor-α（TNF-α） in elderly patients with chronic insomnia. Methods A total of 105 elderly patients with chronic insomnia in the 901th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from June 2020 to June 2022 were selected as the research subjects. Pittsburgh Sleep Quality Index（PSQI），Geriatric Depression Scale（GDS-15） and Generalized Anxiety Disorder Scale（GAD-7） were tested before enrollment. The patients were divided into 32 cases in the mild insomnia group，38 cases in the moderate insomnia group and 35 cases in the severe insomnia group according to the PSQI score. Photoplethysmography （PPG） was used to assess the objective sleep quality of patients，monitor the total sleep time，sleep latency，sleep efficiency and arousal times；the cognitive function of patients was evaluated by Mini-mental State Examination（MMSE） and Montreal Cognitive Assessment（MoCA）. Serum levels of 25（OH）D3 and TNF-α were detected by enzyme-linked immunosorbent assay. Results The sleep latency，arousal times and the level of TNF-α in the severe insomnia group were higher than those in the mild and moderate insomnia groups，with lower total sleep time in the severe insomnia group compared to the mild insomnia group and lower sleep efficiency compared to the mild and moderate insomnia groups；sleep latency in the moderate insomnia group was higher than that in the mild insomnia group，with lower sleep efficiency compared to the mild insomnia group（P<0.05）. Sleep latency in the moderate insomnia group was higher than that in the mild insomnia group，and sleep efficiency was lower than that in the mild insomnia group（P<0.05）. MMSE and MoCA scores were lower in the severe insomnia group than the mild insomnia and moderate insomnia groups，and lower in the moderate insomnia group than the mild insomnia group（P<0.05）. Serum TNF-α level was higher and 25（OH）D3 level was lower in the severe insomnia group than the mild and moderate insomnia groups（P<0.05）；serum TNF-α level was higher in the moderate insomnia group than the mild insomnia group， and 25（OH）D3 level was lower than the mild insomnia group（P<0.05）. Spearman correlation analysis results showed that MMSE and MoCA scores were positively correlated with total sleep time，sleep efficiency and 25（OH）D3 level（P<0.05），and negatively correlated with insomnia severity，sleep latency，arousal times and TNF-α level（P<0.05）. Conclusion Cognitive impairment in elderly patients with chronic insomnia may be associated with insomnia severity，reduced serum 25（OH） D3 level and elevated TNF-α level.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-08-30 Cooperative journals: 《中国全科医学》
Abstract： Ferroptosis plays an important role in the progression of non-alcoholic fatty liver disease（NAFLD） as a novel mode of programmed cell death. Heme oxygenase-1（HO-1），acting as an inducible oxidase，has been shown the capability of alleviating oxidative stress and hepatocyte necrosis to prevent or delay the progression of NAFLD. However，the mechanism of HO-1 regulating ferroptosis and affecting the development of NAFLD remains inadequately explored. This review provided a systematic and comprehensive summary of the effects of HO-1 on NAFLD by regulating ferroptosis，and discussed the mechanism of HO-1 in preventing the development of NAFLD by summarizing the relevant literature in recent years，and showed that HO-1 regulates ferroptosis in NAFLD through the generation of antioxidants（such as bilirubin and CO），activation of the System Xc system，and facilitation of ferrous ion accumulation，in order to provide a theoretical basis for targeting HO-1 gene therapy for NAFLD by methods such as pharmacological interventions and provide a reference for further research.
Subjects: Physics >> General Physics: Statistical and Quantum Mechanics, Quantum Information, etc. submitted time 2023-08-30 Cooperative journals: 《中国全科医学》
Abstract： Background Facial pressure injury is a common complication in patients with prone position ventilation. Local exposure of the trauma can increase the risk of systemic infection，and affect the therapeutic effect of prone position ventilation，and even cause permanent functional damage to local tissues. Exploring the risk factors and constructing a prediction model are of great clinical significance for the prevention of prone position ventilation related facial pressure injuries. Objective To investigate the risk factors for prone position ventilation-related facial pressure injuries and its optimal modeling methods. Methods A total of 159 patients who were admitted to the Department of Critical Care Medicine of the First Affiliated Hospital of Xinjiang Medical University from June 2020 to March 2023 and received prone position ventilation were selected and divided into the pressure injury group （n=22） and non-pressure injury group （n=137） according to whether facial pressure injuries occurred or not. General information，disease diagnosis，therapeutic measures，and laboratory test results were collected. Stepwise Logistic regression，multivariate Logistic regression，and Lasso-Logistic regression were used to screen risk factors for facial pressure injuries and develop predictive models，respectively. The area under receiver operating characteristic curve（AUC） was plotted to evaluate the model discrimination. The Akaike Information Criterion （AIC），Bayesian Information Criterion （BIC），and calibration curve were applied to evaluate the calibration of the model. Decision curves were applied to evaluate the clinical application value of the models. The optimal modeling method was selected by comparing the predictive efficacy and clinical application differences of the three logistic regression models. Results The results of stepwise Logistic regression model showed that the influencing factors of facial pressure injuries were age （OR=39.041），diabetes mellitus （OR=7.256），and duration of a single-prone ventilation session （OR=6.705）. The results of the multivariate Logistic regression model showed that the factors influencing facial pressure injuries were age （OR=26.882），diabetes mellitus （OR=1.770），length of stay in the ICU （OR=2.610），and duration of a single-prone ventilation session（OR=5.340）. The results of Lasso-Logistic regression showed that the factors influencing facial pressure injuries were age （OR=38.256），diabetes mellitus （OR=1.094），duration of single prone ventilation （OR=5.738），and RASS score （OR=1.179）. The AUC，sensitivity and specificity of the Lasso#2;Logistic regression model for predicting prone position ventilation-related facial pressure injuries were 0.855，0.959 and 0.750， respectively，which were better than those of the stepwise and multivariate Logistic regression models. The AIC and BIC were 44.634 and 55.745，respectively，which were lower than the stepwise and multivariate Logistic regression models. The calibration curves showed that the Lasso-Logistic regression model predicted probabilities fitted the actual probabilities best. The decision curve showed that the Lasso-Logistic regression model obtained clinical benefits corresponding to risk thresholds of 0.01 to 0.98， which was better than the stepwise and multivariate Logistic regression models. Conclusion Age，diabetes mellitus，length of a single prone ventilation session，and Richmond Agitation Sedation Score are risk factors for ventilation-related facial pressure injuries. The Lasso-Logistic regression model has better predictive efficacy and clinical application value than stepwise and multivariate Logistic regression models，making it the best modeling method.
Subjects: Physics >> Nuclear Physics submitted time 2023-08-29
Abstract： The sensitivity of an experiment to detect the Majorana neutrino mass via neutrinoless double beta decay (0νββ) strongly depends on the rate of background events that can mimic this decay. One major source of this background is the radioactive emissions from the laboratory environment. In our study, we focused on assessing the background contributions from environmental gamma rays, neutrons, and underground muons to the Jinping bolometric demonstration experiment. This experiment uses an array of lithium molybdate crystal bolometers to probe the potential 0νββ decay of the 100Mo isotope at the China Jinping Underground Laboratory. We also evaluated the shielding effectiveness of the experimental setup through an attenuation study. Our simulations indicate that the combined background from environmental gamma rays, neutrons, and muons in the relevant 100Mo 0νββ Q-value region can be reduced to approximately 0.003 cts/kg/keV/yr.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-08-29 Cooperative journals: 《中国全科医学》
Abstract： Background Coronary microvascular disease（CMVD） is currently a research hotspot in the field of cardiovascular disease，traditional Chinese medicine（TCM） has unique advantages and significant efficacy in the treatment of CMVD，but there are problems in relevant clinical trials，such as inconsistencies in the diagnostic and efficacy criteria，exploring the core outcome set of TCM in the treatment of CMVD is conducive to the development of high-quality evidence in the future. Objective To analyze the application of outcomes measures in randomized controlled trials（RCTs） of CMVD treated with TCM，and propose corresponding questions and recommendations. Methods CNKI，SinoMed，VIP，Wanfang，PubMed，Embase and Cochrane Library were systematically searched for RCTs of CMVD treated with TCM from inception to February 09，2023. The basic information，interventions and outcome measures in RCTs of CMVD treated with TCM were extracted，the Cochrane systematic review manual bias risk assessment tool was used to evaluate the bias risk of the included literature and the Excel software was used to statistically analyze the outcome measures. Results A total of 88 articles were included，involving 2 clinical trial registration protocols and 1 English literature. Cochrane systematic review manual bias risk assessment showed that the included literature were evaluated as unclear in terms of random sequence generation，allocation concealment，blinding of participants and personnel，blinding of outcome assessors，and other bias；mostly low risk in terms of outcome data completeness and selective reporting. A total of 18 RCTs were analyzed for TCM syndromes of patients diagnosed with CMVD，involving 6 RCTs related to blood stasis due to qi deficiency，2 RCTs related to intermingled phlegm and blood stasis. A total of 115 outcome measures were obtained by statistical analysis，the total frequency was 571 times，which can be divided into 7 categories，including clinical efficacy，physicochemical testing，signs and symptoms，TCM syndrome points，quality of life，long-term prognosis，and safety testing. The frequency of total clinical efficacy rate was the highest（46 times），3 months was the most commonly used intervention node. and the highest frequency of composite outcome measures was the clinical efficacy combined with physicochemical testing. Conclusion It was found that the overall quality of RCTs of TCM in the treatment of CMVD was generally low，and there are some problems in the outcome measures，such as the lack of standardized TCM syndrome diagnosis criteria and efficacy criteria，and the lack of long-term prognosis monitoring. In the future，it is also necessary to conduct high-quality RCTs，combined with the characteristics of TCM treatment，to construct a standardized core outcome set of TCM in the treatment of CMVD.
Subjects: Physics >> General Physics: Statistical and Quantum Mechanics, Quantum Information, etc. submitted time 2023-08-29 Cooperative journals: 《中国全科医学》
Abstract： General practice in China has developed rapidly in recent years with remarkable progress， but the gap with developed countries in Europe and the United States is still large，and the training system of general practitioners still remains impefect. In Germany，the construction of the primary health care system and the training system of general practitioners have been well developed. Under the system of universal health insurance coverage and hierarchical diagnosis and treatment，a high level of health and patient satisfaction with primary healthcare services among residents have been achieved in Germany. Therefore，this study compares post-graduate education and continuing education of general practice in China and Germany， analyzes the challenges of general practice education reform in China，drawing on the conceptual framework of general practice education in Germany，and proposes targeted ideas and recommendations for solutions as follows：for the standardized residency training of general practice， increase the rotation flexibility as appropriate to facilitate the optimization of trainees' individualized competencies，incorporate the standardized curriculum of psychosomatic medicine and Balint group training to improve trainees' competence in psychosomatic medicine，establish standardized selection criteria and promote standardized training program for faculty of community hospital，and revisit the duration of general practice （including community） rotation after improving the qualifications of general practice faculty of community hospital ; for the continuing education，incorporate the special interest and small specialties into the general practice continuing education system to strengthen the functional medical characteristics of general practice and promote the professional diversification of general practitioners，and establish a national unified platform for continuing education in general practice. More practical research and resources are needed to improve the training system of general practitioners in China in the future.
Subjects: Physics >> General Physics: Statistical and Quantum Mechanics, Quantum Information, etc. submitted time 2023-08-29 Cooperative journals: 《中国全科医学》
Abstract： In recent years，the Internet of Things technology （IoT） has been developed extremely rapidly，and has been widely applied in the medicine field. Chronic obstructive pulmonary disease （COPD） is one of the most common chronic respiratory diseases in China，and it is worth exploring how IoT can be used to improve the clinical practice of COPD management. We summarized the research progress of IoT technology in COPD management at home and abroad and found that the current research on the application of IoT in COPD management is still in the exploratory stage and lacks high-quality，large-sample studies by reviewing the literature. Real-world studies are needed to conduct systematic evaluation of designed mature models or products in the future，especially the impacts on long-term clinical outcomes of patients，quality of life and health economics evaluation. Products design should be tailored to the characteristics and target of COPD and the characteristics of users，and emphasis should also be placed on qualitative researches to understand the experiences，opinions or attitudes of users toward such products.
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