Consensus on glycemic management for patients with coronary heart disease and type 2 diabetes

The prevalence of patients with coronary heart disease(CHD)and diabetes mellitus is notably high,posing sig-nificant residual cardiovascular risks even after routine interventions such as antihypertensive,lipid-lowering,and antithrombot-ic treatments.Recent studies have demonstrated that certain glucose-lowering medications confer cardiovascular benefits for pa-tients with type 2 diabetes.However,a survey indicates that cardiologists may not be fully acquainted with the optimal screen-ing timing,indicators,and diagnostic criteria for type 2 diabetes,and there is insufficient awareness and a low rate of prescrip-tion of novel glucose-lowering medications with proven cardiovascular efficacy,such as glucagon-like peptide-1 receptor agon-ists(GLP-1 RAs)and sodium-glucose co-transporter-2 inhibitors(SGLT-2i).In this context,based on domestic and international guidelines or consensus and the latest evidence-based evidence,this consensus aims to standardize the glycemic management for patients with acute coronary syndrome,chronic coronary syndrome,and perioperative management for percutaneous coronary intervention.It highlights the key points of screening and diagnosis of type 2 diabetes,and the comprehensive management of cardiovascular risk in patients with CHD.The consensus elaborates on the principles and algorithms of glycemic management for CHD patients,without involving acute complications of diabetes,clarifies the clinical practice of glucose-lowering medications with cardiovascular benefits,and promotes the standardized use of these medications in cardiovascular and other related spe-cialty fields.Additionally,it addresses the glucose-lowering treatment to comprehensively reduce cardiovascular risks.

Sleep quality and characteristics of older adults with acute cardiovascular disease

Sleep plays a vital role in restoring the physical and mental health of people with cardiovascular disease.However,the hospital setting is not a conducive environment for sleep.Sleep interruptions by members of the care team,including vital sign checks,medication delivery,and blood draws for laboratory investigations,are routinely done in many hospitals.Frequent interruptions by staff and noise by other patients have been cited as barriers to restorative sleep in the hospital.

Association between the frontoparietal network,clinical symptoms and treatment response in individuals with untreated anorexia nervosa

Background Anorexia nervosa(AN)has been characterised as a psychiatric disorder associated with increased control.Currently,it remains difficult to predict treatment response in patients with AN.Their cognitive abilities are known to be resistant to treatment.It has been established that the frontoparietal control network(FPCN)is the direct counterpart of the executive control network.Therefore,the resting-state brain activity of the FPCN may serve as a biomarker to predict treatment response in AN.Aims The study aimed to investigate the association between resting-state functional connectivity(RSFC)of the FPCN,clinical symptoms and treatment response in patients with AN.Methods In this case-control study,79 female patients with AN and no prior treatment from the Shanghai Mental Health Center and 40 matched healthy controls(HCs)were recruited from January 2015 to March 2022.All participants completed the Questionnaire Versionof the Eating Disorder Examination(version 6.0)to assess the severity of their eating disorder symptoms.Additionally,RSFC data were obtained from all participants at baseline by functional magnetic resonance imaging.Patients with AN underwent routine outpatient treatment at the 4th and 12th week,during which time their clinical symptoms were evaluated using the same measures as at baseline.Results Among the 79 patients,40 completed the 4-week follow-up and 35 completed the 12-week follow-up.The RSFC from the right posterior parietal cortex(PPC)and dorsolateral prefrontal cortex(diPFC)increased in 79 patients with AN vs 40 HCs after controlling for depression and anxiety symptoms.By multiple linear regression,the RSFC of the PPC to the inferior frontal gyrus was found to be a significant factor for self-reported eating disorder symptoms at baseline and the treatment response to cognitive preoccupations about eating and body image,after controlling for age,age of onset and body mass index.The RSFC in the dIPFC to the middle temporal gyrus and the superior frontal gyrus may be significant factors in the treatment response to binge eating and loss of control/overeating in patients with AN.Conclusions Alterations in RSFC in the FPCN appear to affect self-reported eating disorder symptoms and treatment response in patients with AN.Our findings offer new insight into the pathogenesis of AN and could promote early prevention and treatment.

Cluster sampling methodology to evaluate immunization coverage

BACKGROUND Immunization is a key component of primary health care and an indisputable human right.Vaccines are critical to the prevention and control of infectious disease outbreaks.The coronavirus disease 2019(COVID-19)pandemic and associated disruptions over the past two years have strained the health systems,with many children missing out on essential childhood vaccines.AIM To evaluate the immunization coverage among 12-23-month-old children in the rural areas of Community Health Centre(CHC)Dighal and to determine the factors influencing the existing immunization coverage.METHODS A coverage evaluation survey was conducted according to the 30-cluster sampling technique,which is the standard methodology for such surveys devised by World Health Organization.A total of 300 children aged 12-23 months were included,whose immunization details were noted from their immunization cards.RESULTS Full immunization rate was noted in 86.7%of the children,with partial and non-immunized children accounting for 9%and 4.3%respectively.The full immunization dropout rate was 4.2%.The common reasons for partial or non-immunization were family problem including illness of mother,vaccine not being available and child being ill.Place of birth(P=0.014)and availability of immunization card(P<0.001)were significant predictors of the immunization status.Since the study was conducted in 2020/2021,health services were disrupted due to the COVID-19 lockdown.CONCLUSION Due to the coverage being higher than the national average,it was concluded that the immunization coverage was optimal and not affected by the COVID-19 pandemic.

The Promoting Role of TCM Nursing in the Rehabilitation of Stroke Hemiplegia Patients

Objective: To explore the promoting function of TCM nursing in the rehabilitation of hemiplegia patients with stroke. Methods: 78 stroke hemiplegic patients admitted from April 2022 to April 2024 were randomly divided into a control group of 38 cases who received routine care, and an experimental group of 40 cases who received routine nursing basis plus traditional Chinese medicine nursing;the nursing effects of the two groups of patients were compared. Results: After 12 days of nursing care, the experimental group showed better psychological status [SAS score (21.71 ± 3.21), SDS score (22.18 ± 2.31)], limb motor function, daily living ability, and neurological function [NIHSS score (12.23 ± 2.21)] than the control group, with significant differences in data (P Conclusion: Traditional Chinese medicine nursing for stroke hemiplegia patients is more conducive to promoting rehabilitation than routine nursing.

The Diagnostic Value of Oligoclonal Band Detection in Viral Encephalitis

Objective: This study aims to explore the differences in cerebrospinal fluid oligoclonal band (CSF-OCB) expression among different age groups in viral encephalitis and its reference value for diagnosis. Methods: Forty-two patients with viral encephalitis were divided into two groups: 25 adults and 17 children. The presence of oligoclonal bands in the cerebrospinal fluid (CSF) was detected using polyacrylamide gel electrophoresis, and CSF routine analysis was conducted for comparative analysis. Results: The CSF-OCB positivity rate was higher in the adult group (48%) compared with the pediatric group (11.76%), with a statistically significant difference (P Conclusion: 1) The expression of CSF-OCB positivity in patients with viral encephalitis is age-related, with higher positivity rates observed in adults compared to children. 2) Although CSF oligoclonal band detection is not a specific diagnostic marker for viral encephalitis in adults, it still holds certain reference value.

Analysis of Blood Lipids, Blood Glucose, Blood Uric Acid, and Blood Routine Test Results in Retired Employees of a Unit in the Civil Aviation System

Objective:To investigate and analyze the annual physical examination results of retired employees from a unit in the civil aviation system,focusing on blood lipids,blood glucose,blood uric acid,and blood routine results.The study aims to provide relevant references for formulating reasonable disease management measures for preventing and controlling hyperlipidemia,hyperuricemia,and other conditions in retired employees.Methods:The examination results of 231 participants were collected and analyzed.The participants were divided into four groups based on age:middle-aged group,young-old group,middle-old group,and old-old group.The blood test results were compared across these groups,and an assessment of atherosclerotic cardiovascular disease(ASCVD)risk levels was completed in conjunction with medical history.Blood test results were also compared by gender.Results:There were no significant statistical differences in blood test results when grouped by age.However,the prevalence of hyperuricemia was higher in males than in females,while the prevalence of hypercholesterolemia was higher in females than in males.The LDL-C target achievement rate was lower in the moderate-and-high-risk group as well as the very high-risk group as defined by ASCVD risk levels.Conclusion:Management of hyperuricemia and hyperlipidemia in retired employees(elderly patients)should be strengthened to reduce the risk of ASCVD events and alleviate the potential medical burden associated with disease progression.

Efficacy of repeated intravenous esketamine in adolescents with anxious versus non-anxious depression

Background Patients with anxious major depressive disorder(MDD)are more likely to have poorer outcomes than those with non-anxious MDD.However,the effect of esketamine on adolescents with anxious versus non-anxious MDD has remained unknown.Aims We compared the efficacy of esketamine in adolescents with MDD and suicidal ideation,both anxious and non-anxious.Methods Fifty-four adolescents with anxious(n=33)and non-anxious(n=21)MDD received three infusions of esketamine 0.25mg/kg or active-placebo(midazolam 0.045 mg/kg)over 5 days,with routine inpatient care and treatment.Suicidal ideation and depressive symptoms were assessed using the Columbia Suicide Severity Rating Scale and the Montgomery-Asberg Depression Rating Scale.Multiple-sample proportional tests were used to compare the differences between groups on treatment outcomes 24 hours after the final infusion(day 6,primacy efficacy endpoint)and throughout the 4-week post-treatment(days 12,19 and 33).Results In subjects who received esketamine,a greater number of patients in the non-anxious group than the anxious group achieved antisuicidal remission on day 6(72.7%vs 18.8%,p=0.015)and day 12(90.9%vs 43.8%,p=0.013),and the non-anxious group had a higher antidepressant remission rate compared with the anxious group on day 33(72.7%vs 26.7%,p=0.045).No significant differences in treatment outcomes were observed between the anxious and non-anxious groups at other time points.Conclusions Three infusions of esketamine as an adjunct to routine inpatient care and treatment had a greater immediate post-treatment antisuicidal effect in adolescents with non-anxious MDD than in those with anxious MDD;however,this benefit was temporary and was not maintained over time.

Limiting Magnitudes of the Wide Field Survey Telescope(WFST)

Expected to be of the highest survey power telescope in the northern hemisphere,the Wide Field Survey Telescope(WFST)will begin its routine observations of the northern sky since 2023.WFST will produce a lot of scientific data to support the researches of time-domain astronomy,asteroids and the solar system,galaxy formation and cosmology and so on.We estimated that the 5σlimiting magnitudes of WFST with 30 s exposure are u=22.31mag,g=23.42 mag,r=22.95 mag,i=22.43 mag,z=21.50 mag,w=23.61 mag.The above values are calculated for the conditions of airmass=1.2,seeing=075,precipitable water vapor=2.5 mm and Moon-object separation=45°at the darkest New Moon night of the Lenghu site(V=22.30 mag,Moon phaseθ=0°).The limiting magnitudes in different Moon phase conditions are also calculated.The calculations are based on the empirical transmittance data of WFST optics,the vendor provided CCD quantum efficiency,the atmospherical model transmittance and spectrum of the site.In the absence of measurement data such as sky transmittance and spectrum,we use model data.

Legionella pneumonia complicated with rhabdomyolysis and acute kidney injury diagnosed by metagenomic nextgeneration sequencing: a case report

The triad of Legionella pneumonia,rhabdomyolysis,and acute kidney injury(AKI)is uncommon but can be devastating.[1]It is vital to recognize Legionella species early as a potential cause of pneumonia.Legionella infection remains underdiagnosed because of the nonspecific nature of clinical features and the shortcomings of routinely available diagnostic tests.[2]Metagenomic next-generation sequencing(mNGS)is a culture-free and hypothesis-free diagnostic method that can rapidly identify almost all known pathogens in a sample.[3]Here,we present a successfully cured case of rhabdomyolysis and AKI caused by Legionella pneumophila with etiologic diagnosis aided by the use of mNGS.

Why Kenya should worry about Anopheles stephensi

On the 18th of February, the Kenya Medical Research Institute(KEMRI) raised an alarm that it had detected Anopheles(An.) stephensi in Laisamis and Saku sub counties of Marsabit county during a routine mosquito surveillance[1,2]. Up until this announcement, the invasive mosquito had been reported in other horn of African countries: Djibouti(2012), Ethiopia(2016).

Principal Component Analysis of Ground Level Enhancement of Cosmic Ray Events

We applied principal component analysis(PCA)to the study of five ground level enhancements(GLEs)of cosmic ray(CR)events.The nature of the multivariate data involved makes PCA a useful tool for this study.A subroutine program written and implemented in the R software environment generated interesting principal components.Analysis of the results shows that the method can distinguish between neutron monitors(NMs)that observed Forbush decreases from those that observed GLEs at the same time.The PCA equally assigned NMs with identical signal counts with the same correlation factor(r)and those with close r values equally have a close resemblance in their CR counts.The results further indicate that while NMs that have the same time of peak may not have the same r,most NMs that had the same r also had the same time of peak.Analyzing the second principal components yielded information on the differences between NMs having opposite but the same or close values of r.NMs that had the same r equally had the tendency of being close in latitude.

Health Phys.Abstracts,Volume 123,Number 5

Practical Tools for Patient-specific Characterization and Dosimetry of Radiopharmaceutical Extravasation Extravasation during radiopharmaceutical injection may occur with a frequency of more than 10%.In these cases,radioactivity remains within tissue and deposits unintended radiation dose.Characterization of extravasations is a necessary step in accurate dosimetry,but a lack of free and publicly available tools hampers routine standardized analysis.Our objective was to improve existing extravasation characterization and dosimetry methods and to create and validate tools to facilitate standardized practical dosimetric analysis in clinical settings.Using Monte Carlo simulations,we calculated dosimetric values for sixteen nuclear medicine isotopes:^(11 )C,^(64) Cu,^(18) F,^(67 )Ga,^(68) Ga,^(123) I,^(131) I,111 In,177 Lu,13 N,15 O,82 Rb,153 Sm,89 Sr,99m Tc,and 90 Y.We validated our simulation results against five logical alternative dose assessment methods.We then created three new characterization tools:a worksheet,a spreadsheet,and a web application.We assessed each tool by recalculating extravasation dosimetry results found in the literature and used each of the tools for patient cases to show clinical practicality.Average variation between our simulation results and alternative methods was 3.1%.Recalculation of published dosimetry results indicated an average error of 7.9%.Time required to use each characterization tool ranged from 1 to 5 min,and agreement between the three tools was favorable.We improved upon existing methods by creating new tools for characterization and dosimetry of radiopharmaceutical extravasation.These free and publicly available tools will enable standardized routine clinical analysis and benefit patient care,clinical follow-up,documentation,and event reporting.

Catatonia:“Fluctuat nec mergitur”

In the beginning of the 1900s,the prevalence of catatonia in inpatient samples was reported to be between 19.5%and 50%.From the mid-1900s,most clinicians thought that catatonia was disappearing.Advances in medical sciences,particularly in the field of neurology,may have reduced the incidence of neurological diseases that present with catatonic features or mitigated their severity.More active pharmacological and psychosocial treatment methods may have either eliminated or moderated catatonic phenomena.Moreover,the relatively narrow descriptive features in modern classifications compared with classical texts and ascribing catatonic signs and symptoms to antipsychotic-induced motor symptoms may have contributed to an apparent decline in the incidence of catatonia.The application of catatonia rating scales introduced in the 1990s revealed significantly more symptoms than routine clinical interviews,and within a few years,the notion of the disappearance of catatonia gave way to its unexpected resurgence.Several systematic investigations have found that,on average,10%of acute psychotic patients present with catatonic features.In this editorial,the changes in the incidence of catatonia and the possible underlying causes are reviewed.

Effects of Antimicrobial Peptides on Production,Slaughter Performance and Blood Routine of Tan Sheep

[Objectives]This study was conducted to analyze effects of antimicrobial peptides added to the diet of Tan sheep on their production, slaughter performance and blood composition. [Methods] Ninety two four-month-old Tan sheep were randomly divided into two treatment groups according to their body weight, 46 in each group. The control check group(CK) was feed with conventional diet, and the experimental group was fed with the addition of antimicrobial peptide on the basis of the conventional diet, with the added amount of 2.5 g/sheep per day. The experimental period was 60 d. [Results] The incidence rate was 75.06% lower in the experimental group than in the CK. The average daily weight gain per sheep was 11.27% higher in the experimental group than in the CK(P<0.05). The feed conversion ratio was 8.45% lower in the experimental group than in the CK(P<0.05). The average daily gross profit per sheep was 12.12% higher in the experimental group than in the CK. For slaughter performance, the data difference of each item was not significant. The PH at 45 min and 24 h after slaughter was within the normal range of fresh mutton. The cooked meat percentage and water loss rate showed no significant differences(P>0.05). The marbling ranged from 2.45 to 2.50, indicating that the fat content was moderate, and the difference between groups was not significant(P>0.05). The flesh color ranged from 3.00 to 3.15, between light red and bright red, belonging to the normal color of mutton, and the difference between groups was not significant(P>0.05). The shear force was between 2.50 and 2.65, without a significant difference between groups(P>0.05). The white blood cells, lymphocytes and platelets in the experimental group were lower than those in the CK(P<0.01). The erythrocytes and hemoglobin in the erythrocyte group were higher than those in the CK(P<0.05). The neutrophils and monocytes in the experimental group were lower than those in the CK(P<0.05). [Conclusions] This study provides a technical basis for the rational use of antimicrobial peptides and their application in ruminants.

Microscopic Characteristics and Routine Detection of Hedyotis hedyotidea(DC.)Merr.

[Objectives]To study the microscopic characteristics and routine detection of Hedyotis hedyotidea(DC.)Merr.[Methods]The microscopic characteristics of the root,stem cross section and the whole plant powder of H.hedyotidea were studied by the methods of slide-shaft section,biological staining and microscopic imaging;the routine detection items such as moisture,ash,acid-insoluble ash and extract were detected and analyzed in accordance with the requirements of Chinese Pharmacopoeia.[Results]The microscopic characteristics of the root,the stem and the whole plant powder of H.hedyotidea were obtained.The moisture content of 10 batches of H.hedyotidea samples was in the range of 4.25%-7.90%,the water-soluble extract is in the range of 15.08%-22.52%,the total ash was in the scope of 8.27%-10.45%,and the acid-insoluble ash was in 0.13%-0.95%.The proposed water content of H.hedyotidea should not exceed 10.00%,the water-soluble extract should not be less than 12.00%,the total ash content should not exceed 13.00%,and the acid-insoluble ash content should not exceed 1.20%.[Conclusions]The results of this experiment can provide a reference for the quality control and quality standard of H.hedyotidea.

Rails in Pics

Railway photographer He Junyun records wonderful moments on the China-Laos Railway with his camera.Click,click!He Junyun pressed the shutter of his camera as a train shot down the tracks.As a rail photographer,it’s a routine he has done thousands of times as he witnessed the construction of the China-Laos Railway from start to finish accompanied by the changes and expectations brought by the“iron dragon”.

A Tale of Boundless Care

Chinese medical teams provide much-needed assistance to people in Equatorial Guinea On the morning of 19 May 2022, when Chinese surgeon Chen Zhuanghao was doing his routine work in Bata General Hospital,Equatorial Guinea, he noticed something unusual. More and more local pupils aged12 to 13 were visiting the hospital because of vomiting and abdominal pain. In just several hours.

Ecological Dividends For the People

Every morning,Hong Guoguang walks along the river to check whether there is any sewage being discharged into the water,or if there is any garbage or floating objects in the river.A 5-km river patrol every 10 days is now his routine work.

Productive Union

As South Africans adjust to living in darkness with no end in sight to power outages,many are desperate for alternative energy sources.Known locally as loadshedding,widespread electricity blackouts are carried out multiple times a day by state-owned energy utility Eskom to avoid the total collapse of the grid.For some people,lack of reliable power supply can be the di!erence between life and death,as blackouts have become routine,a!ecting every part of the South African society.