Background: The prediction of severe acute pancreatitis (SAP) is the key to providing timely and targeted intensive care for acute pancreatitis (AP). The heart is one of multiple organs involved in the early stage of SAP, but the predictive ability of cardiac dysfunction for SAP remains elusive. We sought to determine if the serum levels of three cardiac indicators (CI) including N-terminal pro-brain natriuretic peptide (NT-proBNP), cardiac troponin I (cTNI), and creatine kinase myocardial band (CK-MB) at admission could predict the occurrence of SAP and the development of related organ failure (OF). Methods: A retrospective, single-center cohort study was conducted on the files of patients presenting to the emergency intensive care unit and medical ward of a regional hospital in Shanghai. Patients diagnosed as having AP and who met the 2012 Atlanta guideline were admitted within 48 hours after disease onset. Results: Of the 670 AP patients screened, 238 were enrolled into the study and divided into mild acute pancreatitis (MAP) (n=59), moderate severe acute pancreatitis (MSAP) (n=123), and SAP (n=56) groups. No significant difference was found in baseline age, gender, duration from disease onset to admission, comorbidity, or substance abuse. As the levels of three CIs were significantly higher in the SAP group than in the MAP and MSAP groups, the enrolled patients were regrouped into non-SAP and SAP groups for predictive evaluation. Multivariate analysis and nomogram modelling showed that CK-MB, but not cTNI or NT-proBNP predicted the occurrence of SAP [area under curve (AUC) =0.805, confidence interval (CI): 0.794–0.905]. Specifically, 89 patients with OF (Modified Marshall score ≥2) upon admission were selected and CK-MB was shown to predict (AUC =0.805, CI: 0.794–0.905) persistent OF (n=48, duration of OF >48 hours) compared to transient organ failure (TOF) (n=41, duration of OF <48 hours). Conclusions: CIs including NT-proBNP, cTNI, and CK-MB were elevated in the early stage of AP. CK-MB might be used as an efficient predictive biomarker for SAP occurrence and OF development at admission.

Background: The prediction for severe acute pancreatitis (SAP) is the key to give timely targeted treatment. Leukocyte cell population data (CPD) have been widely applied in early prediction and diagnosis of many diseases, but their predictive ability for SAP remains unexplored. We aim to testify whether CPD could be an indicator of AP severity in the early stage of the disease.Methods: The prospective observational study was conducted in the emergency department ward of a territory hospital in Shanghai. The enrolled AP patients should meet 2012 Atlanta guideline.Results: Totally, 103 AP patients and 62 healthy controls were enrolled and patients were classified into mild AP (n = 30), moderate SAP (n = 42), and SAP (n = 31). Forty‐two CPD parameters were examined in first 3 days of admission. Four CPD parameters were highest in SAP on admission and were constantly different among 3 groups during first 3 days of hospital stay. Eighteen CPD parameters were found correlated with the occurrence of SAP. Stepwise multivariate logistic regression analysis identified a scoring system of 4 parameters (SD_LALS_NE, MN_LALS_LY, SD_LMALS_MO, and SD_AL2_MO) with a sensitivity of 96.8%, specificity of 65.3%, and AUC of 0.87 for diagnostic accuracy on early identification of SAP. AUC of this scoring system was comparable with MCTSI, SOFA, APACHE II, MMS, BISAP, or biomarkers as CRP, PCT, and WBC in prediction of SAP and ICU transfer or death.Conclusions: Several leukocyte CPD parameters have been identified different among MAP, MSAP, and SAP. They might be ultimately incorporated into a predictive system marker for severity of AP.

Background: High-altitude pulmonary edema (HAPE) refers to the onset of breathlessness, cough, and fever at rest after arriving at high altitudes. It is a life-threatening illness caused by rapid ascent to high altitudes. Furosemide is controversial in HAPE treatment but is routinely used in China. Further research is needed to assess its efficacy and impact on HAPE management and prognosis. The aim of this study is to determine the effectiveness of furosemide for HAPE. Methods: A retrospective was conducted to analysis of patients with HAPE admitted to the People’s Hospital of Shigatse City from January 2018 to September 2023. Patients were divided into furosemide group and non-furosemide group for further analysis. Clinical variables including demographic information, comorbidities, vital signs, inflammatory markers, biochemical analysis, CT severity score and prognostic indicators were collected. Results: A total of 273 patients were enrolled, with 209 patients in the furosemide group and 64 patients in the non-furosemide group. The furosemide group showed a significantly decrease in CT severity scores compared to the non-furosemide group. Subgroup analysis showed that the longer the duration of furosemide use, the more pronounced the improvement in lung CT severity scores. But there were no significant differences in length of hospital stay and in-hospital mortality between the two groups. Conclusion: Furosemide helps alleviate pulmonary edema in HAPE patients, but further research is needed to clarify its impact on prognosis.

Cognitive impairment constitutes a significant global public health challenge, particularly for countries or regions experiencing the largest increases in aging populations. Most countries have reached a consensus that cognitive impairment screening, care, and intervention should be conducted within community settings. To identify multilevel barriers and facilitators for community health management for cognitive impairment, this study utilized the Consolidated Framework for Implementation Research (CFIR) to systematically evaluate the implementation of strategies for managing cognitive impairment in Shanghai, China. A semi-structured interview guide was developed based on the CFIR. Purposeful sampling was used to select 14 stakeholders from diverse sectors, including public health authorities, community health service centers, and experts in health management related to cognitive impairment, for semi-structured interviews. CFIR served as the coding framework for inductive analysis to identify and clarify the facilitators and barriers to cognitive impairment health management within the existing policy environment. Qualitative interviews with stakeholders in community-based cognitive impairment health management revealed eight facilitators and ten barriers. The facilitators included enhanced social engagement for older adults, efficient digital tools, a supportive policy environment, adequate funding, integration into basic public health services, sufficient community human resources, supportive internal and external teams, and health education. Collectively, these factors fostered a conducive environment for effective cognitive impairment health management. In contrast, the identified barriers comprised a lack of validation for smart tools, absence of collaborative mechanisms, insufficient incentives for primary care physicians (PCPs), a lack of long-term mechanisms, inadequate professional expertise, low energy levels, limited training channels, insufficient disease awareness among older adults, absence of standardized implementation plans, and superficial work practices. These barriers hindered the effective execution of community-based cognitive impairment health management strategies. This study identified the primary facilitators and barriers to community-based cognitive impairment management within the context of current policies. To enhance the effectiveness of interventions, policymakers, health departments, and community organizations should actively address the identified barriers and leverage the facilitators. Additionally, the findings provide valuable insights for other countries facing similar challenges in cognitive impairment management. Future research should focus on integrating these factors into practical applications and evaluating the effectiveness of such interventions. Not applicable.

Social media has become a significant platform for health knowledge popularization worldwide, especially during public health crises. However, the factors influencing healthcare professionals’ intention to engage in health knowledge popularization on social media, particularly in China, remain underexplored due to the unique socio-medical environment. This study examines determinants of Chinese healthcare professionals’ social media-based health knowledge popularization participation, evaluating the applicability of the Unified Theory of Acceptance and Use of Technology (UTAUT) and Perceived Risk Theory. We developed a survey integrating UTAUT constructs (performance expectancy, effort expectancy, social influence, facilitating conditions) with perceived risk. Data from 762 professionals across four Shanghai tertiary hospitals were analyzed using structural equation modeling. Social influence (β = 0.299, p < 0.001), performance expectancy (β = 0.221, p < 0.001), and effort expectancy (β = 0.312, p < 0.001) significantly positively predicted participation intention. Facilitating conditions directly affected actual behavior (β = 0.079, p < 0.05), while perceived risk showed no significant association with intention (β=-0.019, p = 0.581). Institutional support emerges as crucial in mediating healthcare professionals’ social media engagement, with social influence and anticipated effectiveness being primary motivators. The non-significant role of perceived risk may reflect China’s performance evaluation systems and policy safeguards mitigating professional concerns. Practical implications suggest that enhancing organizational support through resource allocation and workload adjustments could effectively promote online health knowledge popularization participation. Not applicable.