Objective:To investigate the application value of scenario simulation combined with standardized patient teaching in the training of doctor-patient communication skills among interns.Methods:A total of 110 clinical medicine interns were selected from Qilu Hospital of Shandong University and were divided into experimental group and control group using a random number table, with 55 interns in each group. The interns in the control group received traditional lecturing, and those in the experimental group received scenario simulation combined with standardized patient case-based teaching. The SEGUE Communication Skill Evaluation Scale and Patient Satisfaction Questionnaire were used to assess the improvement in communication skills in both groups, and Physician Self-Evaluation Scale and Course Satisfaction Questionnaire were used to assess the effectiveness of the course and the degree of satisfaction with the course. SPSS 26.0 was used for the t-test, the Mann-Whitney U test, and the rank sum test. Results:After training, both groups showed significant improvements in communication skills and patient satisfaction [experimental group in terms of communication skills: (55.38±13.11) vs. (74.82±6.75), P<0.001; experimental group in terms of patient satisfaction: 39.00 (39.00, 42.00) vs. 81.00 (79.00, 83.00), P<0.01; control group in terms of communication skills: (56.53±12.34) vs. (65.45±10.18), P<0.001; control group in terms of patient satisfaction: 39.00 (39.00, 42.00) vs. 73.00 (68.00, 77.00), P<0.001], and the experimental group had significantly higher scores than the control group [communication skills: (74.82±6.75) vs. (65.45±10.18), P<0.001; patient satisfaction: 81.00 (79.00, 83.00) vs. 73.00 (68.00, 77.00), P<0.001]. The Physician Self-Evaluation Scale showed that the experimental group had a significant improvement compared with the control group ( P<0.05). The results of the Course Satisfaction Questionnaire showed that the degree of overall satisfaction of the course was only 87.28% in the control group, while all the interns in the experimental group were satisfied with the course ( P<0.001); the new teaching method showed great advantages ( P<0.001). Conclusions:In the training of doctor-patient communication skills among interns, the application of scenario simulation combined with standardized patient case-based teaching can significantly improve their abilities of the application of knowledge application, humanistic concern, and communication skills, and therefore, it is an effective and promising method for the training of doctor-patient communication skills.

Objective To evaluate the efficacy of neurofeedback intervention in the treatment of children and adolescents with au-tism.Methods Systematically searched PubMed,Web of Science,Cochrane Library,ClinicalTrials.gov and SinoMed for randomized controlled trials using neurofeedback to treat children and adolescents with autism spectrum disorder.The search covered studies from data-base inception to 5th December,2024.Data were extracted and analyzed by using RevMan 5.4.1.Results A total of 8 studies were in-cluded,comprising 381 patients.The results of Meta-analysis showed that neurofeedback group had significantly lower scores on various scales compared to those inthe control group(MD=7.49,95％CI:5.33-9.65,P＜0.001).Additionally,theta wave power in the neurofeedback group was notably reduced(OR=18.14,95％CI:7.32-44.96,P＜0.001).Conclusion Compared to placebo inter-ventions and conventional treatments(such as clinical counseling or one intervention models),neurofeedback demonstrates significant ad-vantages in improving social skills,cognitive functioning,and emotional regulation in children and adolescents with autism.

Objective To establish a predictive model for hepatic sinusoidal obstruction syndrome(HSOS)and Budd-Chiari syn-drome(BCS),and to evaluate the performance of the model.Methods From April 2016 to February 2024,20 patients with HSOS and 40 patients with BCS who were first discharged from the Beijing Friendship Hospital Affiliated to Capital Medical University hospital infor-mation system(HIS)system were retrospectively collected.The clinical data of all patients were extracted,and the independent risk fac-tors for HSOS were screened by multi-factor Logistic regression method,and the differential diagnosis model was established accordingly,and then the efficacy was evaluated by receiver operating characteristic(ROC)curve.Results Multivariate Logistic regression analysis showed that hepatic vein stenosis or unclear display(OR=39.441,95％CI:5.928-262.429)was an independent risk factor for HSOS,and paravertebral vein opening was an independent protective factor for HSOS(OR=0.026,95％CI:0.002-0.285).Based on the above two parameters,a prediction model for HSOS in patients with hepatic venous outlet tract obstruction was established.The ROC curve showed that the area under the curve(AUC)of the model was 0.922(95％CI:0.864-0.991),with the sensitivity of 85.0％and the specificity of 92.5％.Conclusion Hepatic vein stenosis or unclear display is an independent risk factor for HSOS in patients with hepatic vein outflow tract obstruction during hospitalization,and the model constructed can predict the risk of HSOS.

Objective To investigate the protective effect and mechanism of calcium dobesilate on oxidative damage induced by high-glucose in Müller cells.Methods The oxidative damage model of Müller cells induced by high-glucose was established and the cells were divided into 4groups.The control group was cultured normally,and the high glucose group was cultured in the medium of 35mmol/L glucose.The control+calcium dobesilate group was treated with 0.5μmol/L calcium dobesilate intervention cells on the basis of routine culture,and the high sugar+calcium dobesilate group was treated with 0.5μmol/L calcium dobesilate intervention cells on the basis of high glucose.Cell proliferation was assessed by CCK-8,apoptosis was detected by flow cytometry,and oxidative stress markers were detected by the kit.Intracellular correction potassium channel subtype 4.1(Kir4.1)and aquaporin 4(AQP4)protein levels were detected by western blot.Results Compared with the control group,the proliferative activity of Müller cells of the high glucose group was decreased,apoptosis rate was increased,oxidative stress occurred,AQP4 protein expression level was increased and Kir4.1 protein level was decreased(P＜0.05).Compared with the high glucose group,the cell activity and apoptosis rate of the high glucose+calcium do-besilate group were increased,the oxidative stress damage was alleviated,the AQP4 protein expression level was decreased and the Kir4.1 protein level was increased(P＜0.05).Conclusion Calcium dobesilate may inhibit the oxidative damage of Müller cells induced by high-glucose by regulating the AQP4/Kir4.1 axis.

Objective To explore the correlation between disease duration and anxiety,depression,sleep quality and quality of life in patients with inflammatory bowel disease(IBD).Methods A cross-sectional survey study was conducted from September 2021 to May 2022 in 42hospitals in 22 provinces(autonomous regions and municipalities directly under the central government).General clinical information and disease duration of adult patients with IBD who voluntarily participated in the study were collected,and the anxiety,de-pression,sleep quality,and quality of life of IBD patients were assessed by using the Generalized Anxiety Disorder(GAD-7),the Pa-tient Health Questionnaire-9(PHQ-9),the Pittsburgh Sleep Quality Index(PSQI),and the Inflammatory Bowel Disease Questionnaire(IBDQ).Results A total of 2476 valid questionnaires were collected.Among them,458(18.50％)patients had a disease duration within 1 year,481(19.43％)patients had a disease duration of 1-2 years,764(30.86％)had a disease duration of 2-5 years,529(21.37％)had a disease duration of 5-10 years,and 244(9.85％)had a disease duration of more than 10 years.The GAD-7score(P=0.005),PHQ-9score(P=0.002),and PSQI score(P=0.005)were statistically significant in different disease duration groups.In pairwise comparisons,IBD patients with a disease duration of 5-10 years were more likely to have depression,anxiety,and sleep disorder.IBDQ scores were statistically significant in different disease duration groups(P=0.005).Among them,bowel symptom score(P=0.001),emotional competence score(P=0.013),and social competence score(P＜0.001)were statistically significant.Patients with a disease duration of 2-5 years seemed to have a better quality of life,including milder bowel symptoms,better emotional,and social competence.Patients with a disease duration of 10 years or more had better social competence.Conclusion Anxiety,depres-sion,sleep disorders,and quality of life are associated with disease duration in patients with IBD,and patients with IBD with a disease duration of 5-10 years are more likely to have depressive states,anxiety and sleep states.

Objective To investigate the role of Taohong Siwu Decoction(THSWD)in microglia pyroptosis mediated neuronal injury in PC12 under oxygen-glucose deprivation/reperfusion(OGD/R)and related mechanisms.Methods PC12 and BV2 cells were co-cultured using the OGD/R model to simulate ischemia-reperfusion injury of in vitro.The experiment was grouped as follows:control(PC12,PC12+BV2),OGD/R group(PC12,PC12+BV2),and OGD/R+10％THSWD-containing serum group(PC12,PC12+BV2).Oxygen and glucose was restored for 24h after 4-6h of deprivation.The severity of damage to PC12 cells was evaluated by cell counting kit-8(CCK-8)and flow cytometry.BV2 cells were used for the experiments and were divided into control,OGD/R and OGD/R+THSWD-containing serum(5％,10％,15％)groups,which were moulded and administered in the same way,and cell py-roptosis proteins proteinscysteinyl aspartate specific proteinase-1(caspase-1),apoptosis-associated speck-like protein containing a CARD(ASC),gasdermin D(GSDMD),interleukin-1β(IL-1β),interleukin-18(IL-18)and nucleotide-binding oligomeriza-tion domain-like receptor protein 3(NLRP3)inflammasome-associated proteins were detected by Western blot.Results In the pres-ence of BV2 cells,THSWD was able to further restore the morphology,increase cell viability(P＜0.05)and reduce apoptosis of PC12 cells after OGD/R injury(P＜0.05).In addition,THSWD was able to reduce the expression of OGD/R-induced pyroptosis proteins(caspase-1,ASC,GSDMD,IL-1β,IL-18)in BV2 microglia cells(P＜0.05).In contrast,the inhibitory effects of THSWD on BV2 cells pyroptosis proteins and NLRP3 inflammasome were reversed by NLRP3/caspase-1 agonist(P＜0.05).Conclusion THSWD protects PC 12 cells against OGD/R injury via inhibiting microglia pyroptosis mediated by the NLRP3/caspase-1 pathway.

Objective To analyze the risk factors for postoperative subdural effusion(SE)in patients with severe traumatic brain in-jury(sTBI)and create a column chart to predict the occurrence of postoperative SE in patients.Methods A retrospective analysis was conducted on the data of 223 patients with sTBI admitted to The People's Hospital of Danyang from March 2020 to December 2023.They were divided into SE group and non-SE group based on with or without postoperative SE.24 items of data collected from the SE group and non-SE group were compared,and multivariate Logistic regression were applied to analyze and screen for risk factors of postoperative SE occurrence.The determined predictive variables were introduced into R software to construct a column chart model,and the area under the receiver operator characteristic curve(ROC)curve(area under the curve,AUC)and correction curve were applied to test the predic-tive performance of the model.Results The incidence of postoperative SE in sTBI patients was 27.80％(62/223).There were statisti-cally obvious differences between the SE group and the non-SE group in terms of Glasgow coma scale(GCS)scores at admission,hema-toma volume,proportion of basilar cistern compression,proportion of subarachnoid hemorrhage(SAH),midline displacement distance,dehydrating agent application time ≥7days,and postoperative intracranial infection rate(P＜0.05).The risk factors for postoperative SE in patients with sTBI mainly included admission GCS score of 3-5 points,hematoma volume＞40ml,basal pool compression,SAH,midline displacement distance≥10mm,and application time of dehydrating agent ≥7days.Internal validation showed that the AUC was 0.840(95％CI:0.784-0.896),and the goodness of fit Hosmer-Lemeshow test showed x2=6.860,P=0.552,with better curve fit-ting.Conclusion A column chart based on GCS score at admission,hematoma volume,whether the basal pool,whether SAH,midline displacement distance and time of dehydrating agent application has a good predictive effect on postoperative SE occurrence in sTBI patients.

Objective To explore the correlation between estimated pulse wave velocity(ePWV)and diabetic retinopathy(DR).Methods Totals of 7468 patients with type 2 diabetes mellitus(T2DM)who were hospitalized from January 2018 to December 2022 were retrospectively selected and classified into the DR group and the no DR group based on fundus examination.Logistic regression was used to analyze the relationship between ePWV,its quartile and cutoff value strata,and the prevalence of DR.Results The ePWV level in the DR group was significantly higher than that in no DR group(P＜0.001);the prevalence of DR was significantly higher in the remaining three groups compared to the lowest quartile of ePWV(Q1 23.2％,Q2 30.4％,Q3 31.9％,Q4 30.1％,P＜0.001);the ePWV cutoff value was 9.27m/s,and the high ePWV group DR prevalence was significantly higher than in the low ePWV group(30.9％vs 22.4％,P＜0.001).ePWV was a risk factor for DR prevalence(OR=1.070,P＜0.001)but was affected by age,sex,diastolic blood pres-sure,lipids,and renal function;whereas,ePWV＞9.27m/s was a risk factor for the prevalence of DR independently of diabetes-related factors(OR=1.421,P＜0.001)and general condition and other confounding factors(OR=1.494,P＜0.001)in addition to risk fac-tors for DR prevalence.Conclusion ePWV was associated with DR prevalence,and T2DM patients with high ePWV levels were at high-er risk of having DR.

Objective To investigate the clinical characteristics of hospitalized children with pertussis based on their pertussis vacci-nation status.Methods From March,2011 to February,2022,children with pertussis hospitalized at the Children's Hospital Affiliated to Capital Institute of Pediatrics were retrospectively selected.Information was analyzed regarding demographic data and clinical data,Pa-tients were divided into three groups based on vaccination status:non-vaccinated,incompletely vaccinated(1dose or 2doses),and com-pletely vaccinated(3doses).Clinical features were compared among the groups.Results A total of 270 children hospitalized with pertus-sis were included.The non-vaccinated group comprised 206 cases(76.3％),the incompletely vaccinated group comprised 24 cases(8.9％),and the completely vaccinated group comprised 40 cases(14.8％).Statistically significant differences were observed in the overall age of onset among the three groups(P＜0.05),with the completely vaccinated group having the highest age of onset.Significant differences were also noted in the proportions of hypoxemia,decreased heart rate,paroxysmal cough,episodic cyanosis,facial flushing during coughing,and elevated peripheral blood lymphocyte proportion(≥0.6)across the groups(P＜0.05),with the completely vacci-nated group showing lower rates compared to the non-vaccinated group.Additionally,significant differences were observed in the rates of severe pertussis and the need for mechanical ventilation(invasive or non-invasive)among the groups(P＜0.05),with the completely vaccinated group having lower rates than the non-vaccinated group.Conclusion Complete vaccination,plays a critical role in allevia-ting clinical symptoms,reducing peripheral blood lymphocytosis,and decreasing the incidence of severe pertussis in children.

Objective A binary Logistic regression model was developed to forecast the pathological grade of invasive adenocarcino-ma by utilizing the CT characteristics of lung nodules.Methods A retrospective analysis was conducted on the clinical data,pathological types,and imaging findings of 303 cases of ground-glass nodules diagnosed with postoperative pathological infiltrative adenocarcinoma at the First Affiliated Hospital of Henan Polytechnic University and the First Affiliated Hospital of Xinxiang Medical College from January 2021 to February 2023.Based on the pathological results,these lesions were categorized into two groups:the low-grade group(compri-sing 262 cases characterized by adherent,acinar,or papillary types as predominant forms of adenocarcinoma with no more than 20％high-grade pattern)and the high-grade group(consisting of 41 cases exhibiting any form of adenocarcinoma with over 20％high-grade components).The Mann-Whitney U test was employed to compare quantitative parameters between both groups,while qualitative parameters were analyzed using the x2 test.Additionally,binary Logistic regression models were utilized to identify independent predictors;further evaluation included area under curve(AUC)values,calibration curves,and decision analysis curves to assess model differentia-tion,calibration accuracy,and clinical applicability.Results Univariate analysis revealed that gender,air bronchial sign,vacuole sign,vascular cluster sign,pleural depression sign,long diameter,short diameter,and CT-enhanced net increment exhibited statistical signifi-cance(P＜0.05),whereas location,burr sign,and solid component ratio did not demonstrate statistical significance(P＞0.05).Binary Logistic regression analysis identified long diameter,CT-enhanced net increment,vascular cluster sign,pleural depression sign,and vacu-ole sign as independent predictors of the pathological grade model for invasive adenocarcinoma.The results of ROC curve analysis indicated that the AUC value of the Logistic regression model was 0.846 with a sensitivity of 81.25％and specificity of 86.52％.Conclusion The logistic regression model based on CT signs has excellent ability and stability in predicting the pathological grade of invasive adenocarcinoma.