Pediatric cancer is one of the leading causes of death in children around the world.Although radiotherapy is an important means of treatment for pediatric cancer,it causes acute or chronic adverse events that may affect patients' survival time and quality of life.As a novel and advanced radiation technique,proton therapy allows for precise dose delivery in target volume,significantly reducing the irradiation to surrounding tissues and organs.Studies have shown that proton therapy is well tolerated in the treatment of pediatric cancer,and it achieves good tumor control;proton therapy is superior to traditional radiotherapy in improving quality of life,protecting intelligence,and reducing the risk of secondary cancer.This article reviews the research advances in the application of proton therapy in the treatment of pediatric cancer.

To achieve the goal of continuous improvement, measures of multi-link management were adopted for antimicrobial use, including establishing and improving organizational frameworks and rules and regulations, conducting various forms of training for all workers and staff, formulating criteria that were based on the frontier theories and could be easily applied, taking effective measures of intervention, using scientific evaluation methods, and getting timely feedback. The measures have proved to be effective in practice.

OBJECTIVE To investigate the pertinency between acute physiology and chronic health evaluation Ⅱ scores(APACHEⅡ)and nosocomial infection.METHODS The clinical data from 1 007 ICU patients were evaluated with APACHEⅡ scores system,and made a prospective survey of nosocomial infection.RESULTS Along with the increase in APACHEⅡ scores,nosocomial infection rate and mortality showed rising trend and they were in linear relationship.CONCLUSIONS APACHEⅡ scores system not only can appraise the degrees of severity of illness,evaluate medical treatment,and estimate the prognosis,but also forecast nosocomial infection.

Objective To investigate the pathogenesis,diagnosis,treatment and prognosis of aort-oesophageal fistula(AEF).Methods Retropective analysis was performed on 6 patients presenting with AEF between January 2002 and December 2014,and relative literature was reviewed on its pathogenesis,di-agnosis,prognosis and treatment.Results Five men and 1 woman with a mean age of 49 (range,27-71 years)were recruited to the study.One case of AEF was caused by esophageal foreign body,2 cases were caused by aneurysm while the other 3 patients presented AEF after aortic surgery.All 6 patients showed he-matemesis,among whom 3 presented sentinel hemorrhage,1 presented exsanguination after sentinel hemor-rhage,2 presented sudden exsanguination.Among 4 patients with sentinel hemorrhage,2 accompanied with chest pain,1 with dysphagia and 1 with fever.Two patients had a history of hypertension.Diagnostic rate was nearly 100% by gastroscopy or CT/CTA.Four patients died from hemorrhagic shock and 2 patients re-covered from surgery.Conclusion AEF should be seriously considered for patients with a history of hyper-tension,aortic disease or esophageal foreign body presenting sentinel hemorrhage,chest pain,dysphagia,fa-tal exsanguination followed by symptom-free interval.Prompt examinations and aggressive surgery are of great significance for survival.

OBJECTIVE To survey the effect of the intervention measures according to the guiding principle of antibiotics rational use. METHODS The data of medication of two groups of patients in Mar 2004 and Mar 2005 were collected respectively,and the condition of antibiotics use was compared. RESULTS In comparison with that in Mar 2004 the average in-hospital days and antibiotics costs in Mar 2005 were reduced remarkably;the percentage of antibiotics use was much lower;the ratio of the rational use of antibiotics increased notably(P

Purpose/Significance The scoping review summarizes the application of large language models in clinical practice,and provides references for their promotion.Method/Process PubMed,Embase,Wanfang and CNKI databases are searched to screen the lit-erature related to the application of large language models in clinical practice,and the content of the included literature is extracted,sum-marized and analyzed.Result/Conclusion Large language models have application value in providing treatment suggestions,assisting disease diagnosis,health education,analyzing text image data,etc.However,their performance in answer accuracy and individualization is not satisfactory.In general,large language models show significant potential in clinical practice,but necessary measures must be taken to control the application risks and confirm the scope of application.

OBJECTIVETo explore a set of scientific evaluation and intervention methods on perioperatur period which fits for China's situation, and to promote the development of rational drug use.

METHODSTwo would tertiary general hospitals were selected and separated in to intervention group and control group. Intervention was carried out and compared at the same period on inpatient surgical cases of thryroidectomy, mastectomy, cholescystectomy, and hysteromyomectomy plus appendix.

RESULTSThe average drug costs was decreased from 1 601.27 yuan to 1 489.59 yuan and the average antibiotics use from 740.20 yuan to 352.03 yuan (P < 0.01) in the intervention group pre and post intervention. There was a remarkable improvement on the rationality of antibiotics use in intervention group, from 31.35% to 91.81% (P < 0.01) pre and post intervention, implemented in the hospital.

CONCLUSIONIt is practicable and effective to implement rational drug use where intervention was carried out, since it plays an active role on promoting safely, effectively and economic antibiotic use in China.

Objective:To investigate the scientific research willingness of nursing undergraduates with senior grades in Beijing and to understand the attitudes of them with scientific research and difficulty in scientific research.Methods:From April to May 2019, this study selected totals of 319 nursing undergraduates with Grade three or four from four medical schools in Beijing as subjects by convenience sampling. The self-designed questionnaire was used to investigate the scientific research willingness, attitude and difficulty among nursing undergraduates.Results:Among 319 nursing undergraduates, 275 (86.21%) nursing undergraduates would like to participate in research projects during the undergraduate level; 270 (84.64%) nursing undergraduates thought it was necessary to carry out nursing research during the undergraduate level. In carrying out or taking part in scientific research, the objective difficulties included lack of guide and help, time and energy as well as academic atmosphere; the subjective difficulties involved the lack of scientific knowledge, difficulties in selecting projects and statistical analysis.Conclusions:Nursing undergraduates have positive attitudes with scientific research, but them meet with many difficulties when carrying out or taking part in scientific research. Research training for nursing undergraduates may help to improve scientific literacy of them and increase their scientific interest.

ObjectiveTo conduct a systematic review of systematic reviews of the effect of preoperative prerehabilitation training on postoperative function of patients after total knee arthroplasty. MethodsThe systematic reviews and meta-analysis about the application of preoperative prerehabilitation training after total knee arthroplasty were retrieved from Cochrane Library, Embase, PubMed, Web of Science, Wanfang Data, CNKI and VIP database, from establishment to March 10th, 2023. The methodological quality was evaluated using AMSTAR. The meta-analysis of the reseaches without repetitive content was performed using RevMan 5.3. ResultsA total of ten systematic reviews/meta analyses were included. Compared with the routine rehabilitation, preoperative prerehabilitation training might decrease the scores of Western Ontario and McMaster Universities Osteoarthritis Index (MD = -1.34, 95%CI -1.94 to -0.74, P < 0.001), and Hospital for Special Surgery Knee Score (MD = -1.04, 95%CI -1.69 to -0.40, P = 0.001), shorten the length of hospital stay (MD = -1.01, 95%CI -1.66 to -0.36, P = 0.002), and enhance muscle strength three months after operation (SMD = 0.63, 95%CI 0.30 to 0.97, P < 0.001). ConclusionPreoperative prerehabilitation training can improve postoperative knee function, enhance muscle strength three months after operation, and shorten length of hospital stay for the patients after total knee arthroplasty.

ObjectiveTo explore the coercive experience of involuntarily hospitalized adolescents with mental disorders during the admission process and hospitalization， providing references for formulating targeted nursing interventions. MethodsSemi-structured interviews were conducted with 15 involuntarily hospitalized adolescents with mental disorders selected from October to December 2023， and the themes were summarized and extracted by content analysis. ResultsA total of 3 themes and 10 sub-themes were extracted， which were used to elaborate the essential contents， causes， and improvement methods of coercive experience. These encompassed the multi-dimensional content of coercive experience （complex emotional experience， different physical sensations， and contradictory cognitive evaluation）， the multi-faceted causes of coercive experience （insufficient personal preparation， inadequate parental communication， and strict medical management system）， as well as the phased improvement of coercive experience （adequate communication before hospitalization， patient notification before coercive intervention， respecting for demands during coercive intervention， and comforting explanation after coercive intervention）. ConclusionThe essential content of the coercive experience of involuntarily hospitalized adolescents with mental disorders is complex and has various causes， which require cooperation from multiple parties to improve. Therefore， parents should respect the expression of their children’s self-will， and medical staff should respect patients’ autonomy， establishing a protection-constrained doctor-patient relationship model and collaborating to reduce the use of coercive interventions， to improve the overall medical satisfaction of adolescents with mental disorders.