Objective: To assess the awareness and associated factors of wild mushroom poisoning among students in Guizhou Province, so as to provide a scientific foundation for wild mushroom poisoning prevention and control among students. Methods: By a multi stage stratified cluster random sampling method, 1 162 students from Guizhou Province were selected in May 2024. The questionnaire survey was administered to evaluate knowledge regarding wild mushroom poisoning. Data were analyzed employing the χ 2 test and Logistic regression model. Results: Among the nine questions assessing awareness of wild mushroom poisoning, only three had the awareness rate exceeding 70%. Binary Logistic regression analysis revealed that students who "actively learn about the prevention of wild mushroom poisoning" ( OR=0.48, 95%CI =0.26-0.92) and "spread knowledge about wild mushroom poisoning to others" ( OR=0.47, 95%CI =0.33-0.69) scored higher on the wild mushroom poisoning knowledge questions ( P <0.05). Conversely, students with a habit of consuming wild mushrooms ( OR=1.52, 95%CI =1.15-2.02) scored lower ( P < 0.05 ). 42.3% of the students suggested that scientific dissemination and publicity about wild mushrooms should be intensified. Conclusions The awareness rate of wild mushroom poisoning knowledge among students in Guizhou Province requires further attention. Comprehensive knowledge should be disseminated systematically through various channels to further improve students awareness of the prevention and control of wild mushroom poisoning.

OBJECTIVE To evaluate the clinical value of anlotinib in third-line treatment for patients with advanced non-small cell lung cancer （NSCLC） through real-world data. METHODS Clinical data of patients with advanced NSCLC who received treatment at the First Affiliated Hospital of Anhui University of Chinese Medicine from February 2021 to December 2024 were retrospectively collected. They were divided into anlotinib group （27 cases， receiving anlotinib therapy） and immunotherapy group （22 cases， receiving immunotherapy agents alone or in combination with chemotherapy drugs） according to treatment regimens. The progression-free survival （PFS） and overall survival （OS） of patients were compared between the two groups， and the occurrence of adverse drug reactions during the treatment period was recorded. Using a partitioned survival model， an economic evaluation of the two treatment regimens was conducted with a cost-utility analysis approach from the perspective of the healthcare system. RESULTS The median PFS and OS of patients in the anlotinib group were 5.93 months and 11.27 months， respectively； the median PFS and OS of patients in the immunotherapy group were 5.33 months and 9.77 months， respectively； the difference was not statistically significant （P＞0.05）. There was no statistical difference in the total incidence of adverse drug reactions and grade 3-4 serious adverse drug reactions between the two groups （P＞0.05）. Compared with the immunotherapy group， the incremental cost-effectiveness ratio of the anlotinib group was 1 806 724.60 yuan/quality-adjusted life year （QALY）， which was significantly higher than three times China’s per capita gross domestic product in 2024 （287 247 yuan/QALY）. CONCLUSIONS For third-line treatment of advanced NSCLC patients， the efficacy of anlotinib is no worse than that of immunotherapy alone or in combination with chemotherapy drugs， and the safety of the two groups is comparable. However， anlotinib is not cost-effective.

Objective:To investigate the effect of B-ultrasonic-guided lower abdominal transverse nerve block on patients after radical resection of colorectal cancer.Methods:Ninety-eight patients who were underwent radical resection of colorectal cancer in Affiliated Tumor Hospital of Nantong University from September 2020 to September 2023, according the numerical random table method divided into two groups, 49 patients in control group were treated with intravenous controlled analgesia pump, 49 patients in observation group were treated with lower abdominal transverse nerve block guided by B-ultrasound, the analgesic effect, oxidative stress reaction, immune function and surgical complications were compared between the two groups.Results:The visual analogue score (VAS) 2, 12, 24, 48 and 72 h after operation in observation group was significantly lower than that in control group: (1.03 ± 0.25) scores vs. (1.32 ± 0.28) scores, (2.78 ± 0.42) scores vs. (3.52 ± 0.47) scores, (2.69 ± 0.38) scores vs. (3.21 ± 0.44) scores, (2.11 ± 0.31) scores vs. (2.65 ± 0.32) scores and (2.05 ± 0.27) scores vs. (2.43 ± 0.31) scores, and there was statistical difference ( P<0.05). The superoxide enzyme (SOD) in observation group was significantly higher than that in control group: (72.65 ± 4.28) kU/L vs. (67.58 ± 4.31) kU/L, and the malondialdehyde (MDA) was significantly lower than that in control group: (16.51 ± 1.23) mg/L vs. (18.82 ± 1.21) mg/L, and there were statistical differences ( t = 5.84 and 8.57, P<0.05). The CD 4+ and CD 8+ in observation group were significantly higher than those in control group (0.334 ± 0.03 vs. 0.282 ± 0.032 and 0.292 ± 0.030 vs. 0.252 ± 0.030), and there were statistical differences ( t = 7.90 and 6.55, P<0.05). The complication rate in observation group was significantly lower than that in control group: 4.08% (2/49) vs. 18.37% (9/49), and there was statistical difference ( P<0.05). Conclusions:B-ultrasound-guided lower transverse abdominal nerve block can further enhance the analgesic effect, effectively improve the oxidative stress reaction and immune function, as well as reduce the occurrence of surgical complications in patients with colorectal cancer after radical surgery.

Objective To identify the factors associated with frailty in lung transplant patients by a meta-analysis.Methods Computerized search was performed for studies on the influencing factors of frailty in lung transplant patients in the CNKI,WanFangData,VIP,CBM,PubMed,Web of Science,Embase,Elsevier ScienceDirect and CINAHL databases.The search was conducted from the time of database construction to November 2023.Literature screening,quality assessment,and data extraction were performed independently by 2 investigators,and Meta-analysis was performed using Stata 17.0 software.Results 10 cohort studies,including 1 999 patients,were finally included,and 13 influencing factors were extracted,including advanced age(OR=1.05),female(OR=2.50),BMI(OR=0.38),diagnosis of primary pulmonary disease(OR=2.90),6MWD(OR=0.34),and lung allocation score(OR=0.69),FVC(OR=0.60),pre-transplant frailty(OR=0.81),hypoproteinemia(OR=4.12),hemoglobin(OR=0.50),anemia(OR=4.37),length of ICU stay(OR=1.24),and total length of stay(OR=1.05).Short Physical Performance Battery is an assessment tool for frailty in lung transplant patients,with an incidence of frailty in 24％before transplantation and 50％in post-transplantation.Fried Frailty Phenotype is an assessment tool for frailty in lung transplant patients,with a pre-transplant frailty incidence of 30％.Conclusion There are many factors involved in the incidence of frailty in lung transplant patients,and nursing staff should dynamically evaluate the frailty of lung transplant patients,and give individualized and precise interventions in combination with a multidisciplinary model to improve or delay the progression of frailty.

Objective To evaluate the effect of remote interventions with digital health technologies in lung transplant patients.Methods Databases,including CKNI,Wangfang,VIP,CMB,Cochrane Library,PubMed,Embase,Web of Science,Scopus and BMJ Best Practice were searched from their inception to July 2023.There were 2 researchers who independently screened and extracted the literature,and then evaluated quality of the included studies.Meta-analysis was performed using RevMan 5.2.Results 10 studies with 1 262 patients were included.The results of meta-analysis showed that compared with conventional intervention,remote intervention based on digital health technology could improve self-monitoring compliance of lung transplant patients[0R=0.64,95％CI(0.46,0.88),P=0.006],improve quality of life including mental health status[OR=3.08,95％CI(0.41,5.74),P=0.020]and physical health status[OR=3.81,95％CI(1.19,6.43),P=0.004].In terms of the intervention forms,the application-based remote intervention had better self-monitoring compliance,and the difference was statistically significant(P=0.007).However,in terms of the comparison of readmission rate[OR=1.73,95％CI(0.98,3.04),P=0.060],anxiety[OR=-0.12,95％CI(-1.36,1.11),P=0.850],and depression[OR=0.62,95％CI(-0.80,2.03),P=0.390],the effect of intervention was unclear.Conclusion Remote intervention based on digital health technology can improve self-monitoring compliance and quality of life in lung transplant patients;applications are the optimal form of intervention.Limited by the quality and quantity of included studies and the heterogeneity of study results,more high-quality studies are needed to further verify the effects of digital health technology on readmission rates,anxiety and depression of lung transplant patients.

Objective To investigate the incidence and risk factors of post-transplant diabetes mellitus(PTDM)in adult lung transplant recipients.Methods Conducting a convenience sampling method,we retrospectively analyzed the clinical data of lung transplant recipients from January 2020 to December 2022 at a tertiary A hospital in Hangzhou,Zhejiang Province.According to the PTDM diagnostic criteria,lung transplant recipients are divided into a PTDM group and a non-PTDM group.The incidence rate of PTDM is calculated,and the influencing factors for PTDM occurrence are analyzed using both univariate and multivariate logistic regression methods.Results A total of 140 patients were included in this study,and 54 lung transplant recipients developed PTDM within 6 months,with an incidence of 38.57％.Univariate analysis showed that there were significant differences in age,gender,BMI,smoking history,pre-operative glycated albumin,pre-operative fasting blood glucose,early post-operative blood glucose and pre-operative creatinine between the 2 groups(P＜0.05).Multivariate Logistic analysis showed that gender(OR=5.283),BMI(OR=6.122),pre-operative glycated albumin(OR=1.330),and early post-operative blood glucose(0R=1.444)were the influencing factors.Conclusion Lung transplant recipients who were male,BMI ≥24.0,with high levels of glycated albumin before surgery,and high blood sugar early after surgery had a higher risk of developing PTDM.Clinical nurses can formulate relevant nursing measures according to the influencing factors to prevent the occurrence of PTDM.

Objective To analyze the latent profiles of active aging among community older adults and its influencing factors,and explore relationship of different categories and nursing care needs.Methods Multistage stratified random sampling was used to select 341 community older people in Qingdao from June 2023 to August 2023 as the survey population.The study instruments included the General Information Questionnaire,the Active Ageing Scale,the Care Needs of the Elderly Scale.Latent profile analysis was used to explore the latent profiles of active aging on the community older adults.The influencing factors of latent profiles were identified by multivariate Logistic regression.Results The active aging of the community older people was identified as a model with 3 latent categories,defined as low active aging type(38.l％),medium active aging-high spiritual intelligence type type(51.6％),and high active aging-comprehensive type(10.3％).The influencing factors include age,education,monthly income level,nursing needs(all P＜0.05).Community older adults with low self-development and contribution needs are more likely to be low active aging type.Community older adults with high needs for life care and living environment(OR=3.268,P=0.0l 1),physical and psychological support(OR=1.972,P=0.025),and interpersonal communication and health knowledge(OR=3.433,P＜0.001)were more likely to be medium active aging-high spiritual intelligence type.Those with low protection and security needs(OR=0.446,P=0.012)were more likely to be medium active aging-high spiritual intelligence type type.Community older adults with low health monitoring needs(OR=0.297,P=0.029)and high specialty care needs(OR=3.019,P=0.033)were more likely to be high active aging-comprehensive type.Conclusion The level of active aging of older adults in the community is medium,which is characterized by 3 categories.Community nursing staffs should focus on the elderly with low active aging type and medium active aging-high spiritual intelligence type,and targeted intervention should be adopted according to different category characteristics,so as to accurately meet their nursing needs,finally improve the level of active aging of community older adults.

Objective:To explore the value of applying multiple genetic testing techniques for the prenatal diagnosis of Turner syndrome fetuses with complex mosaic small supernumerary marker chromosomes (sSMC).Methods:Chromosomal karyotypes of amniotic fluid samples from 5 030 pregnant women who had undergone amniocentesis at the Prenatal Diagnosis Center of the Third Affiliated Hospital of Zhengzhou University from January to December 2022 were retrospectively reviewed. Three fetuses with complex mosaicism fetuses (carrying 2 types of sSMC) were selected as the study subjects. Genetic tests including G-banded chromosomal karyotyping analysis, fluorescence in situ hybridization (FISH), chromosomal microarray analysis (CMA), and copy number variation sequencing (CNV-seq) were used to clarify the origin and mosaic status of the sSMC. This study has been approved by the Medical Ethics Committee of the Third Affiliated Hospital of Zhengzhou University (No. 2023-159-01).Results:G-banded chromosomal analysis of fetus 1 showed a karyotype of 45, X[64]/46, X, + mar1[13]/46, X, + mar2[3]. FISH results showed that 52% of of its cells had contained one X chromosome signal, whilst 48% contained two X chromosome signals. CMA results revealed the fetus had harbored a 32.32 Mb and a 50.93 Mb deletion in Xp22.33p21.1 and Xq22.2q28 regions, respectively, in addition with mosaic deletions of approximately 1.43 copies, 1.78 copies and 1.43 copies in the Xp21.1p11.1, Xq11.1q21.1 and Xq21.2q22.2 regions, respectively. The fetus 2 had a karyotype of 45, X[27]/46, X, + mar1[14]/46, X, + mar2[12]. FISH results indicated that 88% of its cells contained one X chromosomes signal and two Y chromosome signals, and 12% contained signals for one X chromosomes signal and one Y chromosome signal. CNV-seq results revealed a deletion of 7.74 Mb in the Yq11.222q11.23 region and a mosaic duplication of approximately 1.738 copies in the Yp11.31q11.221 region. The fetus 3 had a karyotype of 45, X[60]/46, X, + mar1[11]/46, X, + mar2[6]. FISH results showed that 28% of its cells contained one X chromosome signal, and 72% contained tow X chromosome signals. CNV-seq results revealed deletions of 55.60 Mb and 53.50 Mb in the Xp22.33p11.1 and Xq22.1q28 regions, respectively, along with a mosaic deletion of approximately 1.85 copies in the Xp11.1q13.2 region and a mosaic repeats of approximately 2.66 copies in the Xq13.2q22.1 region. The sSMCs in the 3 fetuses had all originated from sex chromosomes and were of complex mosaic type. After genetic counseling, the three couples had all opted to terminate the pregnancy.Conclusion:The combined use of multiple genetic testing techniques has determined the origin and structure of complex mosaic sSMCs and provided a basis for prenantal diagnosis and genetic counseling.

Malocclusion,identified by the World Health Organization(WHO)as one of three major oral diseases,profoundly impacts the dental-maxillofacial functions,facial esthetics,and long-term development of～260 million children in China.Beyond its physical manifestations,malocclusion also significantly influences the psycho-social well-being of these children.Timely intervention in malocclusion can foster an environment conducive to dental-maxillofacial development and substantially decrease the incidence of malocclusion or reduce the severity and complexity of malocclusion in the permanent dentition,by mitigating the negative impact of abnormal environmental influences on the growth.Early orthodontic treatment encompasses accurate identification and treatment of dental and maxillofacial morphological and functional abnormalities during various stages of dental-maxillofacial development,ranging from fetal stages to the early permanent dentition phase.From an economic and societal standpoint,the urgency for effective early orthodontic treatments for malocclusions in childhood cannot be overstated,underlining its profound practical and social importance.This consensus paper discusses the characteristics and the detrimental effects of malocclusion in children,emphasizing critical need for early treatment.It elaborates on corresponding core principles and fundamental approaches in early orthodontics,proposing comprehensive guidance for preventive and interceptive orthodontic treatment,serving as a reference for clinicians engaged in early orthodontic treatment.

Objective To evaluate the clinical value of neutrophil CD64(nCD64)index as a novel biomark-er in the differential diagnosis of acute and chronic brucellosis.Methods A total of 38 patients with acute bru-cellosis and 48 patients with chronic brucellosis diagnosed in the People's Hospital of Xinjiang Uygur Autono-mous Region from February 2021 to July 2023 were included.Peripheral blood of the patients was collected and nCD64 index was detected by flow cytometry,and the correlation between nCD64 index and disease severi-ty was analyzed.Receiver operating characteristic(ROC)curve was used to analyze the sensitivity and the specificity of nCD64 index in differentially diagnosing acute and chronic brucellosis.Meanwhile,Rose-Bengal Plate Test(RBPT)and Standard Tube Agglutination Test(SAT)were used as controls to evaluate the clini-cal diagnostic value of the three.Results The nCD64 index of acute brucellosis patients was higher than that of chronic brucellosis patients(U=216.00,P<0.001),and the index was positively correlated with the sever-ity of the disease(r=0.670,P<0.001).The ROC curve analysis results showed that the area under the curve of nCD64 index in the differential diagnosis of acute and chronic brucellosis was 0.882(95%CI:0.811-0.952,P<0.001),the cut-off value was 2.81,and sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 83.3%,81.6%,80.4%,81.9%and 82.6%,respectively.The efficacy of nCD64 index in differential diagnosis of nCD64 index was significantly better than those of the qualitative tests of RBPT and SAT.Conclusion nCD64 index has favourable sensitivity and specificity in the differential diag-nosis of acute and chronic brucellosis,and tends to reflect the severity of the disease.It has clinical value in the differential diagnosis of acute brucellosis and chronic brucellosis,and plays an important role in the early diag-nosis and treatment effect monitoring of brucellosis.