Objective:To analyze the association between healthcare workers mental health,institu-tional supplies and facilities,inter-organizational coordination during infectious disease outbreaks,and the healthcare institution resilience.Methods:An online questionnaire survey was conducted among the healthcare workforce from 146 institutions in Beijing from January 13,2023 to February 9,2023,and a total of 1 434 eligible respondents were included.The sample comprised 408 responses from tertiary hos-pitals,117 from secondary hospitals,and 909 from primary care institutions.The resilience indicator for healthcare institutions was defined as the degree to which medical services met patient demands,with in-fluencing factors including physical factors,such as material shortages and facility space adaptation or ex-pansion,organizational factors such as information sharing and patient referral,and psychological factors were evaluated using job satisfaction(extrinsic satisfaction,intrinsic satisfaction),burnout(emotional exhaustion,depersonalization,reduced personal accomplishment),and depression status.Ordered mul-ticlassification Logistic regression was used to examine the impact of various factors on the degree to which healthcare services met patient needs;additionally,demographic factors that might influence institutional resilience were controlled.Results:During the emergency response phase,93％of hospitals maintained the capacity to meet patient needs,though tertiary hospitals demonstrated significantly higher rates of service inadequacy(21.05％).Material shortages were reported across all institutions,with tertiary hos-pitals experiencing more frequent multi-item shortages.Inter-institutional collaboration patterns revealed substantial variation:87.50％of primary care facilities,42.86％of secondary hospitals,and 31.58％of tertiary hospitals.Healthcare workers across all levels reported mild depressive symptoms and moderate-to-severe burnout levels.Regression analysis showed high satisfaction(overall satisfaction β=0.04,ex-trinsic satisfaction β=0.06,and intrinsic satisfaction β=0.08),low degree of job burnout(emotional exhaustion β=-0.04,depersonalization β=-0.07 and reduced personal accomplishment β=0.01),low degree of depression(β=-0.06)were significantly associated with higher healthcare institution re-silience.In addition,material shortages were significantly associated with lower resilience,and renova-tion and expansion of treatment spaces,and information sharing,were all associated with higher resilience.Demographic factors(age,gender,marital status,educational background,etc.)had no sig-nificant impact on resilience.Conclusion:Mental health status significantly influences healthcare institu-tion resilience.As human resources constitute the core asset of healthcare institutions,strategic optimiza-tion of workforce allocation and psychological support interventions can effectively strengthen resilience.Moreover,healthcare institution resilience is positively impacted by orderly material supply chains,timely resource distribution,and adaptive reconfiguration of clinical spaces.Finally,facilitating information sharing also enhances institutional resilience.

To summarize Professor GAO Shuzhong's clinical experience in treating idiopathic tinnitus with a combination of acupuncture and Chinese meteria medica. It is believed that idiopathic tinnitus is mostly caused by weak lungs and spleen， kidney essence deficiency， liver constraint transforming into fire， and binding constraint of heart qi. Treatment advocates the combination of acupuncture and Chinese meteria medica in clinical practice. Acupuncture treatment mainly focus on the method of opening the orifices by syndrome identification in combination with Ermen （TE 21）， Tinggong （SI 19）， Tinghui （GB 2）， Shenmai （BL 62） to regulate qi and blood， and supporting with Baihui （GV 20）， Yintang （EX-HN 3）， Taichong （LR 3）， and Yanglingquan （GB 34） to soothe the liver， resolve constraint， and calm the mind. Oral administration of Chinese medicinal prescription usually includes modified Yiqi Congming Decoction （益气聪明汤） and Tongqi Powder （通气散）， and the external administration of Chinese medicinal prescription can apply self-prescribed Wenqing Powder （温清散） to navel moxibustion.

Objective: To investigate the association between dietary quality and overweight / obesity among primary school students, so as to provide a basis for the prevention and control of childhood obesity. Methods: In September 2022, third-grade students from six primary schools in Ningbo City, Zhejiang Province were selected by a random cluster sampling method. Data on gender, age, height, and weight were collected through questionnaire surveys and physical examinations. Body mass index (BMI) was calculated, and overweight and obesity were determined using gender- and age-specific BMI cut-off points. The Chinese dietary quality questionnaires was administered to assess the intake of health-promoting and restricted foods over the past 24 hours, thereby evaluating overall dietary quality. A multivariate logistic regression model was used to analyze the association between dietary quality and overweight / obesity among primary school students. Results: A total of 1 375 primary school students were included, comprising 722 (52.51%) boys and 653 (47.49%) girls, with a mean age of (8.47±0.30) years. Among them, 165 (12.00%) were overweight and 171 (12.44%) were obese. The score for health-promoting foods was (4.29±2.27) points. The median score of restricted foods was 2.00 (interquartile range, 3.00) points. The total dietary quality score was (10.84±2.42) points. Multivariable logistic regression analysis indicated that the restricted food score was positively associated with overweight (OR=1.073, 95%CI: 1.002-1.148), while the total dietary quality score was negatively associated with overweight (OR=0.911, 95%CI: 0.851-0.976). However, no statistically significant associations were observed between the health-promoting food score and overweight or obesity (both P>0.05), nor between the restricted food score or total dietary quality score and obesity (both P>0.05). Conclusion A higher intake of restricted foods was associated with an increased risk of overweight, while a better dietary quality was associated with a decreased risk of overweight among primary school students.

Objective To investigate the function of the glutamic-oxaloacetic transaminase 2(GOT2)gene in acute myeloid leukemia cells.Methods ShRNAs targeting at GOT2 were constructed to suppress GOT2 expression in the THP-1 human monocytic leukemia cell line.GOT2 mRNA level was measured by RT-qPCR,and GOT2 protein ex-pression was measured by Western blot.Intracellular free amino acid level was quantified using colorimetric assays.The impact of GOT2 knockdown in THP-1 cell function was evaluated through cell viability(CCK-8 assay)and ap-optosis(flow cytometry).Results After GOT2 knockdown,both GOT2 mRNA and protein were significantly de-creased in THP-1 cells(P＜0.05).Compared to the control group,GOT2 knockdown did not affect intracellular glutamate levels(P＞0.05),but led to a marked decrease in aspartate level(P＜0.05).GOT2 knockdown signifi-cantly impaired THP-1 cell viability,inhibited cell proliferation(P＜0.05)and promoted apoptosis(P＜0.05).Conclusions Down regulation of GOT2 significantly decreases intracellular aspartate level in acute myeloid leukemia cells,impairs cellular viability and induces apoptosis,which suggests that GOT2 may play a key role in the regula-tion of amino acid metabolism in acute myeloid leukemia.

Objective To investigate the effect of PIAS3 on glucose fluctuation-induced oxidative stress and mito-chondrial dysfunction in rat cardiomyocytes.Methods H9c2 were cultured in vitro,and divided into normal glucose control group(Control),mannitol-induced osmotic pressure control group(MG),constant high glucose group(HG),intermittent hyperglycemia group(IHG),IHG+siRNA NC group,and IHG+PIAS3 siRNA group.Cell proliferation was assessed using CCK-8 assay.LDH release,MDA and GSH levels,as well as SOD activity,were detected using corresponding kits.Mitochondrial membrane potential was evaluated via JC-1 staining combined with flow cytometry.ROS levels in cells and mitochondria were determined using DCFH-DA and MitoSOX staining,re-spectively.Protein expression of PI3K,p-PI3K,AKT,and p-AKT was analyzed by Western blot.Results Com-pared with the control group,intermittent hyperglycemia promoted oxidative stress and mitochondrial dysfunction,significantly upregulated PIAS3 expression(P＜0.001)and downregulated p-PI3K and p-AKT protein levels(P＜0.001).Knockdown of PIAS3 significantly alleviated oxidative stress and mitochondrial dysfunction induced by glucose fluctuations,and increased p-PI3K and p-AKT protein levels(P＜0.001).Conclusions Knockdown of PIAS3 may alleviate glucose fluctuation-induced oxidative stress and mitochondrial dysfunction in ratcardiomyocytes by activating the PI3K/AKT signaling pathway.

OBJECTIVE: To investigate short-term effectiveness of robot-assisted fracture reduction and fixation combined with arthroscopic exploration for posterolateral depressed tibial plateau fractures. METHODS: Between January 2022 and January 2024, 8 patients with posterolateral depressed tibial plateau fractures (Schatzker type Ⅲ) were treated using robot-assisted fracture reduction and fixation combined with arthroscopic exploration, with simultaneous treatment of concomitant ligament or meniscus tears. There were 3 males and 5 females with an average age of 54.1 years (range, 42-68 years). Injury mechanisms included traffic accidents (3 cases) and falls (5 cases). The time from injury to operation ranged from 2 to 4 days (mean, 3.1 days). Operation time, intraoperative blood loss, hospital stay duration, visual analogue scale (VAS) score for pain, and complications were recorded. Fracture healing and knee Rasmussen scores were assessed radiographically, while knee function was evaluated using range of motion and Hospital for Special Surgery (HSS) scores. RESULTS: All operations were successfully completed. The operation time was 108-129 minutes (mean, 120.1 minutes). The intraoperative blood loss was 10-100 mL (mean, 41.3 mL). The hospital stay duration was 4-7 days (mean, 5.6 days). All incisions healed by first intention without complication such as peroneal nerve injury, vascular damage, or infection. All patients were followed up 32-48 weeks (mean, 40 weeks). Radiographic follow-up confirmed that the knee Rasmussen scores rated as excellent in 8 patients and all fractures healed with the healing time of 12-16 weeks (mean, 13.5 weeks). The VAS score for pain was 2-4 (mean, 2.8) at discharge and improved to 0 at 1 month after operation. The knee range of motion was 80°-110° (mean, 96.1°) at discharge and increased to 135°-140° (mean, 137.9°) at 1 month after operation. At 3 months after operation, the HSS score was 91-94 (mean, 92.8), all graded as excellent. No severe complication, including implant failure, occurred during follow-up. CONCLUSION For posterolateral depressed tibial plateau fractures, the minimally invasive approach combining robot-assisted fracture reduction and fixation with arthroscopic exploration demonstrates multiple advantages, including shorter operation time, reduced intraoperative blood loss, excellent wound healing, fewer complications, and rapid recovery of knee function. This technique achieves satisfactory short-term effectiveness, while its long-term effectiveness requires further evaluation.
Humans ; Male ; Tibial Fractures/surgery* ; Female ; Middle Aged ; Adult ; Arthroscopy/methods* ; Minimally Invasive Surgical Procedures/methods* ; Fracture Fixation, Internal/methods* ; Aged ; Treatment Outcome ; Robotic Surgical Procedures/methods* ; Operative Time ; Range of Motion, Articular ; Fracture Healing ; Length of Stay ; Tibial Plateau Fractures

Objective:To explore the application value of the "Dual-Wing" traction technique in the medial & head lateral laparoscopic left hemicolectomy with radical resection.Methods:The "Dual-Wing " traction technique is based on the theory of mesenteric anatomy. The assistant lifts the proper mesentery of the digestive tract to be resected or the adjacent mesenteric tissue connected to it,thereby elevating the target organ and its mesentery as a whole away from the mesenteric bed. By utilizing the tension transmission between the proper mesenteries of adjacent organs to create counter-tension,the surgeon's operative actions are always maintained along the line of maximum counter-tension.After incising the mesenteric fusion line,this technique assists the surgeon in entering the fusion plane. A descriptive case series study method was adopted to retrospectively analyze the clinical and pathological data of 37 colorectal cancer patients who underwent laparoscopic left hemicolectomy with the "Dual-Wing" traction technique via a medial and cephalad approach, performed by the Department of Gastrointestinal Surgery at Dongjie Campus of the First Hospital of Quanzhou, Fujian Medical University, from May 2023 to November 2023.Results:All patients successfully underwent laparoscopic left hemicolectomy via the medial & head lateral approach using the "Dual-Wing" traction technique.The surgery adhered to the principles of total mesocolic excision and safely mobilized the left colon and its mesentery from the correct anatomical plane. In the entire group of patients,there were 14 males and 23 females; the mean operative time was 94.1±18.3 minutes; the mean intraoperative blood loss was 9.8±5.4 ml; the mean number of lymph nodes dissected was 18.1±3.9; the mean number of positive lymph nodes was 1.4±1.6; the pathological specimen resection margin grading was Grade A in 29 cases, Grade B in 8 cases, and no Grade C cases; the tumor TNM staging was Stage I in 3 cases, Stage IIA in 7 cases, Stage IIB in 6 cases, Stage IIIA in 2 cases, Stage IIIB in 15 cases, and Stage IIIC in 4 cases; the mean time to first flatus postoperatively was 35.7±7.5 hours; the mean length of hospital stay was 9.1±1.7 days. There were no intraoperative injuries to the pancreas or spleen. Postoperative complications occurred in 3 cases. No anastomotic leakage was observed in the entire group, and there were no deaths following the surgery.Conclusion:The application of the "Dual-Wing" traction technique to establish a stable surgical scenario can significantly reduce the demands on the assistant. It is conducive to maintaining mesenteric tension and fully exposing the surgical field. It also allows for the rapid identification and maintenance of the correct anatomical plane. For colorectal cancer patients, the surgery is safe and feasible, with satisfactory short-term therapeutic effects.

Objective To investigate the current symptom status of maintenance hemodialysis(MHD)patients,analyze the influencing factors from the perspective of multidimensional symptom burden,extract symptom groups,and construct a symptom network.Methods A total of 490 patients who received MHD at the blood purification center of a tertiary hospital in Shanghai from March to April 2025 were selected using a convenience sampling method.30 symptoms of MHD patients were investigated using a modified dialysis symptom index table.SPSS and R software were utilized to analyze the influencing factors,extract symptom groups,and construct a multidimensional symptom network.Results A total of 488 valid questionnaires were collected,with a valid questionnaire recovery rate of 99.59％.The median number of symptoms experienced by patients was 6(interquartile range:4,8),with the top 5 symptoms being dry skin(69.88％),fatigue or tiredness(56.97％),itching(56.97％),worry(50.20％),and dry mouth(46.31％).Multidimensional analysis indicated that age,duration of dialysis,education level,and complications were influencing factors of symptom burden scores across different dimensions.6 stable symptom groups were extracted,namely skin discomfort,fatigue and pain,gastrointestinal tract,sleep disorders,water-electrolyte imbalance,and uremia.The results of the symptom network analysis revealed that difficulty of falling asleep had the highest intensity centrality(rs=2.18,2.25,2.12).Conclusion The symptom association is relatively stable,and difficulty of falling asleep is the core symptom.This finding can assist clinical medical staff in achieving efficiency and precision in symptom group management.

This article summarizes the nursing care of a pediatric patient with melioidosis complicated by septic shock.Key nursing interventions included:to arrange the sequence of drugs reasonably to ensure the safety of the combined use of multiple drugs;systemic anti-infection treatment combined with special treatment of locally infected skin promotes wound healing;in view of the characteristics of the bacteria causing melioidosis,strict isolation and long-term monitoring measures for hospital infection control should be formulated;to enhance the disease coping ability of the child and parents and alleviate negative emotions.After 100 days of intensive treatment and meticulous nursing care,the patient's condition improved,and the discharge was achieved.