Objective To explore the application effect of upper abdominal moxibustion combined with bedside ultrasound monitoring of gastric residual volume(GRV)in pre-pyloric feeding in stroke patients.Methods Eighty stroke patients admitted to the Department of Rehabilitation Medicine of Zhejiang Provincial People's Hospital from January 1,to December 31,2023 were selected as the study subjects.They were divided into control group(n=38)and observation group(n=42)using a random number table method.All patients had a nasogastric tube for pre-pyloric feeding.The control group used the traditional syringe aspiration method to monitor GRV,while the observation group used upper abdominal moxibustion combined with bedside ultrasound to monitor GRV.The study compared the differences between two groups in terms of enteral nutrition intolerance,feeding complications,enteral nutrition compliance rate within 7 days of admission,time to achieve enteral nutrition compliance,and changes in hemoglobin(Hb),serum prealbumin,serum albumin(ALB),and serum transferrin before and after 14 days of feeding.Results The incidence rates of vomiting,abdominal distention,intra-abdominal hypertension,reflux,and aspiration pneumonia in observation group were lower than those in control group(P＜0.05).The rate of achieving intestinal nutrition standard within 7 days of hospitalization was significantly higher in observation group compared to the control group.The time to achieve intestinal nutrition standard was shorter in observation group compared to control group.Furthermore,after 14 days of feeding,the levels of Hb and ALB in observation group were higher than those in control group,and the differences were statistically significant(P＜0.05).Conclusion Upper abdominal moxibustion combined with bedside ultrasonic monitoring of GRV can significantly reduce intestinal nutrition intolerance and feeding complications during pre-pyloric feeding in stroke patients,shorten the time to achieve nutritional benchmarks,and improve nutritional status.

Objective:This study focused on the importance of mutual recognition of medical ethics review and the necessity of collaborative governance, combining with the current situation of mutual recognition of medical ethics review in China, and analyzing the difficulties in promoting mutual recognition of review and exploring improvement strategies.Methods:A literature research method was used to sort, summarize, refine and conclude the findings of the literature related to mutual recognition of medical ethics review.Results:Challenges persisted in the mutual recognition of medical ethics review in China, including inadequate impetus for mutual recognition among medical institutions, insufficient system and organizational support, limited acknowledgment of the audit unit's review capacity, and a lack of coordination and cooperation mechanisms.Conclusions:Implementing effective measures in benefit coordination, system and organization coordination, ability coordination, and platform coordination will facilitate the mutual recognition of medical ethics review.

ObjectiveTo understand the epidemic characteristics of notifiable infectious diseases （NIDs） other than coronavirus disease 2019 （COVID-19） in Shanghai in 2020， and to provide evidence for formulating infectious disease prevention and control strategies. MethodsData of NIDs reported in Shanghai from 2015 to 2020 were collected through the National Information System for Disease Control and Prevention. Descriptive epidemiological methods were used to analyze the incidence and prevalence characteristics of NIDs in Shanghai in 2020， and compared them with the average values of 2015 to 2019. ResultsA total of 45 574 cases of 23 kinds of NIDs were reported in Shanghai in 2020， except for COVID-19， with an incidence of 187.69/10⁵， and a decrease rate of 50.58% compared with the average value of 2015 to 2019. The incidence of category B and C infectious diseases decreased by 38.07% and 57.47%， respectively （All P<0.001）. The top 3 reported infectious diseases with the highest incidence rate were influenza （64.58/10⁵）， syphilis （39.09/10⁵） and tuberculosis （24.90/10⁵）. The incidence of most infectious diseases decreased compared with the average of 2015 to 2019， among which measles （97.15%）， rubella （88.81%）， pertussis （87.43%）， hand foot mouth disease （85.99%） and scarlet fever （79.84%） decreased significantly （all P<0.001）. In general， compared with the average from 2015 to 2019， respiratory infectious diseases declined most， followed by intestinal infectious diseases， insect-borne and natural focal infectious diseases， blood-borne and sexually transmitted diseases. Districts with higher incidence in 2020 were Fengxian District （310.23/10⁵）， Xuhui District （271.93/10⁵） and Hongkou District （254.38/10⁵）. Respiratory infectious diseases in Fengxian District， intestinal infectious diseases in Jinshan District， blood-borne and sexually transmitted infectious diseases in Changning District， and insect-borne and natural focal infectious diseases in Yangpu District showed the highest incidence rate. Incidence of infectious diseases in 16 districts of Shanghai decreased with different degrees （all P<0.001）. Incidence of infectious diseases in males （209.44/10⁵） was higher than that in females （164.89/10⁵） （χ²=624.864， P<0.001）. Children aged 0-9 years had the highest incidence of respiratory and intestinal infectious diseases. People aged 70‒79 years and 20‒29 years had higher incidence of blood-borne and sexually transmitted infectious diseases， and people aged 20‒29 years had the highest incidence of insect-borne and natural focal infectious diseases. Majority of the patients were students （8 327 cases， 18.27%）， retired people （6 393 cases， 14.03%） and unemployed household workers （5 988 cases， 13.14%）. ConclusionUnder the COVID-19 prevention and control policies， the incidence of most NIDs in Shanghai decreased significantly in 2020.

Objective:To explore the effect of narrative nursing in patients with retinal detachment undergoing surgery.Methods:From February 2020 to August 2021, 40 patients with retinal detachment who underwent surgical treatment in the Department of Geriatrics and Ophthalmology of Beijing Tongren Hospital, Capital Medical University were selected as the research object by the convenient sampling method. According to the random number table method, the patients were divided into the observation group and the control group, 20 cases in each. The patients in the control group were given routine nursing, and the patients in the observation group received narrative nursing on this basis. Before and after the intervention, Self-Rating Anxiety Scale (SAS) , Self-Rating Depression Scale (SDS) , Memorial University of Newfoundland Scale of Happiness (MUNSH) , and Generic Quality of Life Inventory-74 (GQOLI-74) were used to investigate the two groups of patients. The hospitalization time and complications of the two groups of patients were recorded.Results:At discharge, the SAS and SDS scores of the observation group were lower than those of the control group, the GQOLI-74 and MUNSH scores of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.01) . The hospitalization time of the observation group was shorter than that of the control group, and the difference was statistically significant ( P<0.05) . There was no significant difference in the number of cases of postoperative intraocular hypertension between the two groups ( P>0.05) . Conclusions:Narrative nursing can effectively relieve anxiety and depression in patients with retinal detachment surgery, improve patients' well-being and quality of life, and shorten hospitalization time.

Objective:To develop a convolutional neural network based model for assisting pathological diagnoses on thyroid liquid-based cytology specimens.Methods:Seven-hundred thyroid TCT slides were collected, scanned for whole slide imaging (WSI), and divided into training and test sets after labeling the correct diagnosis (benign versus malignant). The extracted regions of interest after noise filtering were cropped into pieces of 512 × 512 patch on 10 × and 40 × magnifications, respectively. A classification model was constructed using deeply learning algorithms, and applied to the training set, then automatically tuned in the test set. After data enhancement and parameters optimization, accuracy, sensitivity, specificity, positive predictive value and negative predictive value of the model were calculated. Results The training set with 560 WSI contained 4 926 cell clusters (11 164 patches), while the test set with 140 WSI contained 977 cell clusters (1 402 patches). YOLO network was selected to establish a detection model, and ResNet50 was used as a classification model. With 40 epochs training, results from 10× magnifications showed an accuracy of 90.01%, sensitivity of 89.31%, specificity of 92.51%, positive predictive value of 97.70% and negative predictive value of 70.82%. The area under curve was 0.97. The average diagnostic time was less than 1 second. Although the model for data of 40× magnifications was very sensitive (98.72%), but its specificity was poor, suggesting that the model was more reliable at 10× magnification. Conclusions:The performance of a deep-learning based model is equivalent to pathologists′ diagnostic performance, but its efficiency is far beyond. The model can greatly improve consistency and efficiency, and reduce the missed diagnosis rate. In the future, larger studies should have more morphology diversity, improve model′s accuracy and eventually develop a model for direct clinical use.

Objective: To explore the effect of modified cold therapy instrument on postoperative pain and swelling of patients with tibiofibular fracture. Methods: Eighty patients with tibia and fibula fracture who underwent surgery in Changzhou Cancer Hospital from June 2016 to June 2017 were selected and divided into control group and experimental group according to random number table method, 40 cases in each group. Patients in the control group were treated with conventional ice care, and the experimental group was treated with a modified cold therapy device. The Numerical Rating Scale (NRS) scores, tension blisters and skin dermatoglyphics, swelling and complications were observed before and after treatment. Results: Before the intervention, the difference in pain score and swelling degree between the two groups was not statistically significant (P>0.05). After nursing intervention, the pain scores of the two groups decreased, but the score of the experimental group was 2.2 ± 0.3, which was significantly lower than that of the control group (3.6 ± 0.5) (t= 15.185, P < 0.05); the incidence of tension blisters, the incidence of dermatoglyph and moderate swelling in the experimental group were 10% (4/40), 77.5% (31/40), 10% (4/40), which were lower than 30% (12/40), higher than 50% (20/20), less than 27.5% (11/40) of the control group (χ²= 5.000, 6.545, 4.021, P<0.05); no complications such as deep vein thrombosis and compartment syndrome were found in both groups. Conclusion The improved cold therapy device cold compress is better than the conventional ice dressing treatment, and can reduce the swelling and pain degree of the patients with tibiofibular fracture, which is beneficial to the rehabilitation of the patient and is worthy of clinical application.

Objective? To explore the effects of musicotherapy on elderly ophthalmic patients during the perioperative period. Methods? Totally 40 elderly patients receiving ophthalmic surgery in the Department of Ophthalmology, Beijing Tongren Hospital between May and September 2018 were selected using purposive sampling and divided into the observation group (n=20) and the control group (n=20). Patients in the control group received conventional optimal nursing care during the perioperative period, while patients in the observation group received musicotherapy on this basis. Self-Anxiety Scale (SAS), Visual Analogue Scale (VAS) and the self-designed satisfaction questionnaire were used to compare the effects of intervention. Results? The SAS score of the observation group at discharge was (44.4±3.26), lower than that of the control group (t=-9.913, P＜0.01), which was (53.4±2.42). The VAS score of the observation group postoperatively was (2.10±0.50), lower than that of the control group (t=-13.299, P＜ 0.01), which was (4.78±0.72). The observation group＇s satisfaction with nursing was 95%, higher than that of the control group (χ2=4.329, P＜ 0.05), which was 70.0%. Conclusions? Musicotherapy for ophthalmic patients during the perioperative period can reduce the anxiety and pain and improve the satisfaction with nursing in the patients, which is worth promoting in clinical practice.

Objective Study on 60 cases of advanced non-small cell lung cancer patients in the Apa imatinib mesylateadverse reactions after treatment , and to develop nursing methods for these adverse reactions. Methods Non-small cell lung cancer patients who were treated in our hospital from September 2015 to September 2016 were treated with Apa imatinib mesylate and observed the adverse reactions during the course of treatment. Results Adverse reactions occurred in 45 patients, and the incidence of adverse reactions was 75.00％.29 cases of patients with skin rash, 24 cases occurred in patients with hypertension, 30 cases of patients with diarrhea, nausea and vomiting occurred in 21 patients, 5 cases occurred in patients with proteinuria, 7 cases of patients with oral mucositis.Conclusion Non-small cell lung cancer patients had adverse reactions after treatment with Apa imatinib mesylate and nursing intervention can improve the quality of life of patients.

Objective To evaluate the effect of zinc deficiency factor on cognitive function after isoflurane anesthesia in mice with Alzheimer's disease (AD).Methods One hundred and forty-four APP/ PS1 transgenic mice with AD,weighing 22-28 g,aged 8-10 months,were divided into 6 groups (n=24 each) using a random number table:zinc adequate group (group ZA),zinc adequate plus isoflurane anesthesia group (group ZA+Iso),zinc deficiency group (group ZD),zinc deficiency plus isoflurane anesthesia group (group ZD+Iso),zinc treatment group (group ZT) and zinc treatment plus isoflurane anesthesia group (group ZT+Iso).The mice were fed a diet adequate in zinc and deionized water for 2 months in ZA and ZA+Iso groups.The mice were fed a diet low in zinc (0.01‰ zinc) and deionized water for 1 month in ZD and ZD+Iso groups.The mice were fed a diet adequate in zinc and 0.12‰ ZnSO4 · 7H2O water for 2 months in ZT and ZT+Iso groups.The mice underwent 2 h of anesthesia with 1.4％ isoflurane starting from the end of feeding in ZA+Iso,ZD+Iso and ZT+Iso groups.At 24 h after anesthesia,the mice were sacrificed and hippocampal tissues were obtained for determination of the contents of soluble amyloid beta protein 40 (Aβ40) and Aβ42 and insoluble Aβ40 and Aβ42 (using enzyme-linked immunosorbent assay) and expression of total Aβ,Aβ40,Aβ42,tau pSer396,tau pSer262 and tau pThr231 (by Western blot).Morris water maze test was performed at 24 h after anesthesia.Results There was no significant difference in each parameter between group ZA and group ZA+Iso and between group ZT and group ZT+Iso (P＞0.05).Compared with group ZD or group ZT+Iso,the escape latency was significantly prolonged,the space exploration time was shortened,the expression of hippocampal Aβ42,tau pSer396,tau pSer262 and tau pThr231 was up-regulated,and the contents of soluble and insoluble Aβ42 were increased in group ZD+Iso (P＜0.05 or 0.01).Conclusion Zinc deficiency can aggravate the impairment of cognitive function after isoflurane anesthesia in mice with AD,and the mechanism is related to the promotion of hippocampal Aβ aggregation and tau protein phosphorylation.

Coronary artery disease (CAD) is a complex human disease, involving multiple genes and their nonlinear interactions, which often act in a modular fashion. Genome-wide single nucleotide polymorphism (SNP) profiling provides an effective technique to unravel these underlying genetic interplays or their functional involvements for CAD. This study aimed to identify the susceptible pathways and modules for CAD based on SNP omics. First, the Wellcome Trust Case Control Consortium (WTCCC) SNP datasets of CAD and control samples were used to assess the joint effect of multiple genetic variants at the pathway level, using logistic kernel machine regression model. Then, an expanded genetic network was constructed by integrating statistical gene–gene interactions involved in these susceptible pathways with their protein–protein interaction (PPI) knowledge. Finally, risk functional modules were identified by decomposition of the network. Of 276 KEGG pathways analyzed, 6 pathways were found to have a significant effect on CAD. Other than glycerolipid metabolism, glycosaminoglycan biosynthesis, and cardiac muscle contraction pathways, three pathways related to other diseases were also revealed, including Alzheimer’s disease, non-alcoholic fatty liver disease, and Huntington’s disease. A genetic epistatic network of 95 genes was further constructed using the abovementioned integrative approach. Of 10 functional modules derived from the network, 6 have been annotated to phospholipase C activity and cell adhesion molecule binding, which also have known functional involvement in Alzheimer’s disease. These findings indicate an overlap of the underlying molecular mechanisms between CAD and Alzheimer’s disease, thus providing new insights into the molecular basis for CAD and its molecular relationships with other diseases.