From January 2018 to August 2019, 87 children aged 2 to 8 years with upper gastrointestinal ulcer bleeding were admitted to the Department of Pediatrics of Shangqiu First People′s Hospital. Patients were randomly assigned in two groups, 45 cases received omeprazole for treatment (group A) and 42 cases received ulinastatin and omeprazole for treatment (group B). The omeprazole 10 mg/d was administrated orally for 2 to 4 weeks in two groups, while in group B additional ulinastatin injection (10 000-50 000 IU·kg -1·d -1 was given for 1 week. The effective rate in group B was 95.2% (40/42), which was significantly higher than that in group A (80.0%, 36/45) (χ2=4.567, P=0.03). After treatment, gastroscopy showed that the time of hemostasis, the time of stopping hematemesis, the time of fecal occult blood turning negative, and the length of hospital stay in group B were significantly shorter than those in group A ( P<0.05). The results of flow cytometry showed that the percentages of CD3 + and CD4 + increased and the percentages of CD8 + decreased significantly after treatment in the two groups, while the changes in group B were more marked than those in group A ( P<0.05). Serum inflammatory factors (serum procalcitonin, high-sensitivity C-reactive protein and tumor necrosis α) were significantly reduced after treatment in the two groups, while the above indicators in group A were significantly lower than those in group A (all P<0.05). In group A, there was 1 case of nausea and vomiting, 1 case of abdominal pain and diarrhea, and 1 case of lethargy; in group B, there was 1 case of nausea and vomiting and 1 case of abdominal pain and diarrhea. The study suggests that ulinastatin combined with omeprazole has a better effect than omeprasole alone in treatment of children with upper gastrointestinal ulcer bleeding without increasing adverse effects.

Objective:To construct a standardized training program for full-time nursing postgraduate students, and to provide a basis for the training the high-quality nursing talents in hospitals.Methods:Through literature review and demi structured interview, preliminarily develop the training program was established from January to March 2021. Through two rounds of expert consultations of 16 experts, the standardized training program for nursing postgraduates was formulated.Results:The recovery rate of the two rounds were both 16/16. The expert authority coefficients of the two rounds of consultation were 0.819, respectively. The Kendall′s coordination coefficients of the two rounds of consultation were 0.329 and 0.334, respectively, and the difference was statistically significant ( P< 0.01). Finally, a standardized training program for entry-level nursing postgraduates was formed, which included five parts: training objects and quality requirements, training methods, training objectives, training contents and evaluation, with a total of 225 items. Conclusions:The standardized training program for nursing postgraduates formed is reliable, scientific and practical, which provides guidance and reference for the training and use of highly educated clinical nursing talents in hospitals.

Objective To investigate changes of laboratory indicators and pathological features of Henoch-Schonlein purpura nephritis(HSPN)children after crescent formation,and to explore non-invasive biomarkers for predicting crescent formation.Methods A total of 278 children with HSPN who were hospitalized from January 2018 to July 2023 were selected and divided into the crescent formation group(196 cases)and the non crescent formation group(82 cases)based on their crescent formation status.Patients in the crescent formation group were sub-divided into the cellular crescent formation group(52 cases)and the cellular fibrous crescent formation group(144 cases)based on the type of crescent formation.Laboratory indicators and pathological characteristics were compared between different groups.The correlation between each indicator and the proportion of crescent formation was analyzed.The influencing factors of crescent formation were analyzed by Logistic regression.Receiver operating characteristic(ROC)curves were plotted,and the effectiveness of laboratory indicators in predicting crescent formation was evaluated.Results Compared with the non crescent formation group,24-hour urine protein quantification(24 hUP),urine immunoglobulin G/creatinine(UGCR),urine red blood cell count(URBC),neutrophil/lymphocyte ratio(NLR),blood urea nitrogen(BUN)and triglycerides(TG)were significantly increased in the crescent formation group.There were increased proportion of diffuse mesangial hyperplasia(Mb),renal tubular atrophy or interstitial fibrosis(T1)(P＜0.05).Compared with the cellular crescent group,the proportion of glomerular segmental sclerosis or adhesion(S1)and T1 were increased,and the proportion of crescent formation was higher in the cellular fibrous crescent group.The proportion of capillary endothelial cell proliferation(E1)was decreased in the cellular crescent group(P<0.05).Spearman correlation analysis showed that 24 hUP,UGCR,URBC,NLR,BUN,TG,Mb and T1 were positively correlated with the proportion of crescent formation(all P＜0.05).The results of multivariate Logistic regression analysis showed that elevated UGCR and T1 were risk factors for crescent formation.The area under the curve(AUC)predicted by UGCR for crescent formation was 0.731(95%CI:0.667-0.795,P＜0.05),with an optimal cutoff value of 5.00 mg/mmol,sensitivity of 0.744 and specificity of 0.610.Conclusion UGCR can be used as a non-invasive biomarker to assist in evaluating crescent formation in children with HSPN.

Objective:To construct an indicator system for the development of nursing disciplines in ClassⅢ Grade A general hospitals.Methods:An initial draft of the indicator system was established through literature research and expert meetings. The Delphi method and purposive sampling were used from January to April 2023 to conduct two rounds of expert consultations with 17 nursing experts from four medical units nationwide and three nursing colleges. The indicators were revised and refined, resulting in the establishment of a nursing discipline construction indicator system for ClassⅢ Grade A general hospitals. The level of expert engagement was represented by the questionnaire recovery rate, expert authority by the expert authority coefficient ( Cr), and the degree of expert opinion coordination by Kendall 's harmony coefficient (Kendall 's W) . Results:The recovery rates for both rounds of expert consultation questionnaires were 100.00% (17/17), with expert Cr of 0.87. The CV values ranged from 0.049 to 0.260 and 0 to 0.140, respectively, while Kendall 's W were 0.221 and 0.257 ( P< 0.01). The final indicator system for the construction of nursing disciplines in ClassⅢ Grade A general hospitals included six primary indicators, 18 secondary indicators, and 63 tertiary indicators. Conclusions:The nursing discipline construction indicator system developed for ClassⅢ Grade A general hospitals in this study is scientific, reliable, and comprehensive. It can provide a reference for the construction of nursing disciplines in Class Ⅲ Grade A general hospitals.

OBJECTIVE: To propose a sensitivity test method for geometric correction position deviation of cone-beam CT systems. METHODS: We proposed the definition of center deviation and its derivation. We analyzed the influence of the variation of the three-dimensional spatial center of the steel ball point, the projection center and the size of the steel ball point on the deviation of geometric parameters and the reconstructed image results by calculating the geometric correction parameters based on the Noo analytical method using the FDK reconstruction algorithm for image reconstruction. RESULTS: The radius of the steel ball point was within 3 mm. The deviation of the center of the calibration parameter was within the order of magnitude and negligible. A 10% Gaussian perturbation of a single pixel in the 3D spatial coordinates of the steel ball point produced a deviation of about 3 pixel sizes, while the same Gaussian perturbation of the 2D projection coordinates of the steel ball point produced a deviation of about 2 pixel sizes. CONCLUSION The geometric correction is more sensitive to the deviation generated by the three-dimensional spatial coordinates of the steel ball point with limited sensitivity to the deviation generated by the two-dimensional projection coordinates of the steel ball point. The deviation sensitivity of a small diameter steel ball point can be ignored.
Algorithms ; Calibration ; Cone-Beam Computed Tomography ; Steel

Objective To establish a mouse model of hepatocyte-specific TM6SF2 knockout, and to investigate the role of TM6SF2 in the development of nonalcoholic fatty liver disease (NAFLD). Methods The CRISPR/Cas9 technique and the Cre/LoxP strategy were used to establish a stable mouse model of hepatocyte-specific TM6SF2 knockout. The mice with hepatocyte-specific TM6SF2 knockout and the control mice were given a normal diet or a high-fat diet (HFD) for 16 weeks, and related indices were measured, including general status (body weight and liver weight), glucose metabolic indices (fasting blood glucose and insulin), and lipid metabolism (plasma triglyceride, cholesterol, and liver triglyceride). The t -test was used for comparison of normally distributed continuous data between two groups. Results Under the condition of HFD, compared with the control mice, the mice with hepatocyte-specific TM6SF2 knockout had significantly higher liver weight (2.235±0.175 g vs 1.258±0.106 g, t =4.789, P < 0.01) and liver index (4.970%±0.298% vs 3.210%±0.094%, t =5.630, P < 0.01), and the loss of the TM6SF2 gene in hepatocytes aggravated the abnormal level of alanine aminotransferase induced by HFD (62.517±1.526 U/L vs 25.991±5.947 U/L, t =5.949, P < 0.01). Compared with the control mice under the condition of normal diet or HFD, the mice with TM6SF2 knockout had a significant increase in plasma insulin level (normal diet: 37.203±0.836 mIU/L vs 34.835±0.426 mIU/L, t =2.520, P =0.025; HFD: 41.093±1.226 mIU/L vs 35.817±0.500 mIU/L, t =3.985, P =0.007), while there were no significant differences in the other indices associated with glucose metabolism (all P > 0.05). Under the condition of HFD, there were no significant differences in the levels of plasma triglyceride and cholesterol between the mice with hepatocyte-specific TM6SF2 knockout and the control group ( P > 0.05), while the mice with hepatocyte-specific TM6SF2 knockout had a significant increase in the level of liver triglyceride compared with the control mice (23.969±0.978 mg/g vs 18.229±1.633 mg/g, t =3.015, P =0.024). Conclusion Hepatocyte-specific knockout of TM6SF2 can aggravate liver lipid accumulation and liver injury in mice with NAFLD.