ObjectiveTo establish an educational intervention framework of electronic picture books for children with autism spectrum disorder (ASD) based on Creative Problem Solving (CPS) model, and observe the effect on social function. MethodsElectronic picture books were designed using CPS model, including the program of reading, interactive animation design and associated artistic activities. From March to June, 2023, 24 children with mild to moderate ASD were recruited from Maanshan Institute of Special Education, and randomly assigned into experimental group 1 (CPS-based cognitive picture book interventions, n = 8), experimental group 2 (CPS-based social picture book interventions, n = 8) and control group (Bloom's Taxonomy-based picture book interventions, n = 8), and received the interventions for four weeks, with a total of twelve times. They were assessed with speech, social, perceptual and health behavior using Autism Treatment Evaluation Checklist (ATEC) before and after treatment, and the differences were calculated. ResultsThere was a significant difference among the groups in the social and perceptual scores differences (F > 4.344, P < 0.05) and a near-significant difference in the health behaviour score difference (F = 2.921, P = 0.076). Post Hoc test showed that the differences in social scores were higher in both experimental groups than in the control group (P < 0.05); the difference in perceptual scores was significantly higher in experimental group 1 than in experimental group 2 (P < 0.01), but there was no significant difference with the control group (P > 0.05); the difference in health behavior scores was higher in experimental group 2 than in the control (P < 0.05), and the difference in experimental group 1 was slightly higher than in the control group (P = 0.072). ConclusionElectronic picture book interventions based on the CPS model may be more effective in enhancing social, perceptual and health behavior in children with ASD, but there may be differences among models.

A good social network can ensure the safety of women during pregnancy and reduce the incidence of adverse pregnancy outcomes. However, there is currently relatively little research on the overall social network of pregnant women, and the influencing factors of the overall social network of pregnant women are not yet clear. This paper reviews the current situation, influencing factors, and measurement tools of the social network in pregnant women, aiming to improve their social network, help them access high-quality nursing resources, ensure the health of pregnant women and infants, and decrease the incidence of adverse pregnancy outcomes.

Objective:To systematically review and integrate the caring experience of caregivers of lung transplant patients.Methods:Qualitative studies on the caregiving experience of caregivers of lung transplant patients were searched by computer from PubMed, Web of Science, Embase, Cochrane Library, China Biology Medicine disc, China National Knowledge Infrastructure and Wanfang data, and the search period was from establishment of the databases to April 30, 2023. The qualitative research quality evaluation criteria (2016 edition) of the Joanna Briggs Institute Evidence Based Health Care Center in Australia were used to evaluate the quality of the included literature, and the Meta-synthesis was used to integrate the literature results.Results:A total of ten articles were included, and 33 clear research results were extracted, which were summarized into eight new categories, and finally summarized into four integrated results, such as heavy burden experience, strong demand, positive experience and satisfaction with the medical service system.Conclusions:Medical workers should attach importance to and pay attention to the burden and needs of caregivers of lung transplant patients, provide professional and emotional support to caregivers, improve their caring ability and quality, and ultimately improve the quality of life of lung transplant patients.

Objective:To detect the concentration of various cytokines in aqueous humor of patients with diabetes retinopathy (DR) with Luminex liquid chip, and analyze the relationship between the cytokines and the occurrence and development of DR.Methods:A cross-sectional study was conducted.Sixty-three DR patients (97 eyes) treated with anti-vascular endothelial growth factor (VEGF) drugs in the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from March 1, 2019 to December 31, 2019 were enrolled as DR group, including 38 nonproliferative DR (NPDR) eyes in NPDR group and 59 proliferative DR (PDR) eyes in PDR group, 39 eyes in photocoagulation group and 58 eyes in non-photocoagulation group.Twenty-seven patients (31 eyes) hospitalized for cataract surgery at the same time were collected as the control group.Aqueous humor was extracted during the operation, and Luminex liquid chip was used to detect the concentrations of vascular endothelial growth factor-A (VEGF-A), placental growth factor (PLGF), platelet-derived growth factor (PDGF)-AA, PDGF-BB, angiopoietin-like protein 4 (ANGPTL4), interleukin-6 (IL-6), IL-8, IL-1β, monocyte chemotactic protein-1 (MCP-1), intercellular cell adhesion molecule-1 (ICAM-1) and tumor necrosis factor-α (TNF-α) in aqueous humor.The concentrations of various cytokines of different groups were compared, and the correlation among various aqueous humor cytokines was analyzed by Spearman rank correlation analysis.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of First Affiliated Hospital of Guangzhou University of Chinese Medicine (No.Y[2019]230). Written informed consent was obtained from each patient.Results:The concentrations of VEGF-A, PLGF, PDGF-AA, ANGPTL4, IL-6, IL-8, MCP-1 and ICAM-1 in DR group were significantly higher and the concentration of IL-1β was significantly lower than those of control group ( Z=-4.747, -5.164, -3.373, -8.062, -4.535, -5.954, -5.098, -3.228, -5.954, all at P<0.01). The concentrations of VEGF-A, PLGF, PDGF-AA, ANGPTL4, IL-6, IL-8 and MCP-1 of the photocoagulation and non-photocoagulation groups were higher and the concentration of IL-1β was significantly lower than those in the control group (all at P<0.017). The concentration of ICAM-1 in the photocoagulation group was significantly higher than that in the control group ( P<0.017). The concentrations of PLGF, PDGF-AA and ANGPTL4 of PDR group were higher than those of NPDR group, and the differences were statistically significant ( Z=-2.291, -3.396, -2.276, all at P<0.05). VEGF-A was positively correlated with the other cytokines except ICAM-1 ( rs=0.237-0.540, all at P<0.05). ANGPTL4 was positively correlated with the other cytokines except IL-1β ( rs=0.361-0.733, all at P<0.01). Conclusions:The occurrence and development of DR are closely related to VEGF family, PDGF family, ANGPTL family and inflammatory factors.The concentrations of PLGF, PDGF-AA and ANGPTL4 are higher in PDR eyes.There are close and complex relationships among a variety of cytokines in the eyes of DR patients.

Objective:To conduct a scoping review of health behavior-related assessment tools for pregnant women with gestational diabetes mellitus (GDM).Methods:A total of 6 Chinese and English databases, including CNKI, Wanfang Database, China Biomedical Literature Database, PubMed, Web of Science Core set and Embase, were systematically searched by the terms of “gestational diabetes mellitus”，“health behavior”，“assessment”. The relevant contents of GDM health behavior-related assessment tools were retrieved for systematic analysis, and the results were normalized reported. The search period was from the establishment of the databases to February 1, 2023.Results:A total of 2 657 literatures were retrieved, and 41 literatures were finally included after screening, including 16 literatures on the development and verification of assessment tools, 2 literatures on localization of assessment tools, and 23 literatures on the application of the assessment tools. A comprehensive analysis was conducted on 18 assessment tools, including 16 original assessment tools and 2 localized assessment tools, spanning the years 1987 to 2020. The assessment content covered dietary behavior, physical activity behavior, medication adherence, blood glucose monitoring behavior, treatment adherence, self-management behavior, and health-promoting lifestyles. Among them, 7 assessment tools were validated for reliability and/or validity in pregnant women with GDM. Among the 23 studies that covered the implication of the assessment tools, the Pregnancy Physical Activity Questionnaire and Health-Promoting Lifestyle Ⅱ were the most commonly utilized tools for assessing health behaviors in pregnant women with GDM.Conclusions:There is a wide variety of assessment tools related to health behaviors in pregnant women with GDM, and the assessment content is relatively rich. However, most of the assessment tools have not been validated for their reliability and validity within the GDM population, limiting their clinical application and promotion.

Objective : To investigate the effects of different occlusal veneer preparation designs and fiber posts on the fracture load and failure mode of endodontically treated maxillary premolars with pulp-piercing wedge-shaped defect． Methods : 60 maxillary first premolars were randomly divided into group A and group B after Root Canal Therapy (RCT) and severe defects(n = 30) ．Group A was filled with glass fiber post and resin core，and group B was filled with resin core only．Then the occlusal veneer( G2) ，buccal-occlusal veneer( G3) and buccal-proximal-occlusal veneer ( G4 ) were applied to the isolated teeth．The teeth filled with composite resin ( G1 ) and full crown ( G5) were set as negative and positive control respectively，with 6 samples in each group．The sample was subjected to 5 000 hot and cold cycles and 20 000 vertical compression load aging．Finally，all the samples were loaded with static load until the sample broke at the speed of 0．5mm / min．The fracture load and failure mode of each sample were recorded. Results : Both the fracture load in group A and B was G5 ＞G3 ＞G2 ＞G4 ＞G1，and the fracture load in G2，G3，G4，G5 was significantly higher than that in G1 (P＜0. 05) ，and there was no significant difference between group A and B (P＞0. 05) ．The fracture form of G3 was mostly unbonding of the repair body，which was conducive to re-repair． Conclusion Buccal ( occlusal) veneer is the most effective in repairing pulp-piercing wedge-shaped defects．The fiber post could not significantly enhance the fracture load of the pulp-piercing wedge- shaped defects teeth.

Objective : To explore the effects of Er: YAG laser irrigation technology on smear layer removal and dentin microhardness. Methods : A total of 102 ex vivo premolars were selected to amputate the crown , leaving a root length of 13 mm , after mechanical preparation , there were divided into experimental group (3% sodium hypochlorite , 3% NaOCl) and control group (0. 9% sodium chloride solution , NS) , and received syringe , ultrasound and Er: YAG laser terminal irrigation , which were specifically grouped into NaOCl + syringe , NaOCl + ultrasound , NaOCl + laser, NS + syringe , NS + ultrasound and NS + laser groups ( n = 17 ) . Scanning electron microscopy (SEM) evaluated smear layer removal from the upper, middle and apical parts of the root. The Vickers microhardness tester measured the microhardness before and after irrigation. Results : The NaOCl + laser group had the best effect on removing the root canal smear layer, and the amplitude of reducing the microhardness of dentin was the largest. There was no significant difference in the reduction of microhardness compared with the NaOCl + ultrasonic group (P > 0. 05) . Conclusion Er: YAG laser⁃activated NaOCl solution improves the clearance of the smear layer and reduced the microhardness of dentin.

Platform method is a modeling method that forces experimental animals to stand on the platforms for a long time without rest by taking advantage of the rodent's fear of water. The application time and node of platform method in model construction can be adjusted according to the needs of different types of animal models. At present， the research hotspot of platform method focuses on constructing animal models of sleep deprivation， anxiety and depression and other mental diseases as well as fatigue. In recent years， with the development of the modernization of traditional Chinese medicine （TCM）， this method has been gradually applied to the study of TCM syndrome model and TCM disease and syndrome combination model with "heart"，"liver" and "spleen" as the centers. Due to the extensive application of platform method and the diversity of modeling diseases， there is still a lack of systematic discussion on this method as the core. This paper systematically summarized the research in China and abroad and explored the application of platform method in animal models of human diseases from three dimensions： its development process， current application and problems and future development. In addition， through the analysis of the research hotspots on sleep deprivation， mental diseases， fatigue， TCM syndrome model and TCM disease and syndrome combination model，the ideas and specific applications of platform method in construction of various animal models were discussed. This paper was expected to provide reference for researchers and promote further exploration and research of this modeling method.

Objective:To analyze the risk factors for rotator cuff tear and evaluate the corresponding prediction efficacy.Methods:A case-control study was conducted in 69 patients with rotator cuff tear admitted to Affiliated Hospital of Qingdao University from June 2020 to June 2021 (rotator cuff tear group) and 51 normal volunteers or medical examiners (normal control group). There were 55 males and 65 females, with the age range of 34-77 years [(58.2±7.2)years]. Body mass index (BMI) ranged from 19.5-32.4 kg/m 2 [(25.4±2.5)kg/m 2]. Univariate analysis was performed for the correlation of gender, age, history of hypertension, history of smoking, history of diabetes, BMI, angle of humeral greater tuberosity and notch angle of humeral greater tuberosity with rotator cuff tear in the two groups. Factors with statistically significant differences were included in multivariate Logistic regression analysis to determine the independent risk factors for rotator cuff tear. Spearman correlation analysis was used to find factor correlation between the two groups. The receiver operating characteristic (ROC) curve of relevant factors for the diagnosis and prediction of rotator cuff tear was analyzed. Results:Univariate analysis showed that age, angle of humeral greater tuberosity and notch angle of humeral greater tuberosity related to rotator cuff tear (all P<0.05). On the contrary, gender, history of hypertension, history of smoking, history of diabetes and BMI were not correlated with rotator cuff tear (all P>0.05). Multivariate Logistic regression analysis showed significant correlations of angle of humeral greater tuberosity and notch angle of humeral greater tuberosity with rotator cuff tear (all P<0.05). Spearman correlation analysis showed that age was not correlated with angle of humeral greater tuberosity and notch angle of humeral greater tuberosity ( r=0.09, 0.13, all P>0.05), but there was significant positive correlation between angle of humeral greater tuberosity and notch angle of humeral greater tuberosity ( r=0.76, P<0.01). When the optimal cutoff values of angle of humeral greater tuberosity and notch angle of humeral greater tuberosity were 70.05° and 150.55°, the area under the ROC curve (AUC) for predicting rotator cuff tear was 0.79 (95% CI 0.71-0.87, P<0.01) and 0.81 (95% CI 0.74- 0.89, P<0.01). Conclusions:Angle of humeral greater tuberosity and notch angle of humeral greater tuberosity are independent factors for rotator cuff tear, and larger angles suggest higher prevalence of rotator cuff tear. Besides, the notch angle of humeral greater tuberosity has relatively better predictive performance.

Objective:To understand the user experience of Nursing-Online Practice Promotion Application ("N-OPP" APP) .Methods:This study was a cross-sectional study. Using the convenient sampling method, a total of 537 nursing students who had practiced in the Affiliated Hospital of Qingdao University from August to November 2020 and had used "N-OPP" APP were selected as the research objects. The general data questionnaire and the "N-OPP" APP user experience evaluation questionnaire were used for the investigation. A total of 537 questionnaires were distributed in this study and 529 valid questionnaires were recovered, with an effective recovery rate of 98.51%.Results:The total average score of the "N-OPP" APP user experience evaluation questionnaire items of 529 nursing students was (3.89±0.47) , and the average scores of items of operation performance, service performance, user experience and risk were respectively (3.87±0.65) , (4.04±0.60) , (3.90±0.70) and (3.42±0.62) . There were statistically significant differences in the use experience and operation performance dimensions of nursing students from different educational backgrounds, contact time of mobile learning APP, use time and use frequency of "N-OPP" APP ( P<0.05) . The service performance dimension items of nursing students with different educational background and frequency of "N-OPP" APP were compared, and the differences were statistically significant ( P<0.01) . The risk dimension items of nursing students with different "N-OPP" APP use frequencies were compared, and the difference was statistically significant ( P<0.01) . Conclusions:The development of "N-OPP" APP can solve some problems in the traditional teaching and training of clinical nursing skills, help nursing students to consolidate their nursing skills and obtain high recognition from nursing students, which can be used as an auxiliary tool for teaching and training of clinical nursing skills.