OBJECTIVE To observe the clinical efficacy of Yangyin Jiedu Decoction in the prevention and treatment of acute ra-diation-induced oral mucositis(RTOM).METHODS A total of 80 inpatients who were diagnosed with head and neck tumors by pathological examination and received radiotherapy in the Department of Radiotherapy,Affiliated Hospital of Nanjing University of Chi-nese Medicine from November 2021 to September 2023 were selected and randomly divided into an observation group and a control group with 40 cases in each group.The control group was given mouthwash treatment from the onset of RTOM symptoms until the symp-toms disappeared;the observation group was given Yangyin Jiedu Decoction from the first day of radiotherapy on the basis of the treat-ment of the control group until the end of radiotherapy.During the treatment,the onset time,duration and incidence of grade Ⅱ-ⅣRTOM in the two groups were observed;the pain numerical rating scale(NRS)score,Karnofsky performance status(KPS)score,body mass index(BMI)changes were evaluated;and the levels of serum inflammatory factors[C-reactive protein(CRP),interleukin 6(IL-6),interleukin 1β(IL-1β),tumor necrosis factor α(TNF-α)]were detected.RESULTS After radiotherapy,RTOM ap-peared in both groups to varying degrees.The incidence of grade Ⅱ-Ⅳ RTOM,the onset time,duration and NRS score of RTOM in the observation group were significantly better than those in the control group(P<0.05,P<0.01).After radiotherapy,the levels of se-rum CRP,IL-6,IL-1β and TNF-α in the observation group were lower than those in the control group(P<0.05,P<0.01).After radiotherapy and 1 month of follow-up,the KPS score and BMI in the observation group were higher than those in the control group(P<0.05,P<0.01).CONCLUSION Yangyin Jiedu Decoction can decrease the incidence and severity of RTOM in patients with head and neck tumors,shorten its duration,improve the quality of life of patients,downregulate the level of inflammatory cytokines,and has a preventive effect on RTOM caused by radiotherapy in patients with head and neck tumors.

This paper explores the logic of scientific research management system of public hospitals in the new era,i-dentifying its connotations,principles,and pathways.From a value perspective,the system underscores the integration of effi-ciency and equity.In terms of governance logic,it advocates a shift from a single government-centric approach to a collaborative model that includes both government and market operation logics.The principles guiding transformation advocate for combination of ethical and market considerations,balance of rights and responsibilities,and integration of individual self-efficacy and organi-zational support.In terms of pathway selection,the paper proposes a comprehensive strategy that begins with forging a unified sci-entific research vision,serving as the foundation for creating a pedagogical organization to foster continuous learning,and the im-plementation of performance assessments based on core value.These strategies aim to modernize and enhance the efficiency of the scientific research management system in public hospitals.

Hip fracture in the elderly is characterized by high incidence, high disability rate, and high mortality and has been recognized as a public health issue threatening their health. Surgery is the preferred choice for the treatment of elderly patients with hip fracture. However, lower extremity deep venous thrombosis (DVT) has an extremely high incidence rate during the perioperative period, and may significantly increase the risk of patients′ death once it progresses to pulmonary embolism. In response to this issue, the clinical guidelines and expert consensuses all emphasize active application of comprehensive preventive measures, including basic prevention, physical prevention, and pharmacological prevention. In this prevention system, basic prevention is the basis of physical and pharmacological prevention. However,there is a lack of unified and definite recommendations for basic preventive measures in clinical practice. To this end, the Orthopedic Nursing Professional Committee of the Chinese Nursing Association and Nursing Department of the Orthopedic Branch of the China International Exchange and Promotive Association for Medical and Health Care organized relevant nursing experts to formulate Expert consensus on perioperative basic prevention for lower extremity deep venous thrombosis in elderly patients with hip fracture ( version 2024) . A total of 10 recommendations were proposed, aiming to standardize the basic preventive measures for lower extremity DVT in elderly patients with hip fractures during the perioperative period and promote their subsequent rehabilitation.

Objective:To understand the identification value of pointing gestures in children with autism spectrum disorder(ASD) and its relationship with functional development.Methods:From December 2020 to November 2021, 1 099 children from Children’s Health Care Center of Beijing Children’s Hospital were tested by pointing gestures test, including 942 ASD children and 157 typical developed children.And the data of children's neuropsychological development scale from 800 children aged 1.0-5.9 were collected.SPSS 20.0 was used for statistical analysis. Trend test was used to analyze the distribution of pointing gestures test sensitivity in autistic children, and ANOVA was used to analyze the relationship between pointing gestures test scores and functional development fields.Results:The sensitivity of pointing gestures was 83.5% in children aged 1.0-10.0 years, 76.3%-93.1% in children aged 1.0-4.9 years, and 93.1%-95.1% in children aged 1.0-2.9.With the increase of age, the sensitivity of pointing gestures in autistic children (linear-by-linear association =164.889, P<0.001) and the Yoden index had a decreasing trend. The positive predictive value (91.53%-100.00%) and negative predictive value (75.36%-91.84%) were found in the children aged 1.0-10.0 years.The sensitivity of pointing gestures test was 44.9% in children with mild autism aged 1.0-10.0 years and 46.5%-65.9% in children with mild autism aged from 1.0-3.9 years. The sensitivity of pointing gestures test was 81.5% in children with moderate autism aged from 1.0-10.0 years and 87.3%-97.8% in children with moderate autism aged 1.0-3.9 years. The sensitivity of the pointing gestures test was 97.2% in children with severe autism aged 1.0-10.0 years, and 100.0% in children with severe autism aged 1.0-3.9 years. The sensitivity of the pointing gestures in mild, moderate and severe autism children decreased with age (linear-by-linear association values were 16.725, 64.232, 66.732 respectively, all P<0.001). The children with severe autism mainly scored 2 points (80.3%, 419/522) on the pointing gestures test , and children with moderate autism mainly scored 1 point(64.2%, 170/265) on the pointing gestures test. There were significant differences in functional development among different pointing gestures test groups.Functional development score in the autism children with 0 score of pointing gestures test was significantly higher than those with 1 score and 2 scores of pointing gestures test (all P<0.05). Conclusion:Pointing gestures has good sensitivity in children with autism (especially 1.0-4.9 years of age), and may serve as an objectively observable screening method. The better children with autism score on the pointing gestures, the better their functional development.

Objective To investigate the effectiveness and feasibility of standardized nursing training in reducing the incidence rate of post-endoscopic retrograde cholangiopanography(ERCP) pancreatitis. Methods A total of 521 patients were collected from January 2015 to June 2016 in ERCP therapy as control group.The patients in this group did not have standardized nursing training.A total of 289 patients were selected from July 2016 to April 2017 in ERCP therapy as intervention group.The patients in this group were carried out the standardized nursing training. The incidence of hyperamylasemia and post-ERCP pancreatitis was observed in two groups. Results The incidence of hyperamylasemia and post-ERCP pancreatitis was 12.09%(63/521),7.87%(41/521)in control group,and 7.61% (22/289), 3.11% (9/289) in intervention group,the difference was statistically significant between two groups(χ2=3.972,7.258,P<0.05 or 0.01). Conclusions The standard nursing training and intraoperative coordination can reduce its risk factors, and to reduce the post-ERCP pancreatitis and hyperamylasemia has important meaning and function.

Objective To evaluate the effect of case-based learning combined with standardized patients in probation of nuclear radionuclide therapy.Methods 360 interns were randomly assigned separately into CBL+SP group and LBL group (180 people),case based on SP as the center of clinical teaching mode was used for CBL+SP group,while traditional classroom teaching mode was used for LBL group.Theoretical test,case analysis and teaching satisfaction survey were used to evaluate the two teaching mode,using SPSS 20.0 software for statistical analysis of the data.t test was used for two independent samples of both theoretical test and case analysis and chi-square test was used for teaching satisfaction survey.Results The score of theory and case analysis of CBL+SP group was higher than that of LBL group,and the difference had statistical significance [(83.26 ± 4.18) vs.(80.36 ± 3.62),t=-7.041,P=0.000;(85.79 ± 4.15) vs.(81.26 ± 3.96),t=-10.844,P=0.000].Satisfaction survey showed that satisfaction degree of CBL+SP group in stimulating and training the correct clinical thinking,grasping the information skills and cultivating their ability to analyze and solve the problem was higher than that of LBL group,and the difference had statistical significance (x2=40.319,x2=33.620,x2=23.493,x2=23.283;P=0.000).Conclusion Case-based learning combined with standardized patients in probation of nuclear radionuclide therapy can obtain satisfactory teaching effort.

Objective To investigate the establishment,operation and performance of external quality assessment(EQA) system for microbial morphology and detection of special drug-resistance in clinical laboratory,and explore the value of the developed system in clinical application.Methods The pictures of known bacteria and fungi colony,gram staining and acid-fast staining from clinical microbiology were distributed to the participating laboratories in Gansu province twice a year at regular intervals.The pictures of standard knowledge points from CLSI,such as special drug resistance were distributed simultaneously.All the participating laboratories were required to complete the interpretation for the pictures and report their resuhs in a scheduled time.Then the resuhs were summarized and analyzed as 3 modes:complete consistency,general consistency and non-consistency.Results During the 2 years when the EQA system for microbial morphology and detection of special drug-resistance were performed for 24 times,the rate of annual complete consistency increased year by year and reached to 91.3％ in 2015.Conclusion The EQA system based on the examinations of microbial morphology and CLSI standard knowledge points for clinical laboratory may supervise the staff of clinical microbiology laboratories in the hospitals at second grade or above to master the skills of morphological identification and learn CLSI knowledge points,so their professional skills of clinical microbiology could be comprehensively improved.

APOBEC-1 Deaminase ; genetics ; Clustered Regularly Interspaced Short Palindromic Repeats ; Codon, Terminator ; Gene Editing ; methods ; Humans ; Zygote ; beta-Globins ; genetics

Objective To explore the effects of nursing intervention based on health belief model (HBM) in improving compliance of screen by gastroscope in high risk group of gastric cancer so as to provide theoretical bases for clinical nursing activity.Methods High risk group of gastric cancer with preliminary screening without completing gastroscopy from five communities of Yanta District, Beilin District, Lianhu District of Xi'an City were selected by convenience sampling from 20th March 2015 to 15th December 2016. They were divided into observation group (n=500, conventional education on screening of gastric cancer) and control group (n=500, nursing intervention based on HBM for one year) with the method of random number table. And then, the cognition, score of health belief and the screening rate of gastroscope of both groups were compared. Results After intervention, the scores of all dimensions on cognition about gastric cancer in observation group were higher than those in control group with significant differences (P<0.05). There were statistically significant differences in scores of all dimensions on cognition about gastric cancer before and after intervention in observation group (P<0.05), while there was no statistically significant differences in those in control group (P>0.05). There were also statistically significant differences in scores of all dimensions of health belief between two groups (P<0.05). Compared within groups, there was no statistically significant differences in scores of all dimensions of health belief except for self efficacy in control group before and after intervention (P>0.05), while there were statistical significances in scores of all dimensions in observation group (P<0.05). After intervention, the screening rate of gastroscope in observation group was significantly higher than that in control group (P<0.05).Conclusions The nursing intervention based on HBM helps high risk group of gastric cancer sets up health belief, improves the participation rate of screening by gastroscope along with having important significance for the discovery rate of early gastric cancer.

Bile Ducts, Intrahepatic ; Dilatation, Pathologic ; Humans ; Synchrotrons