ObjectiveTo compare the histological staining performance of four various tissue fixatives, including a self-developed fixative, for preparing paraffin sections of rat eyeball tissue. MethodsTwenty 5-week-old male Sprague-Dawley (SD) rats were randomly divided into 4 groups (n=5 per group). After anesthesia by intraperitoneal injection of Zoletil™ 50 at a dose of 45 mg/kg body weight, the rats were euthanized by exsanguination via the abdominal aorta. Bilateral eyeballs were carefully extracted intact and fixed for 72 h in 10% formaldehyde fixative, glutaraldehyde-formaldehyde mixed fixative, Davidson's fixative, and self-developed fixative, respectively. After fixation, the eyeballs were longitudinally sectioned along the optic nerve, with the portions containing the optic nerve preserved. The tissues were then dehydrated, embedded, and sectioned. Following hematoxylin and eosin (HE) staining, histological staining quality was compared among ocular structures including the cornea, lens, and retina. ResultsThe overall appearance of rat eyeballs showed marked shrinkage in the 10% formaldehyde group and the glutaraldehyde-formaldehyde group, whereas the eye morphology remained round and intact in the modified Davidson's fixative group and self-developed fixative group. The corneal stroma exhibited obvious rupture, and the cells were arranged in folded arrangement in the modified Davidson's fixative group, 10% formaldehyde group, and self-developed fixative group. In contrast, the corneal cells in the glutaraldehyde-formaldehyde group were neatly arranged, showing no rupture or folding, and exhibited clear staining, indicating the highest quality of corneal sectioning among all groups. In the 10% formaldehyde group, cracks were observed in the equatorial and cortical regions of the lens, but the lens fiber structure remained intact. The lenses in the modified Davidson's fixative group showed extensive rupture and detachment. The glutaraldehyde-formaldehyde group displayed only slight cracks at the equator. In the self-developed fixative group, mild red folding was limited to the peripheral lens region, with the remaining structures intact and unbroken. These findings indicated that the glutaraldehyde-formaldehyde and self-developed fixative groups achieved the best lens sectioning quality. The retina was severely detached from the choroid/sclera layer, with extensive rupture of each cellular layer in the 10% formaldehyde fixative group. In the glutaraldehyde-formaldehyde group, partial detachment between the retina and choroid/sclera was observed. The outer plexiform layer and nerve fiber layer showed separation with edema, while the cells in all layers were neatly arranged. In both the Davidson's fixative and the self-developed fixative groups, the retina remained intact without rupture, and no structural separation was observed in any layer. Both demonstrated advantages in preserving the integrity and orderly arrangement of all retinal layers; however, the self-developed fixative group exhibited greater contrast. ConclusionThe choice of fixative significantly affects the morphological preservation of various structures in the rat eye. The self-developed fixative demonstrates the best overall performance in maintaining overall eye morphology, the structural integrity of the lens, and retinal adhesion. For studies focusing solely on the corneal structure, the glutaraldehyde-formaldehyde mixed fixative is recommended. The 10% formaldehyde fixative exhibits unsatisfactory fixation effects for all the aforementioned ocular structures and is not recommended for detailed morphological studies of eyeball tissues.

Objective:To explore the clinical effects of tibial periosteal distraction combined with antibiotic bone cement in treating diabetic foot ulcer.Methods:The study was a retrospective observational study. From March 2021 to March 2024, 52 patients with diabetic foot ulcers who met the inclusion criteria were admitted to Gansu Provincial People's Hospital, including 25 males and 27 females, aged 34-77 years. According to the treatment methods used by the patients, they were divided into control group (22 cases) treated with antibiotic bone cement alone and combined group (30 cases) treated with tibial periosteal distraction combined with antibiotic bone cement. Toe amputation rate, limb amputation rate, length of hospitalization, and ulcer healing time-consuming of patients were recorded. Before the first treatment and 3 weeks after the last treatment, the ankle skin temperature and ankle-brachial index of the affected foot were measured routinely, the pain of the affected foot was evaluated by using visual analog scale (VAS), and the peripheral nerve function of the affected foot was evaluated by 10 g nylon thread examination (denoted as 10 g nylon thread test value). Three weeks after the last treatment, the clinical efficacy of patients was evaluated and the overall rate of clinical efficacy was calculated.Results:There were no statistically significant differences in the comparison of toe amputation rate and limb amputation rate of patients in the 2 groups ( P>0.05). The length of hospitalization and ulcer healing time-consuming of patients in combined group were (23±5) and (41±6) d, respectively, which were significantly shorter than (27±5) and (46±6) d in control group (with t values of 3.08 and 3.18, respectively, both P values <0.05). The ankle skin temperature of the affected foot of patients in combined group was (34.1±1.5) ℃, and the ankle-brachial index was 0.72±0.08 three weeks after the last treatment, which were significantly higher than (32.1±1.6) ℃ and 0.58±0.09 before the first treatment within the group (with t values of 5.10 and 6.37, respectively, P<0.05) and (31.8±1.1) ℃ and 0.59±0.09 three weeks after the last treatment in control group (with t values of 6.88 and 5.49, respectively, P<0.05). The pain VAS score of the affected foot of patients in combined group 3 weeks after the last treatment was significantly lower than that before the first treatment within the group and 3 weeks after the last treatment in control group (with t values of 8.16 and 6.83, respectively, both P values <0.05), and the 10 g nylon thread test value was significantly higher than that before the first treatment within the group and 3 weeks after the last treatment in control group (with t values of 6.15 and 4.23, respectively, both P values <0.05). Three weeks after the last treatment, the overall rate of clinical efficacy of patients in combined group was 96.7% (29/30), which was significantly higher than 63.6% (14/22) in control group, χ2=7.51, P<0.05. Conclusions:Tibial periosteal distraction combined with antibiotic bone cement has good clinical effects in the treatment of diabetic foot ulcers. It can shorten the length of patients' hospitalization, promote the healing of the ulcers, reduce the pain in the affected foot, and improve the blood supply and peripheral nerve function in the affected foot.

Objective To investigate the detection rate and related influencing factors of gastrointestinal diseases in grass-roots personnel.Methods A total of 481 grass-roots personnel were enrolled and examined by magnetic-controlled capsule endoscopy(MCCE).Multivariate logistic regression were used to analyze the influencing factors of gastrointestinal diseases detected by MCCE.Results All personnel completed MCCE,and gastrointestinal diseases were detected in 154(32.0%)cases,including 106 cases of erosive gastritis,25 cases of chronic atrophic gastritis,17 cases of digestive tract polyp,16 cases of gastric ulcer,5 cases of reflux esophagitis,4 cases of cardia,1 case of duodenitis,and 1 case of enteritis.Gastrointestinal diseases was correlated with special operation posts,long-term tasks within recent 6 months,abdominal distension,belching,nausea and vomiting,diarrhea and other symptoms(all P＜0.05).Multivariate logistic regression analysis showed that the risk factors of gastrointestinal diseases were working in special operation posts,performing long tasks within 6 months,belching,nausea and vomiting symptoms(all P＜0.05).Conclusion The overall detection rate of gastrointestinal diseases(mainly acid related diseases)is relatively high,and its incidence is closely related to working in special operation posts and performing long-term tasks within recent 6 months.Personnel working in special operation posts should be more alert to gastrointestinal diseases.Gastrointestinal symptoms have reference value for the prediction of lesions,but more attention should be paid to the identification of functional gastrointestinal diseases with endoscopy.

Crystalline nephropathy is a kidney disorder characterized by crystal deposition in the renal tubules and interstitium，leading to renal dysfunction. Clinical manifestations include polydipsia，polyuria，renal function abnormalities，with or without crystalluria. The pathogenesis involves direct and indirect cytotoxicity caused by crystal deposition，inflammatory kidney injury，tubular obstruction，oxidative stress and inflammatory responses，which further promote renal fibrosis. It represents a significant cause of both acute and chronic renal failure. In adults，it is primarily induced by medications and secondary factors，while it is relatively rare and mainly caused by genetic and metabolic disorders in children. Diagnosis relies on clinical presentation，urinalysis，and medical imaging，while confirmatory diagnosis requires renal biopsy. Currently，due to the limitid awareness of pediatric crystalline nephropathy，it is essential to enhance pediatrician' understanding of this disease for early and precise diagnosis and treatment，thereby improving prognosis and reducing the risk of end-stage renal disease.

Objective:To analyze the four lab test results of infectious diseases among patients in a stomatological hospital in Shaanxi Province from 2018 to 2023,so as to provide evidence for clinical prevention and control of infection.Methods:The pa-tients who see a doctor in stomatological hospital from January 2018 to December 2023 were tested for four infectious diseases.HB-sAg and anti-HIV were detected by electrochemical luminescence method,and anti-HCV and anti-TP were detected by ELISA method.Results:There was no statistical difference in the positive rates of HBsAg,anti-HCV and anti-HIV in each year,and the positive rate of anti-TP decreased year by year.There was no statistical difference in the positive rate of anti-HCV between different sexes,and the positive rates of HBsAg,anti-TP and anti-HIV are higher in male than in female.HBsAg and anti-HCV positive pa-tients were mostly concentrated in 51-60 years old.Anti-TP positive patients were mostly concentrated in people over 60 years old and anti-HIV positive patients were mostly concentrated in 41-60 years old.78.38％of HIV-positive patients with oral mucosal dis-eases were initially diagnosed as oral candidiasis.Conclusion:Male and people over 41 years old were the high-risk groups of vari-ous infectious diseases.

Renal cell carcinoma with hemangioblastoma components (RCC-HBc) is a rare subtype of renal cell carcinoma reported in recent years. This tumor is rare. This article reports 1 case of RCC-HBc. A solid mass in the right kidney was found during physical examination. CT showed a high possibility of renal cancer.Laparoscopic partial nephrectomy was performed. After tumor resection, the pathological diagnosis was clear cell renal cell carcinoma with hemangioblastoma components. There was no tumor recurrence or metastasis 33 months after surgery.

Objective To construct and validate a nomogram prediction model for poor prognosis in elderly patients with gastrointestinal bleeding.Methods A total of 176 elderly patients with gastrointestinal bleeding were enrolled as the research objects.According to the prognosis during hospitalization,patients were divided into the poor prognosis group(56 cases)and the good prognosis group(120 cases).The clinical data of the two groups of patients were collected.The best variables of poor prognosis were screened by Lasso regression model,and the selected variables were included in the multivariate Logistic regression model to analyze the influencing factors.Nomogram was constructed based on the above influencing factors.Receiver operating characteristic(ROC)curve,clinical calibration curve and decision curve analysis(DCA)were drawn to validate clinical practicability of nomogram prediction model.Results Multivariate Logistic regression analysis showed that urea nitrogen(BUN,OR=2.766,95％CI:1.066-7.175)and high level of shock index(SI,OR=3.853,95％CI:1.028-14.446)were independent risk factors of poor prognosis in elderly patients with gastrointestinal bleeding(P＜0.05),while high levels of albumin(ALB,OR=0.100,95％CI:0.036-0.277)were protective factors(P＜0.05).ROC curve validated that the area under the curve of the prediction model was 0.845(95％CI:0.786-0.904).Calibration curve showed that the model had a relatively high degree of calibration.DCA showed that the model had a clear positive net benefit.Conclusion The nomogram prediction model constructed based on BUN,SI and ALB levels to predict the poor prognosis of elderly patients with gastrointestinal bleeding has a high predictive value.

Objective To investigate the bacterial contamination of water specimens at different pre-discharge time of flexible endoscopic final rinse water before daily use,and provide reference basis for choosing the optimal pre-dis-charge time in clinical work.Methods From August to December 2023,the water produced by the purified water equipment of the digestive endoscopy centers of 4 tertiary first-class medical institutions in Jiangxi Province,as well as the final rinsing water at the terminal-point at different pre-discharge times(before pre-discharge,discharge of 1,3,5,and 10 minutes)were subjected to on-site sampling,the collected water specimens were performed microbio-logical cultures by pouring and filter membrane methods,unqualified water specimens were performed bacterial i-dentification.Results 48 specimens of water produced by purified water equipment were collected,with qualified rate of 100％.480 final water specimens were collected,with a qualified rate of 0 before pre-discharge.The quali-fied rates of pre-discharge at 1,3,5,and 10 minutes were 0,21.88％,55.21％,and 73.96％,respectively.Bac-terial colony counts in the final rinse water with different pre-discharge times in 4 medical institutions showed statis-tically significant differences(all P＜0.001).As the pre-discharge time increased,bacterial colony counts in the fi-nal rinse water of all four medical institutions showed a decreasing trend.The pairwise comparison of the overall bacterial colony count of the final rinse water at different pre-discharge time showed that there was no statistically significant difference in the bacterial colony count of the final rinse water at 5 and 10 minutes of pre-discharge(P＞0.05),while the pairwise comparison between other time points showed statistically significant differences(all P＜0.001).Environmental contaminated bacteria such as Micrococcus luteus,Cupriavidus paucula,and Sphin-gononas paucimobilis were detected from the unqualified water specimens.Conclusion With the extension of pre-discharge time,the degree of bacterial contamination in the final rinse water significantly decreases.All levels of medical institutions need to pre-discharge the final rinse water daily,and the pre-discharge time should last for at least 5 minutes.

Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.

Objective:To construct an early rehabilitation management model for postoperative kinesiophobia patients after total knee arthroplasty (TKA) based on a topic-oriented quality control circle method, aiming to improve the quality of early rehabilitation management.Methods:Using a convenience sampling method, 120 TKA patients with kinesiophobia treated in the Department of Orthopedics at the First Affiliated Hospital of Zhengzhou University from January to April 2022 and September to December 2022 were selected. The patients from January to April 2022 were set as the control group, and those from September to December 2022 were set as the observation group, with 60 patients in each group. The control group received routine rehabilitation management after TKA surgery, while the observation group received the early rehabilitation management model based on the 10 steps of the topic-oriented quality control circle (topic selection, activity planning, clarification of the topic, goal setting, countermeasure formulation, pursuit of optimal strategies, etc.) in addition to the routine management. The differences between the two groups were compared in terms of kinesiophobia score, knee function score, pain score, early rehabilitation assessment rate, effective analgesia rate, and 24-hour ambulation rate.Results:After the intervention, the observation group showed significantly lower knee pain scores (2.89±0.66) and kinesiophobia scores (23.27±4.87) compared to the control group, with a significantly higher knee function score (74.47±7.40), all differences were statistically significant (all P<0.01). Additionally, the observation group had a significantly higher early rehabilitation assessment rate, effective analgesia rate, 24-hour ambulation rate, early rehabilitation compliance rate, earlier time for the first ambulation, shorter hospital stay, and reduced costs compared to the control group, with all differences showing statistical significance (all P<0.01) . Conclusions:The application of the topic-oriented quality control circle to construct and implement an early rehabilitation management model for postoperative kinesiophobia patients after TKA can effectively improve the quality of early rehabilitation management, reduce kinesiophobia levels, enhance knee joint function, and alleviate the economic burden.