Objective To assess the efficacy of combining specialized scenarios with workshop-based teaching in training newly recruited nurses for occupational exposure.Methods This study was conducted with 200 nurses recruited between January 2020 and December 2021 as the control group and 200 nurses from January 2022 to December 2023 as the intervention group.The control group and the intervention group received routine training and workshop-based training,respectively.The efficacy was assessed through theoretical exams,skills assessments,occupational exposure incidence,and training satisfaction,measured u-sing the Simulation Design Scale(SDS).Results The intervention group demonstrated higher scores on theoretical knowledge and operational skills assessments compared to the control group.The occupational exposure were lower in the intervention group.Additionally,the intervention group scored higher on the SDS and reported greater satisfaction with the training(P＜0.05).Conclusion The teaching method integrated with specialized scenarios and workshop-based teaching effectively enhances the theoretical knowledge and operational skills related to occupational exposure among newly recruited nurses.It reduces the inci-dence of occupational exposure,such as needlestick injuries,and improves training outcomes and nurse satisfaction,making it a valuable approach for clinical application.

Objective:To explore the clinical effect on the treatment of radiation induced deep ulcers in the inguinal region with ipsilateral anterolateral thigh chimeric perforator flap.Methods:From March 2020 to March 2024, retrospective analysis of 8 patients with radiation induced deep ulcers in the inguinal region were treated with ipsilateral anterolateral thigh chimeric perforator flap in the Medical Centre of Burn Plastic and Wound Repair, the First Affiliated Hospital of Nanchang University. All ulcers induced by radiation were caused by postoperative radiotherapy in the inguinal region, of which 4 were of vulvar or penile cancer, 2 of urinary tract tumour, 1 of inguinal protuberant dermatofibrosarcoma and 1 of myofibroblastic sarcoma in lower abdominal wall. The course of the radiation induced ulcer was 0.5-11.0 years, with an average of 2.9 years. The sizes of the ulcerative wound were 2.5 cm × 3.0 cm - 5.5 cm × 7.5 cm. Preoperative biopsies of the tissues around wound and pelvic CT scans were performed to preliminarily exclude a tumour recurrence or an ulcerative malignancy, as well as to confirm the depth of radiation ulcer. The wound size after debridement was 4.5 cm × 6.0 cm-13.5 cm × 19.0 cm, with a depth of 2.0-4.0 cm. An ipsilateral anterolateral thigh chimeric perforator flap was transferred to reconstruct the wound, after the wound edges were cleared from tumour through intraoperative frozen section examinations. The flaps were 5.5 cm × 7.0 cm - 14.0 cm × 20.0 cm in size, with the volumes of muscle flap at 7.0 cm × 4.0 cm × 3.0 cm - 14.0 cm × 7.0 cm × 3.0 cm. After having the deep defect at the base of wound filled with a muscle flap, the wound surface was covered by the flap. Four patients had direct suture of the donor sites and 4 received a thick skin graft of head or contralateral thigh grafting. Survival of the anterolateral thigh chimeric perforator flaps and the healing of donor sites were observed after surgery through scheduled postoperative follow-up by the visits of outpatient clinic and distant interviews via telephone, WeChat or the internet hospital.Results:One of the ipsilateral anterolateral thigh chimeric perforator flaps had venous occlusion within 24 hours after surgery. Emergency surgical exploration revealed that it was caused by a haematoma compression due to haemorrhage in the muscle flap. Further debridement, haemostasis and suture were performed, then the wound healed. The rest of 7 flaps all survived. All donor sites healed primarily. The postoperative follow-up lasted for 5-17 months with all of the 8 patients, at 8.4 months in average. Both the donor and recipient sites healed well without recurrence of radiation ulcer in the affected sites. The appearance and texture of the flaps were good, and there was no obvious functional impairment at the donor sites.Conclusion:The treatment of radiation induced deep ulcer in the inguinal region with an ipsilateral anterolateral thigh chimeric perforator flap has shown good results, without recurrence of ulcer after surgery. The appearance and texture of the affected sites are good, and there is no secondary functional impairment at the donor site.

Objective:To investigate the clinical features of patients with congenital atresia of the oval window (CAOW).Methods:A retrospective analysis was conducted on 7 cases (8 ears) of surgically confirmed CAOW treated at our department from July 2018 to July 2024. Among the cases, 1 patient had bilateral CAOW, and 4 patients had unilateral CAOW combined with other types of ossicular chain malformations in the contralateral ear. We collected and analyzed the clinical data, audiological features, and temporal bone HRCT results of all patients.Results:The 7 patients were diagnosed at ages ranging from 8 to 19 years, with a mean age of (13.2±6.9) years. None of the patients exhibited significant auricular deformities. All presented with conductive hearing loss or mixed hearing loss predominantly of the conductive type, with an intact tympanic membrane. The diagnosis of CAOW was confirmed via endoscopic tympanotomy, revealing a concave oval window area on the medial wall of the tympanic cavity, sealed by a bony plate. All 8 ears exhibited additional ossicular chain deformities. Stapes absence was present in all 8 ears. Partial absence of the incus long process was observed in 3 ears, while, abnormal bony connections between the incus long process and the promontory were seen in 4 ears, 1 ear had a short malleolar handle, 1 ear had a smaller than normal malleus volume. In addition, facial nerve deformities were found in 6 ears, with 4 ears showing bifurcation of the facial nerve and 2 ears showing facial nerve obscuration of the oval window. Pure-tone audiometry revealed that 62.5% (5/8 ears) of patients had air conduction (AC) thresholds≥60 dB preoperatively, with a mean pure-tone average (PTA) of (69.0±11.8) dB HL and a mean air-bone gap (ABG) of (52.0±7.0) dB. The mean AC threshold and ABG were higher in the low-frequency (125-1 000 Hz) range compared to the high-frequency (2 000-8 000 Hz) range (both P<0.05). Preoperative HRCT showed abnormalities in all patients, with 7 ears being diagnosable as CAOW. Although the remaining 1 ear could not be diagnosed as CAOW, stapes and incus long process absence were detected. Conclusion:CAOW is rare in clinical, as the patients with non-progressive conductive hearing loss (AC≥60 dB, ABG≥50 dB) since childhood, intact tympanic membrane without malformations of auricle and external auditory canal, and thick bony plate covered the oval window of the HRCT imaging, CAOW should be highly suspected, which could be confirmed by the exploratory tympanotomy.

Objective To investigate the molecular mechanism of the induction of gastric cancer cell line AGS death by p97 inhibitor eeyarestatin Ⅰ(Eer Ⅰ).Methods AGS cells were treated with Eer Ⅰ.Then liquid chro-matography-mass spectrometry was used to perform proteome analysis for screening differentially expressed proteins and to find underlying signaling pathways.At the same time,the proteins of related pathway were investi-gated by protein immunoblotting.Cell proliferation was detected using the CCK-8 test kit;Cell apoptosis was detec-ted using TUNEL staining test kit;Liperfluo probe was used to detect ferroptosis-related lipid peroxides.Results In Eer Ⅰ treatment group,there were significant changes in proteins(fold change＞1.5 and P＜0.05),in which 125 proteins were increased and 132 proteins were decreased.The enrichment analysis of these DEPs showed that Eer Ⅰ might significantly affect cell apoptosis and ferroptosis-related signaling pathways.Furthermore,Eer Ⅰcould increase genomic DNA fragmentation related to cell apoptosis,increase of lipid peroxides in the ferroptosis pathway,causes changes in cell death related proteins,and inhibit the proliferation of gastric cancer cells.Conclusions p97 inhibitor Eer Ⅰ can induce cell apoptosis and ferroptosis in AGS cells,thereby inhibiting tumor cell proliferation.

Objective This study aims to explore the efficacy and complication rates of the transcranial approach(TCA)and extended endoscopic endonasal approach(EEEA)for the treatment of craniopharyngiomas based on the QST classification,providing a scientific reference for clinical decision-making on surgical approach.Methods A total of 151 patients who underwent craniopharyngioma surgery at our center from January 2018 to December 2023 were enrolled.The patients were categorized into Q-CP(suprasellar type),S-CP(infundibular type),and T-CP(tuberal type)according to the QST classification.Systematic collection and analysis were performed on the outcomes of TCA and EEEA treatments,respectively.The differences in effectiveness between the two approaches were evaluated based on the QST classification.Results The improvement rate of visual symptoms was overall higher in the EEEA group than in the TCA group(59.1%vs.36.5%,P=0.006),and the visual deterioration rate was lower(3.0%vs.14.1%,P=0.006).However,the incidence of cerebrospinal fluid leakage was higher in the EEEA group(15.2%vs.3.5%,χ2=4.986,P=0.026).The incidence of postoperative seizures(8.2%vs.0,P=0.019),brain contusions(10.6%vs.0,P=0.005),and subdural hematoma(9.4%vs.0%,P=0.01)was higher in the TCA group.For patients with Q-CP type,the EEEA group had a higher rate of total tumor resection(92.9%vs.65.2%,P=0.025)and a lower recurrence rate(3.6%vs.21.7%,P=0.047),with shorter hospital stays and lower postoperative costs.The TCA group had higher intraoperative blood loss in this type(300 mL vs.200 mL,Z=-2.261,P=0.024).For S-CP type patients,the EEEA group showed a higher rate of total tumor resection(91.3%vs.74.2%)and a lower recurrence rate(0 vs.12.9%,P=0.031),with lower postoperative hospital costs.In T-CP type,due to the deeper location,EEEA showed limitations in protecting hypothalamic function and the TCA group had a better postoperative hypothalamic function score(P=0.035).Conclusion Based on QST classification,EEEA has advantages in Q-CP and S-CP types and is recommended as the preferred surgical procedure;In the T-CP type,TCA surgery is more helpful in protecting hypothalamic function.

Objective:To investigate the prevalence and risk factors of overweight and obesity among Chinese children aged 3-18 years from 11 provinces, antonomous regions, or municipalities.Methods:This national cross-sectional community health survey utilized a multistage stratified cluster-random sampling method to recruit 193 997 nationally representative participants from 11 provinces, autonomous regions, or municipalities between January 2017 and December 2019. All participants underwent physical examinations, and their caregivers completed questionnaires assessing participants′ dietary, lifestyle, familial, and perinatal information. Multilevel multinomial logistic regression models were employed to identify the potential risk factors.Results:The cohort comprised 193 997 children (102 178 boys, 91 819 girls),aged (10±4) years. Overall prevalence rates were 30 574(15.8%)overweight children and 17 217(8.9%) obesity children. Boys exhibited higher overweight and obesity rates than girls (17.0% (17 368/102 178) vs. 14.4% (13 206/102 178), 11.3% (11 553/91 819) vs. 6.2% (5 664/91 819), χ2=249.12,1 578.69,both P<0.001). The detection rates of obesity in Tanner stage 2 and 3 were the highest in boys and girls, with 13.4%(2 231/16 665) and 8.6%(880/10 221) respectively. Risk factors for obesity included parental overweight (paternal OR=2.34 and maternal OR=2.29), annual household income of 100 000-200 000 yuan (compared with<100 000 yuan, OR=1.04), higher paternal education (compared with below high school,high school and a college education OR=1.09,1.14), birth weight >4.0 kg (≤5 and>5 years old OR=1.74, 1.44,respectively), and western food consumption≥1 time/month (compared with<1, 1-2, 3-4,>4 times/month OR=1.36, 1.30, 1.67(≤5 years), 1.19, 1.16, 1.15 (>5 years), respectively) (all P<0.05). Conversely, coarse grain intake≥1 times/week (compared with<1 times/week, every day, 3-4, 1-2 times/week OR=0.74, 0.80, 0.71 (≤5 years), 0.75, 0.87, 0.90(>5 years), respectively, all P<0.05) was associated with reduced obesity risk. Conclusions:Obesity epidemiology in children demonstrates significant heterogeneity across age, gender, geographic regions, and pubertal stages. It is necessary to establish a personalized prevention and control strategy.

Objective This study aims to explore the efficacy and complication rates of the transcranial approach(TCA)and extended endoscopic endonasal approach(EEEA)for the treatment of craniopharyngiomas based on the QST classification,providing a scientific reference for clinical decision-making on surgical approach.Methods A total of 151 patients who underwent craniopharyngioma surgery at our center from January 2018 to December 2023 were enrolled.The patients were categorized into Q-CP(suprasellar type),S-CP(infundibular type),and T-CP(tuberal type)according to the QST classification.Systematic collection and analysis were performed on the outcomes of TCA and EEEA treatments,respectively.The differences in effectiveness between the two approaches were evaluated based on the QST classification.Results The improvement rate of visual symptoms was overall higher in the EEEA group than in the TCA group(59.1%vs.36.5%,P=0.006),and the visual deterioration rate was lower(3.0%vs.14.1%,P=0.006).However,the incidence of cerebrospinal fluid leakage was higher in the EEEA group(15.2%vs.3.5%,χ2=4.986,P=0.026).The incidence of postoperative seizures(8.2%vs.0,P=0.019),brain contusions(10.6%vs.0,P=0.005),and subdural hematoma(9.4%vs.0%,P=0.01)was higher in the TCA group.For patients with Q-CP type,the EEEA group had a higher rate of total tumor resection(92.9%vs.65.2%,P=0.025)and a lower recurrence rate(3.6%vs.21.7%,P=0.047),with shorter hospital stays and lower postoperative costs.The TCA group had higher intraoperative blood loss in this type(300 mL vs.200 mL,Z=-2.261,P=0.024).For S-CP type patients,the EEEA group showed a higher rate of total tumor resection(91.3%vs.74.2%)and a lower recurrence rate(0 vs.12.9%,P=0.031),with lower postoperative hospital costs.In T-CP type,due to the deeper location,EEEA showed limitations in protecting hypothalamic function and the TCA group had a better postoperative hypothalamic function score(P=0.035).Conclusion Based on QST classification,EEEA has advantages in Q-CP and S-CP types and is recommended as the preferred surgical procedure;In the T-CP type,TCA surgery is more helpful in protecting hypothalamic function.

Objective To assess the efficacy of combining specialized scenarios with workshop-based teaching in training newly recruited nurses for occupational exposure.Methods This study was conducted with 200 nurses recruited between January 2020 and December 2021 as the control group and 200 nurses from January 2022 to December 2023 as the intervention group.The control group and the intervention group received routine training and workshop-based training,respectively.The efficacy was assessed through theoretical exams,skills assessments,occupational exposure incidence,and training satisfaction,measured u-sing the Simulation Design Scale(SDS).Results The intervention group demonstrated higher scores on theoretical knowledge and operational skills assessments compared to the control group.The occupational exposure were lower in the intervention group.Additionally,the intervention group scored higher on the SDS and reported greater satisfaction with the training(P＜0.05).Conclusion The teaching method integrated with specialized scenarios and workshop-based teaching effectively enhances the theoretical knowledge and operational skills related to occupational exposure among newly recruited nurses.It reduces the inci-dence of occupational exposure,such as needlestick injuries,and improves training outcomes and nurse satisfaction,making it a valuable approach for clinical application.

Objective:To explore the predictive value of miR-21 combined with high mobility group box-1 protein (HMGB1) for postoperative prognosis in patients with hypertensive intracerebral hemorrhage (HICH).Methods:A total of 137 HICH patients (HICH group) admitted to the Central Hospital of Yongzhou from March 2021 to March 2023 were retrospectively selected, and 60 healthy subjects undergoing physical examination in the same hospital during the same period were enrolled as the control group. Serum miR-21 and HMGB1 levels were compared between the two groups, and differences in serum miR-21 and HMGB1 levels among HICH patients with different disease severities and prognoses were analyzed. Univariate and multivariate logistic regression analyses were used to screen influencing factors for postoperative prognosis in HICH patients, and receiver operating characteristic (ROC) curve was applied to evaluate the predictive value of miR-21 combined with HMGB1 for postoperative prognosis.Results:The relative expression level of serum miR-21 on postoperative day 1 in the HICH group was significantly lower than that in the control group ( P<0.05), while the HMGB1 level was significantly higher ( P<0.05). With the aggravation of HICH severity, the relative expression of serum miR-21 significantly decreased (all P<0.05), while the HMGB1 level significantly increased (all P<0.05). The relative expression of serum miR-21 in the good prognosis group was significantly higher than that in the poor prognosis group ( P<0.05), while the HMGB1 level was significantly lower ( P<0.05). Univariate and multivariate logistic regression analyses showed that miR-21, HMGB1, preoperative Glasgow Coma Scale (GCS) score, and preoperative hematoma volume were influencing factors for postoperative prognosis in HICH patients (all P<0.05). ROC curve showed that the areas under the curve (AUC) of miR-21 and HMGB1 for predicting poor postoperative prognosis in HICH patients were 0.925 and 0.913, respectively, while the AUC of miR-21 combined with HMGB1 was 0.950. Conclusions:Peripheral blood miR-21 is significantly decreased and HMGB1 level is significantly increased in HICH patients. miR-21 combined with HMGB1 has a good predictive value for poor postoperative prognosis in patients with hypertensive intracerebral hemorrhage.

Objective:To explore the predictive value of miR-21 combined with high mobility group box-1 protein (HMGB1) for postoperative prognosis in patients with hypertensive intracerebral hemorrhage (HICH).Methods:A total of 137 HICH patients (HICH group) admitted to the Central Hospital of Yongzhou from March 2021 to March 2023 were retrospectively selected, and 60 healthy subjects undergoing physical examination in the same hospital during the same period were enrolled as the control group. Serum miR-21 and HMGB1 levels were compared between the two groups, and differences in serum miR-21 and HMGB1 levels among HICH patients with different disease severities and prognoses were analyzed. Univariate and multivariate logistic regression analyses were used to screen influencing factors for postoperative prognosis in HICH patients, and receiver operating characteristic (ROC) curve was applied to evaluate the predictive value of miR-21 combined with HMGB1 for postoperative prognosis.Results:The relative expression level of serum miR-21 on postoperative day 1 in the HICH group was significantly lower than that in the control group ( P<0.05), while the HMGB1 level was significantly higher ( P<0.05). With the aggravation of HICH severity, the relative expression of serum miR-21 significantly decreased (all P<0.05), while the HMGB1 level significantly increased (all P<0.05). The relative expression of serum miR-21 in the good prognosis group was significantly higher than that in the poor prognosis group ( P<0.05), while the HMGB1 level was significantly lower ( P<0.05). Univariate and multivariate logistic regression analyses showed that miR-21, HMGB1, preoperative Glasgow Coma Scale (GCS) score, and preoperative hematoma volume were influencing factors for postoperative prognosis in HICH patients (all P<0.05). ROC curve showed that the areas under the curve (AUC) of miR-21 and HMGB1 for predicting poor postoperative prognosis in HICH patients were 0.925 and 0.913, respectively, while the AUC of miR-21 combined with HMGB1 was 0.950. Conclusions:Peripheral blood miR-21 is significantly decreased and HMGB1 level is significantly increased in HICH patients. miR-21 combined with HMGB1 has a good predictive value for poor postoperative prognosis in patients with hypertensive intracerebral hemorrhage.