Objective To analyze the clinical application of the Donabedian-based structure-process-result three-dimensional quality evaluation model for the prevention of stress injury in bone tumor surgery.Methods A total of 284 patients with bone tumor who were admitted to The Second Affiliated Hospital of Naval Medical University from January 2022 to December 2023 were enrolled and assigned to two groups according to the random number table.The control group received routine nursing.In the observation group,the Donabedian-based structure-process-result three-dimensional quality evaluation model was applied to prevent the stress injury in bone tumor surgery.The indexes of the two groups were compared and analyzed.Results Before intervention,there was no significant difference in scores between the two groups(P>0.05).After intervention,the scores of stress injury behavior,skill and knowledge in the observation group were higher than those in the control group(P<0.05).The incidence of stress injury in the observation group was lower than that in the control group(P<0.05).There was significant difference in nursing satisfaction between the two groups(P<0.05).Conclusion Donabedian-based structure-process-result three-dimensional quality evaluation model can not only enhance the self-care ability of the patients undergoing bone tumor surgery,but also prevent stress injury,thus improving patient satisfaction.

Background Prenatal chronic psychological stress may increase the risk of allergic diseases in children, and eczema is the most common allergic disease in children, the pathogenesis of which is not yet fully understood. Objective To preliminarily clarify the changes in offspring intestinal flora after chronic stress exposure during pregnancy in rats that increases offspring immune imbalance and eczema susceptibility. Methods Thirty SPF-grade adult female SD rats were selected and randomly divided into a model group and a control group (n=15). Sixteen male rats were randomly divided into a model mating group and a control mating group (n=8). A 28-day chronic unpredictable mild stress (CUMS) model during pregnancy was established. On the 7th day of stress, male and female rats were caged in a ratio of 3:1. Blood samples were collected from female rats in each group via angular vein on the 1st day before stress, and on the 7th, 14th, 21st, and 28th days after stress. The content of plasma corticosterone during pregnancy was determined by enzyme-linked immunosorbent assay (ELISA). For the offspring rats, an eczema model was constructed using 2,4-dinitrochlorobenzene (DNCB). The number of scratching times of the offspring rats within 5 min was recorded. The offspring rats were divided into 4 groups: DNCB-CUMS group (MM), DNCB-control group (MC), solvent control-CUMS group (CM), and blank control group (CC), with 8 rats in each group. The eczema was induced once every 3 days, and the induction period was 12 d. The expression level of immunoglobulin E (IgE) in the serum of offspring rats after the eczema induction experiment were determined by ELISA. The concentrations of tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), interleukin-2 (IL-2), interleukin-4 (IL-4), and interleukin-13 (IL-13) in the serum were quantified by multi-parameter flow cytometry. The composition and abundance of intestinal microbiota in the feces of offspring rats were detected by 16S rRNA high-throughput sequencing technology. Results The plasma corticosterone concentrations in the model group were higher than those in the control group on the 7th and 21st days of stress (P<0.05). On the 14th and 21st days of stress, the 1% sucrose preference percentages of female rats in the model group were lower than that in the control group. On the 7th, 14th, and 21st days of stress, the horizontal movement scores of female rats in the model group and the vertical movement scores on the 7th and 14th days were lower than those in the control group (P<0.05). After 6, 9, and 12 d of model building, the scratching frequencies in the MC group and MM group were significantly higher than those in the CC group and CM group (P<0.05). Moreover, there were differences in the contents of cytokines including IFN-γ, IL-2, TNF-α, IL-4, IL-13, and IgE among the offspring rat groups (P<0.05). The CM group and MM group led to an increase in the contents of TNF-α, IL-4, IL-13, and IgE cytokines (P<0.05), while the MM group caused a decrease in the contents of IFN-γ and IL-2 (P<0.05). After the eczema induction experiment, the α-diversity analysis showed that the Simpson index and Shannon index in the CM were higher than those in the CC (P<0.05), indicating that CUMS during the pregnancy of female rats could increase the species abundance of their offspring. The abundances of Prevotella and Lactobacillus in the CM group decreased (P<0.05). Conclusion Intestinal dysbiosis in offspring due to chronic prenatal psychological stress, which may be one of the mechanisms linking maternal stress to immune imbalance and increased susceptibility to eczema in offspring.

Objective: To understand the indoor light at night (LAN) exposure intensity during sleep among children and adolescents in Shanghai, so as to provide a basis for exploring potential health risks and formulating effective interventions. Methods: From April to December in 2024, a total of 628 students in grades 4-7 were recruited from three schools in Shanghai. A portable illuminance meter was used to measure LAN for one week, and participants recorded their sleep time. The Kruskal-Wallis H- test was used for comparison between groups, and the error bar chart was used to show the trend and variation range of average LAN exposure intensity in different sleep periods. Results: The indoor LAN exposure intensity of children and adolescents in Shanghai was [2.4(0.8, 5.9)lx] during sleep, and 28.8% of children and adolescents were exposed to indoor LAN≥5 lx. There was no significant differences in indoor LAN exposure intensity between boys [2.4(1.0, 5.9)lx] and girls [2.3(0.7, 5.9)lx] ( Z=-0.86, P > 0.05 ). The indoor LAN exposure intensity of primary school students [2.9(1.1, 6.6)lx] was higher than that of junior high school students [1.0(0.3, 3.1)lx] ( Z =-5.87), and indoor LAN exposure intensity of students in the main urban area [3.2(1.1, 7.8)lx] was higher than that of rural students [1.6(0.5, 4.3)lx] ( Z =-5.23)(both P <0.05). The indoor LAN exposure intensity showed an overall decreasing trend during sleep of children and adolescents ( tau=-0.81, P =0.02), with a slight increase before waking up. Conclusions Indoor LAN exposure intensity among children and adolescents in Shanghai is generally high, especially among primary school students and students living in the main urban area. Health policy and education should be strengthened to reduce the impact of LAN on children and adolescent health.

Objective:To systematically analyze the incidence and influencing factors of frailty in elderly patients with hematologic malignancies.Methods:Research on frailty in elderly patients with hematologic malignancies was retrieved from Chinese and English databases such as China National Knowledge Infrastructure, Wanfang Data, PubMed, and Web of Science. The search period was from database establishment to August 23, 2024. Two researchers screened the included studies, conducted quality assessment, and extracted data. Meta-analysis was conducted using Stata 18 and RevMan 5.4.Results:A total of seven studies were included, encompassing 19 076 elderly hematologic malignancy patients, with a frailty incidence of 59% [95% CI (0.48, 0.69) ]. Meta-analysis revealed that age [ MD=4.31, 95% CI (3.67, 4.96) ], gender [ OR=0.88, 95% CI (0.83, 0.93) ], alcohol consumption [ OR=1.67, 95% CI (1.15, 2.44) ], self-care ability [ MD=-1.79, 95% CI (-3.17, -0.41) ], anemia [ OR=6.67, 95% CI (2.94, 15.14) ], infection [ OR=1.81, 95% CI (1.16, 2.84) ], and neuropathy [ OR=2.52, 95% CI (1.38, 4.61) ] were the influencing factors of frailty in elderly patients with hematologic malignancies. Conclusions:The incidence of frailty is high in elderly patients with hematologic malignancies. Elderly patients with hematologic malignancies who are older, female, consume alcohol, have low self-care ability, anemia, infections, and neuropathy are prone to frailty. Healthcare providers can conduct early screening and intervention for high-risk populations of frailty based on risk factors to improve the quality of life for elderly hematologic malignancy patients.

Objective To investigate the types and incidence of bifid mandibular canal using cone beam computed tomography(CBCT)technology so as to enhance our understanding of these anatomical features and help reduce complications caused by trauma to the neurovascular bundle within them.Methods CBCT data of 803 patients from College of Stomatology,Xi'an Jiaotong University,were collected,and the types and incidence of bifid mandibular canal were statistically analyzed according to the Naitoh classification method.Results The incidence of bifid mandibular canal was 54.05％,with the occurrence rates for the retromolar canal and forward canal being 26.40％ and 32.75％,respectively.Conclusion To ensure the safety of treatments,it is recommended that oral clinical practitioners use CBCT to obtain three-dimensional images for precise assessment of bifid mandibular canal,thereby avoiding potential complications during the perioperative period.

Objective To investigate the application of chromosome microarray analysis(CMA)in prenatal diagnosis of 18q deletion syndrome and to analyze the genotype-phenotype correlation of 18q deletion syndrome.Methods Prenatal diagnosis of three fetuses with 18q deletion syndrome was conducted through amniotic fluid karyotype analysis and CMA.Results Karyotype analysis results of the three fetuses were 46,XY,del(18)(q22);46,XY,-18,+mar;and 46,XX,del(18)(q21.2),respectively.The results of CMA showed that Case 1 had a deletion of 10.0 Mb in the 18q22.2q23 region,Case 2 had a deletion of 5.5 Mb in the 18p11.32p11.31 region and a deletion of 20.9 Mb in the 18q21.32q23 region,and Case 3 had a deletion of 24.1 Mb in the 18q21.2q23 region.Therefore,all the three fetuses had 18q deletion syndrome.Conclusion As a molecular diagnostic technique,CMA can accurately detect the location and size of pathogenic chromosome copy number,and identify the pathogenic genes.It can provide useful evidence for prenatal diagnosis and genetic counseling of 18q deletion syndrome.

Objective To investigate the association between plasma atherogenic index of plasma(AIP)and metabolism-associated steatotic liver disease(MASLD),and to evaluate the potential value of AIP as a predictive marker for MASLD risk.Methods We enrolled a total of 4 850 health check-up participants from The Second Affiliated Hospital of Xi'an Jiaotong University between June 2021 and May 2023.The participants were divided into quartiles(Q1-Q4)according to their AIP level.Biochemical indicators and MASLD prevalence were compared across groups.Logistic regression,subgroup analysis,and restricted cubic splines(RCS)were used to explore the relationship between AIP and MASLD.Results Among the 4 850 participants,the prevalence of MASLD was 26.08％(1 265/4 850).MASLD prevalence increased across AIP quartiles:4.0％,13.8％,30.8％,and 55.6％in Q1-Q4,respectively(P＜0.001).Compared with Q1,Q2-Q4 groups showed higher proportions of males,BMI,smokers,overweight/obesity,central obesity,prediabetes,hypertension,serum uric acid,and fatty liver index(FLI)(all P＜0.001).Lipid profiles worsened with increased AIP:total cholesterol,triglycerides,and LDL-C increased,while HDL-C decreased(P＜0.001).RCS analysis demonstrated a significant linear relationship between AIP and MASLD risk.After adjusting for confounders,the participants in Q4 had an 8.71-fold higher risk of MASLD than those in Q1(OR:8.71,95％CI:6.20-12.23,P＜0.001).A composite model incorporating AIP,BMI,and FLI showed superior discriminative performance(AUC:0.883,95％CI:0.873-0.892).Interaction analysis suggested that AIP had significant interactions with BMI,hypertension,and prediabetes(P＜0.05).In individuals without these metabolic abnormalities,the association between AIP and MASLD was more pronounced.Conclusion Elevated AIP was significantly associated with an increased risk of MASLD,with a stronger association observed in individuals with normal BMI,blood pressure,and blood glucose levels,suggesting that AIP may serve as a potential indicator for early screening of MASLD.

With the rapid development of artificial intelligence technology,its application in the field of medical education is increasingly extensive.In order to truly understand students'mastery and application of Medical Immunology knowledge as well as students'comprehensive quality,this study applied the formative assessment based on academic intelligence assessment platform to the teaching practice of Immunology in Daqing Campus of Harbin Medical University.Compared with previous formative assessment,the intelligent platform developed by artificial intelligence technology has many advantages in teaching assessment and evaluation.Good feedback has been obtained between teachers and students,and the teaching quality of teachers and the learning effect of students have been significantly improved,which is worth further promotion.

Objective:To study the epidemiological characteristics of human brucellosis in Ordos City and provide reference and theoretical guidance for prevention and control of the disease.Methods:The surveillance data of human brucellosis cases and the serological surveillance data of key occupational populations reported by the Ordos City Center for Disease Control and Prevention from 2013 to 2022 were collected and analyzed descriptively. ArcGIS 10.8 software was used to draw a spatial distribution map of human brucellosis in Ordos City, and SPSS 26.0 software was used to conduct Spearman correlation analysis to further explore the impact of economic factors on human brucellosis.Results:From 2013 to 2022, a total of 8 676 cases of human brucellosis were reported in Ordos City, with an average annual incidence rate of 40.93/100 000. In 2022, 2 570 cases were reported, with an incidence rate of 116.78/100 000, reaching the peak in the past 10 years. The cases were mainly distributed in Dalad Banner, Hangjin Banner, and Otog Front Banner, with a total of 6 415 cases, accounting for 73.94% of the total number of cases. The spatial distribution spread from north to south and from north to east. The majority of cases were in the age group of 40 to 65 years old (6 061 cases, accounting for 69.86%), male (6 089 cases, accounting for 70.18%), and farmers and herdsmen (7 367 cases, accounting for 84.91%). The median time interval between onset and diagnosis was 16 days. The positive rate of serological surveillance in key occupational groups was 5.38% (7 058/131 229). The results of Spearman correlation analysis showed that the number of agricultural legal entities, the number of animal husbandry legal entities, regional gross domestic product, per capita disposable income of rural and pastoral residents, total agricultural output value, the number of cattle and sheep at the end of the year, milk production, and mutton production were important factors affecting the incidence of brucellosis ( P < 0.05). Conclusions:The incidence of brucellosis in Ordos City is on the rise, and the epidemic situation is severe. It is necessary to strengthen the surveillance and joint prevention and control of human brucellosis to prevent the spread and expansion of the epidemic.

OBJECTIVE To study the prevention and control strategies for carbapenem-resistant Acinetobacter bau-mannii(CRAB)infection through inves-tigating an outbreak of CRAB infection in an intensive care unit(ICU),and provide a scientific basis for the prevention and control of such hospital-acquired infections.METHODS Epide-miological investigations were conducted on patients with CRAB infection in the ICU of a hospital from Jul.7 to Jul.29,2023,and microbial sampling,identification and drug sensitivity testing were conducted on suspected con-taminated environments and items.Targeted prevention and control measures were taken to control the outbreak.RESULTS Within a short period,8 patients in this hospital developed CRAB hospital-acquired infection,among whom,the drug resistance profiles of CRAB isolated from the specimens of 7 patients in bed A4,A14,B18,B19,B20,B21 and B22 were consistent.Through environmental hygiene monitoring,CRAB isolated from patient clothing,isolation gowns and medical staff uniforms matched the drug resistance profiles of the seven patient iso-lates.After taking targeted measures,no new CRAB infection cases occurred in Oct.,and CRAB was no longer i-solated from the environment and medical fabrics.CONCLUSIONS The suspected outbreak of CRAB infection may be related to the inadequate management and contamination of medical fabrics.Therefore,in addition to strictly implementing the routine prevention and control measures for multidrug-resistant bacteria,it is also crucial to strengthen the standardized management of medical fabrics for the prevention and control of hospital-acquired in-fections and outbreaks.