Objective:To analyze the incidence and perinatal factors of death or severe intraventricular hemorrhage (sIVH) within the first week of life in preterm infants with gestational age <32 weeks.Methods:Based on the online data platform of Sina-northern Neonatal Network, a case-control study was conducted using clinical data from 8 903 preterm infants with gestational age <32 weeks admitted to 35 neonatal intensive care unit (NICU) between 2019 and 2023. Infants were classified by gestational age at birth into very preterm infants and extremely preterm infants. Infants who died or developed sIVH within the first week of life were defined as the case group, while those who survived and did not develop sIVH were defined as the control group. The general information of the infants, maternal perinatal factors, the 5 th minute Apgar score, incidence of hypothermia or early-onset sepsis, and the first arterial blood pH value were compared between the case and control groups of very preterm infants and extremely preterm infants. The χ2 test and Wilcoxon rank-sum test were used for intergroup comparisons. A multivariable logistic regression model was used to analyze the factors for death or sIVH within the first week of life in very preterm and extremely preterm infants. Results:Among the 8 903 preterm infants with gestational age <32 weeks, 4 993 (56.1%) were male, with a gestational age at birth of 30.0 (28.4, 31.0) weeks. A total of 865 cases (9.7%) were death or sIVH within the first week of life. The case group took up 5.8% (426/7 316) and 27.7% (439/1 587) of very preterm infants and extremely preterm infants, respectively. Compared to the control group, the case group of very preterm and extremely preterm infants both had higher incidences of low gestational age, low birth weight, small for gestational age, the 5 th minute Apgar score ≤7, early-onset sepsis, hypothermia at admission, and first arterial blood pH <7.20 (all P<0.001). The proportion of mother′s full course antenatal corticosteroids use were both lower in both case group (both P<0.001). Multivariate Logistic regression analysis revealed several risk factors for death or sIVH within the first week of life in very preterm and extremely preterm infants, including: low gestational age ( OR=0.70 and 0.74, 95% CI 0.60-0.82 and 0.66-0.83, both P<0.001), low birth weight ( OR=0.99 and 0.99, 95% CI 0.99-1.00 and 0.99-1.00, both P<0.05), early-onset sepsis ( OR=1.82 and 2.20, 95% CI 1.42-2.34 and 1.74-2.79, both P<0.001), the 5 th minute Apgar score ≤7 ( OR=1.41 and 2.69, 95% CI 1.10-1.81 and 2.17-3.34, both P<0.01), hypothermia at admission ( OR=1.55 and 1.38,95% CI 1.17-2.07 and 1.08-1.76,both P<0.05) and the first arterial blood pH <7.20 ( OR=2.20 and 2.57, 95% CI 1.70-2.84 and 2.05-3.21, both P<0.001). Multiple births were an independent risk factor only for extremely preterm infants ( OR=1.32, 95% CI 1.02-1.71, P<0.05). Prenatal administration of a full course of antenatal corticosteroids was identified as a protective factor in very preterm and extremely preterm infants ( OR=0.74 and 0.62, 95% CI 0.58-0.95 and 0.51-0.76, both P<0.05). Conclusions:The incidence of death or sIVH within the first week of life remains high in preterm infants with gestational age <32 weeks. The smaller gestational age and lower birth weight, early-onset sepsis, birth asphyxia, hypothermia at admission, and a first arterial blood pH <7.20 were independent risk factors for death or sIVH within the first week of life in preterm infants with gestational age <32 weeks. A full course of antenatal corticosteroids significantly reduced the risk of these adverse outcomes.

Objective To explore and establish a technical pathway for size-specific dose estimate (SSDE) in pediatric CT patients of different age groups based on structured dose files and DICOM files, and to provide an effective method for precise monitoring of medical radiation exposure in pediatric CT scans. Methods Structured radiation dose reports (SR files) for pediatric patients aged 15 and under, who underwent CT scans between January and December 2023, were exported from the hospital information system. Scanning parameters and dose information were extracted using specialized software, and SSDE was calculated based on the patient body size parameters. The data were grouped by age (0- < 1 year, 1- < 5 years, 5- < 10 years, and 10-15 years) for statistical analysis. Results From January to December 2023, a total of 2706 pediatric CT scans were performed at the hospital, including 385 (14.23%) head scans, 1990 (73.54%) chest scans, 143 (5.28%) abdominal scans, 112 (4.14%) limb scans, and 76 (2.81%) other scans. The typical volume CT dose index (CTDI_vol) for head CT in the age groups of 0- < 1 year, 1- < 5 years, 5- < 10 years, and 10-15 years were 36.21, 35.29, 37.27, and 41.18 mGy, respectively; the corresponding SSDE values were 41.27, 32.82, 30.56, and 28.41 mGy, respectively. For chest CT scans, the typical CTDI_vol for the age groups of 1- < 5 years, 5- < 10 years, and 10-15 years were 1.91, 2.11, and 2.51 mGy, respectively; the corresponding SSDE values were 2.36, 2.21, and 3.50 mGy, respectively. For abdominal CT scans, the typical CTDI_vol for the age groups of 1- < 5 years, 5- < 10 years, and 10-15 years were 3.94, 4.33, and 6.26 mGy, respectively; the corresponding SSDE values were 5.77, 7.10, and 9.79 mGy, respectively. Conclusion This study developed a technical pathway to estimate the medical radiation doses of pediatric CT patients of different ages based on structured dose files and DICOM files. The feasibility of this approach was validated using data collected over a one-year period.

Objective:To analyze the incidence and perinatal factors of death or severe intraventricular hemorrhage (sIVH) within the first week of life in preterm infants with gestational age <32 weeks.Methods:Based on the online data platform of Sina-northern Neonatal Network, a case-control study was conducted using clinical data from 8 903 preterm infants with gestational age <32 weeks admitted to 35 neonatal intensive care unit (NICU) between 2019 and 2023. Infants were classified by gestational age at birth into very preterm infants and extremely preterm infants. Infants who died or developed sIVH within the first week of life were defined as the case group, while those who survived and did not develop sIVH were defined as the control group. The general information of the infants, maternal perinatal factors, the 5 th minute Apgar score, incidence of hypothermia or early-onset sepsis, and the first arterial blood pH value were compared between the case and control groups of very preterm infants and extremely preterm infants. The χ2 test and Wilcoxon rank-sum test were used for intergroup comparisons. A multivariable logistic regression model was used to analyze the factors for death or sIVH within the first week of life in very preterm and extremely preterm infants. Results:Among the 8 903 preterm infants with gestational age <32 weeks, 4 993 (56.1%) were male, with a gestational age at birth of 30.0 (28.4, 31.0) weeks. A total of 865 cases (9.7%) were death or sIVH within the first week of life. The case group took up 5.8% (426/7 316) and 27.7% (439/1 587) of very preterm infants and extremely preterm infants, respectively. Compared to the control group, the case group of very preterm and extremely preterm infants both had higher incidences of low gestational age, low birth weight, small for gestational age, the 5 th minute Apgar score ≤7, early-onset sepsis, hypothermia at admission, and first arterial blood pH <7.20 (all P<0.001). The proportion of mother′s full course antenatal corticosteroids use were both lower in both case group (both P<0.001). Multivariate Logistic regression analysis revealed several risk factors for death or sIVH within the first week of life in very preterm and extremely preterm infants, including: low gestational age ( OR=0.70 and 0.74, 95% CI 0.60-0.82 and 0.66-0.83, both P<0.001), low birth weight ( OR=0.99 and 0.99, 95% CI 0.99-1.00 and 0.99-1.00, both P<0.05), early-onset sepsis ( OR=1.82 and 2.20, 95% CI 1.42-2.34 and 1.74-2.79, both P<0.001), the 5 th minute Apgar score ≤7 ( OR=1.41 and 2.69, 95% CI 1.10-1.81 and 2.17-3.34, both P<0.01), hypothermia at admission ( OR=1.55 and 1.38,95% CI 1.17-2.07 and 1.08-1.76,both P<0.05) and the first arterial blood pH <7.20 ( OR=2.20 and 2.57, 95% CI 1.70-2.84 and 2.05-3.21, both P<0.001). Multiple births were an independent risk factor only for extremely preterm infants ( OR=1.32, 95% CI 1.02-1.71, P<0.05). Prenatal administration of a full course of antenatal corticosteroids was identified as a protective factor in very preterm and extremely preterm infants ( OR=0.74 and 0.62, 95% CI 0.58-0.95 and 0.51-0.76, both P<0.05). Conclusions:The incidence of death or sIVH within the first week of life remains high in preterm infants with gestational age <32 weeks. The smaller gestational age and lower birth weight, early-onset sepsis, birth asphyxia, hypothermia at admission, and a first arterial blood pH <7.20 were independent risk factors for death or sIVH within the first week of life in preterm infants with gestational age <32 weeks. A full course of antenatal corticosteroids significantly reduced the risk of these adverse outcomes.

Objective:Surface electromyography was used to observe the activation and co-contraction strategies of mus-cles surrounding the knee in female patients with knee osteoarthritis(KOA)during sitting,standing and step-ping.Method:Female KOA patients admitted to the Affiliated Hospital of Southwest Medical University from March 2023 to January 2024 were recruited.Surface electromyography was used to collect the integral EMG and root mean square values of the vastus medialis,biceps femoris,lateralis femoris,semitendinosus and rec-tus femoris of the affected side of KOA patients during the process of standing to sitting,sitting to standing,ascending and descending steps.The activation of peri-knee muscles and the change of co-contraction strategy were observed in the control group without KOA.Result:Thirty-five KOA patients and 20 control patients were recruited.From sitting to standing,the root mean square(RMS)and integrated electromyography(iEMG)activation of biceps femoris and semitendinosus in KOA group were significantly lower than those in control group(|Z|>3.097,P<0.005),and the co-contraction of hamstring/quadriceps muscle decreased(|Z|=4.164,P<0.001).From standing to sitting,KOA patients had signifi-cantly higher quadriceps and hamstring muscle activation(|Z|>3.009,P<0.005)and decreased medial/lateral co-contraction(|Z|=2.310,P<0.001).During the stair ascent initiation phase,the iEMG levels of lateral femoris,bi-ceps femoris and semitendinosus in KOA group were higher than those in control group(|Z|>2.899,P<0.005).In the following stage,iEMG levels of lateral femoris muscle and rectus femoris muscle were higher than those of control group(|Z|>2.110,P<0.005).During the stair descent initiation phase,the iEMG levels of later-al femoris,biceps femoris and semitendinosus in KOA group were higher than those in control group(|Z|>2.092,P<0.005).In the following stage,iEMG levels of lateral femoris muscle and rectus femoris muscle were higher than those of control group(|Z|>2.606,P<0.005).During stair ascent and descent activities,there was no significant difference in the co-contraction of hamstring and quadriceps,medial and lateral muscles(P>0.05).Conclusion:Middle-aged and elderly women with KOA showed changes in muscle activation intensity and common contraction strategies during functional activities,which varied according to the type of task(sit-stand,stand-sit,stairs activity).

Objective:Surface electromyography was used to observe the activation and co-contraction strategies of mus-cles surrounding the knee in female patients with knee osteoarthritis(KOA)during sitting,standing and step-ping.Method:Female KOA patients admitted to the Affiliated Hospital of Southwest Medical University from March 2023 to January 2024 were recruited.Surface electromyography was used to collect the integral EMG and root mean square values of the vastus medialis,biceps femoris,lateralis femoris,semitendinosus and rec-tus femoris of the affected side of KOA patients during the process of standing to sitting,sitting to standing,ascending and descending steps.The activation of peri-knee muscles and the change of co-contraction strategy were observed in the control group without KOA.Result:Thirty-five KOA patients and 20 control patients were recruited.From sitting to standing,the root mean square(RMS)and integrated electromyography(iEMG)activation of biceps femoris and semitendinosus in KOA group were significantly lower than those in control group(|Z|>3.097,P<0.005),and the co-contraction of hamstring/quadriceps muscle decreased(|Z|=4.164,P<0.001).From standing to sitting,KOA patients had signifi-cantly higher quadriceps and hamstring muscle activation(|Z|>3.009,P<0.005)and decreased medial/lateral co-contraction(|Z|=2.310,P<0.001).During the stair ascent initiation phase,the iEMG levels of lateral femoris,bi-ceps femoris and semitendinosus in KOA group were higher than those in control group(|Z|>2.899,P<0.005).In the following stage,iEMG levels of lateral femoris muscle and rectus femoris muscle were higher than those of control group(|Z|>2.110,P<0.005).During the stair descent initiation phase,the iEMG levels of later-al femoris,biceps femoris and semitendinosus in KOA group were higher than those in control group(|Z|>2.092,P<0.005).In the following stage,iEMG levels of lateral femoris muscle and rectus femoris muscle were higher than those of control group(|Z|>2.606,P<0.005).During stair ascent and descent activities,there was no significant difference in the co-contraction of hamstring and quadriceps,medial and lateral muscles(P>0.05).Conclusion:Middle-aged and elderly women with KOA showed changes in muscle activation intensity and common contraction strategies during functional activities,which varied according to the type of task(sit-stand,stand-sit,stairs activity).

Objective:To investigate the association between congenital hypothyroidism (CH) and the adverse outcomes during hospitalization in very low birth weight infants (VLBWI).Methods:This prospective, multicenter observational cohort study was conducted based on the data from the Sino-northern Neonatal Network (SNN). Data of 5 818 VLBWI with birth weight <1 500 g and gestational age between 24-<37 weeks that were admitted to the 37 neonatal intensive care units from January 1 st, 2019 to December 31 st, 2022 were collected and analyzed. Thyroid function was first screened at 7 to 10 days after birth, followed by weekly tests within the first 4 weeks, and retested at 36 weeks of corrected gestational age or before discharge. The VLBWI were assigned to the CH group or non-CH group. Chi-square test, Fisher exact probability method, Wilcoxon rank sum test, univariate and multivariate Logistic regression were used to analyze the relationship between CH and poor prognosis during hospitalization in VLBWI. Results:A total of 5 818 eligible VLBWI were enrolled, with 2 982 (51.3%) males and the gestational age of 30 (29, 31) weeks. The incidence of CH was 5.5% (319 VLBWI). Among the CH group, only 121 VLBWI (37.9%) were diagnosed at the first screening. Univariate Logistic regression analysis showed that CH was associated with increased incidence of extrauterine growth retardation (EUGR) ( OR=1.31(1.04-1.64), P<0.05) and retinopathy of prematurity (ROP) of stage Ⅲ and above ( OR=1.74(1.11-2.75), P<0.05). However, multivariate Logistic regression analysis showed no significant correlation between CH and EUGR, moderate to severe bronchopulmonary dysplasia, grade Ⅲ to Ⅳ intraventricular hemorrhage, neonatal necrotizing enterocolitis in stage Ⅱ or above, and ROP in stage Ⅲ or above ( OR=1.04 (0.81-1.33), 0.79 (0.54-1.15), 1.15 (0.58-2.26), 1.43 (0.81-2.53), 1.12 (0.70-1.80), all P>0.05). Conclusion:There is no significant correlation between CH and in-hospital adverse outcomes, possibly due to timely diagnosis and active replacement therapy.

Objective To explore the application effect of"personalized"video propaganda and educa-tion combined with AI technology in hyperbaric oxygen therapy of the patients.Methods A total of 208 new-ly admitted patients with hyperbaric oxygen therapy in this hospital from June to September 2023 were select-ed as the control group,and 215 newly admitted patients from October 2023 to January 2024 were selected as the experimental group.The control group adopted the oral propaganda and education combined with paper propaganda and education to explain the principle and function of hyperbaric oxygen,informed that electronic products and flammable and explosive materials should not be brought into the cabin,and reminded the items needing to be prepared during treatment and the precautions in the treatment process.On the basis of the con-trol group,the experimental group combined with AI to make the"personalized"propaganda and education video and the patient's signature confirmation method,and the plan-do-check-action(PDCA)cycle mode was used to continuously improve the quality of hyperbaric oxygen health propaganda and education.The correct answer situation of relevant knowledge,carrying prohibited items into the cabin,the implementation of pre-cautions,satisfaction and anxiety self-rating scale(SAS)scores were compared between the two groups Re-sults The experimental group had better answers to hyperbaric oxygen related knowledge than the control group,and the difference was statistically significant(P＜0.05).Before entering the cabin,the proportion of carrying the prohibited items in the control group was 6.3％(13/208),which was higher than 0.9％(2/215)in the experimental group,and the difference was statistically significant(P＜0.05).During the whole process of hyperbaric oxygen therapy,the complete implementation rate of precautions in the experimental group was better than that in the control group(68.8％vs.44.2％),and the difference was statistically significant(P＜0.05).The satisfaction rate of the experimental group was 93.4％,which was higher than 46.6％of the con-trol group,and the difference was statistically significant(P＜0.05).The mild and moderate anxiety scores of the experimental group were lower than those of the control group,and the difference was statistically signifi-cant(P＜0.05).The severe anxiety score had no statistical difference between the two groups(P＞0.05).Conclusion The application of"personalized"video propaganda and education combined with AI technology has a good effect in the treatment of hyperbaric oxygen patients,which could reduce the patients'anxiety,in-crease the patients'confidence,and improve the patients'knowledge awareness rate,treatment compliance and satisfaction on nursing work.

Objective To analyze the influencing factors and principal components of care needs outside hospital for acute leukemia patients with chemotherapy.Methods A total of 240 acute leu-kemia patients with chemotherapy in authors'hospital from January 2021 to December 2022 were se-lected as research objects,and the patients were divided into no demand group and unsatisfied group according to score of the Supportive Care Needs Questionnaire.The survey questionnaire was used to collect the related materials of patients;the influencing factors were analyzed by Logistic regression coefficient;the principal component analysis(PCA)was used to extract the principal components of influencing factors.Results A total of 240 patients completed the Supportive Care Needs Questionnaire assessment,of which 132 cases(55.00％)had a need for health information,121 cases(50.42％)had a need for care and support,101 cases(42.08％)had a need for psychology,86 cases(35.83％)had a need for physiology and daily life,and 31 cases(12.92％)had a need for sexual support.There were significant differences in gender,age,educational level,average household income and payment method between the two groups(P＜0.05);there were significant differences in the course of dis-ease,patterns of activity and comorbidity of symptoms between the two groups(P＜0.05).Univari-ate Logistic regression analysis showed that gender,age,education level,payment method,average household income,course of disease,patterns of activity and comorbidity of symptoms were the influencing factors of care needs(P＜0.05).Principal component analysis extracted three principal components:payment method,syndrome merging status,anddisease course,with a cumulative con-tribution rate of 63.556％.Conclusion Acute leukemia patients have the highest proportion of health information needs and the lowest proportion of sexual support needs.Payment methods,comor-bidity of symptoms and the course of disease show significant impacts on the care needs of patients.

ObjectiveTo observe the lower limb muscle activation strategy of healthy middle-aged and old women during stair ascent and descent with surface electromyography. MethodsFrom August, 2021 to February, 2022, 20 healthy middle-aged and old women were measured the surface electromyography root mean square (RMS) and integrated electromyography (iEMG) of bilateral vastus lateral, rectus femoris, vastus medialis, biceps femoris and semitendinosus during stair ascent and descent, and co-contraction ratio was calculated. ResultsDuring stair ascent, the RMS of bilateral vastus lateral, rectus femoris and vastus medialis was higher at starting stage than at following stage (|t| > 6.650, P < 0.001), while the RMS of biceps femoris and semitendinosus was lower (t > 3.559, P < 0.01); and the co-contraction ratio of hamstrings/quadriceps was lower at starting stage than at following stage (t > 8.185, P < 0.001). During stair descent, the RMS of bilateral vastus lateral, vastus medialis, biceps femoris and semitendinosus was higher at following stage than at starting stage (t > 2.345, P < 0.05), as well as the co-contraction ratio of hamstrings/quadriceps (t > 2.405, P < 0.05). ConclusionThe activities of the muscles around the knees are almost symmetrical during stair ascent and descent for healthy middle-aged and old women. The activation and co-contraction ratio of quadriceps and hamstring are various at starting/following stages.

Objective To understand the relationship between air pollutants and digestive system cancers, and to provide a reference for future research and prevention and control of digestive system cancer. Methods All relevant literature published in English between 1970-2022 was searched through the databases of PubMed, web of science and Embase, and meta-analysis was used to explore the effects of specific air pollutants on digestive system cancers. Results PM_2.5 was able to increase the risk of incidence or mortality of total digestive cancers by 11% (1.05 to 1.17). For specific cancers, PM_2.5 was only associated with an increased risk of liver cancer in this study, with a combined RR (95% CI) of 1.31 (1.19 to 1.46), while there was no statistically significant association with other specific digestive cancers ( P>0.05）. NO2 increased the risk of incidence or mortality of total digestive cancers by 3% (1.00 to 1.07). Conclusion For specific digestive system cancers, PM_2.5 has the most pronounced effect on liver cancer. More evidence is needed to support the relationship between NO₂ and cancer. Currently, it has been observed that NO2 has a negative effect on overall digestive cancers. This study provides insights for the prevention and control of digestive system cancer in countries and regions with high PM_2.5 and NO₂ concentrations.