Objective:To analyze the application effect of hyperbaric oxygen chamber management system based on five-dimensional quality management model included safety,reliability,effectiveness,availability and economy of equipment in management for the equipment of hyperbaric oxygen chamber management. Methods:The hyperbaric oxygen chamber management system was built on the basis of five-dimensional quality management model,and an assessment indicator system was constructed to perform quality control evaluation with five-dimensional maturities included preparation mode,thinking mode,communication mode,action mode and review mode. Then,a whole process management was conducted for the equipment of hyperbaric oxygen chamber. A hyperbaric oxygen chamber that was used during 2022 and 2023 in The 940th Hospital of People's Liberation Army Joint Service Support Force was selected,and the conventional management was used to manage the equipment during January and October 2022,and the hyperbaric oxygen chamber management system based on five-dimensional quality management model (model management) was used to manage the equipment during January and October 2023. A total of 400 operation logs of hyperbaric oxygen chamber equipment were selected,which included 200 logs of each mode,and the timeliness score,the satisfaction score of relevant personnel and the effect of equipment management between the two models were compared. Results:The timeliness scores of matching ratio of equipment,reasonable configuration of equipment,standard arrangement of equipment and equipment maintenance of model management were respectively (9.26±1.21) points,(9.12±0.98) points,(9.26±1.36) points and (9.36±2.03) points for hyperbaric oxygen chamber,which were higher than those of conventional management,and the differences were statistically significant (t=16.107,15.481,18.671,6.971,P<0.05). The satisfaction scores of operators,operation and maintenance personnel and engineers of equipment of model management were respectively (93.62±4.63) points,(92.69±4.33) points and (95.33±4.36) points,which were higher than those of conventional management method,and the differences of them between two methods were statistically significant (t=17.711,10.082,10.197,P<0.05). In the 200 logs of adopting model management,the ratio of complete files and good operation of equipment were respectively 95.0％ and 94.0％,which were higher than those of conventional management method. While the ratio of operation without standard and abnormal operation of equipment were respectively 1.0％ and 1.5％,which were lower than those of conventional management methods,and the differences of them were statistically significant (x2=14.709,12.754,11.402,11.308,P<0.05). Conclusion:The application of the hyperbaric oxygen chamber management system based on the five-dimensional quality management model in the management of hyperbaric oxygen chamber equipment can maximum improve the operating efficiency of hyperbaric oxygen chamber equipment,and effectively increase the quality and effect of equipment management,and enhance the operation satisfaction of relevant personnel.

Objective:To explore the impact of adverse childhood experiences on psychosomatic symptoms and job burnout in the nursing population.Methods:Utilizing a multistage stratified cluster random sampling meth-od,1 661 nurses were selected.Through a 1∶2 propensity score matching approach,demographic and work-related characteristics were balanced between the positive and negative groups of adverse childhood experiences.Finally,880 cases were successfully matched(positive group:300 cases,negative group:580 cases).Linear regression was employed to explore the relationship between nurses'adverse childhood experiences and psychosomatic symptoms(anxiety,depression,physical symptoms),as well as job burnout.The average treatment effect among the treated(ATT)was calculated.Results:Linear regression results revealed a significant positive association between adverse childhood experiences and scores for anxiety symptoms,depression symptoms,physical symptoms,and job burnout(B=1.68,2.67,2.89,5.90;ATT=1.64,2.58,2.82,5.96,Ps＜0.001).However,there was no statistically signif-icant association with scores for a sense of inadequacy in individual achievements(P＞0.05).Conclusion:Nurses who have experienced childhood adverse experiences may exhibit more severe psychosomatic symptoms and job burnout compared to those who have not experienced such adversities during childhood.

Objective To investigate the cognition of both doctors and patients in the neurology department of a tertiary hospital in Linyi City regarding graded diagnosis and treatment,and to explore its influencing factors.Methods Convenient sampling was used to select 456 survey subjects from 20 medical institutions within the medical consortium of a tertiary hospital in Linyi City,including 191 medical staffs and 265 patients;A total of 35 medical staffs and patients were interviewed.Results The overall awareness of graded diagnosis and treatment among medical staff and patients was(3.731±0.563)points and(3.136±0.367)points,respectively.The influencing factors of medical staff on grading diagnosis and treatment are professional title,years of work experience,and hospital grade.The influencing factors of patient on grading diagnosis and treatment are age,type of medical insurance,average monthly income,and whether they had a transfer experience.Conclusion While strengthe-ning information technology construction,government supervision and investment,and enhancing the capacity building of grassro-ots medical institutions,it is also necessary to actively promote the construction of close medical consortia to accelerate the forma-tion of a standardized and orderly new system for medical treatment and diagnosis.

Objective To investigate the cognition of both doctors and patients in the neurology department of a tertiary hospital in Linyi City regarding graded diagnosis and treatment,and to explore its influencing factors.Methods Convenient sampling was used to select 456 survey subjects from 20 medical institutions within the medical consortium of a tertiary hospital in Linyi City,including 191 medical staffs and 265 patients;A total of 35 medical staffs and patients were interviewed.Results The overall awareness of graded diagnosis and treatment among medical staff and patients was(3.731±0.563)points and(3.136±0.367)points,respectively.The influencing factors of medical staff on grading diagnosis and treatment are professional title,years of work experience,and hospital grade.The influencing factors of patient on grading diagnosis and treatment are age,type of medical insurance,average monthly income,and whether they had a transfer experience.Conclusion While strengthe-ning information technology construction,government supervision and investment,and enhancing the capacity building of grassro-ots medical institutions,it is also necessary to actively promote the construction of close medical consortia to accelerate the forma-tion of a standardized and orderly new system for medical treatment and diagnosis.

Objective:To analyze the application effect of hyperbaric oxygen chamber management system based on five-dimensional quality management model included safety,reliability,effectiveness,availability and economy of equipment in management for the equipment of hyperbaric oxygen chamber management. Methods:The hyperbaric oxygen chamber management system was built on the basis of five-dimensional quality management model,and an assessment indicator system was constructed to perform quality control evaluation with five-dimensional maturities included preparation mode,thinking mode,communication mode,action mode and review mode. Then,a whole process management was conducted for the equipment of hyperbaric oxygen chamber. A hyperbaric oxygen chamber that was used during 2022 and 2023 in The 940th Hospital of People's Liberation Army Joint Service Support Force was selected,and the conventional management was used to manage the equipment during January and October 2022,and the hyperbaric oxygen chamber management system based on five-dimensional quality management model (model management) was used to manage the equipment during January and October 2023. A total of 400 operation logs of hyperbaric oxygen chamber equipment were selected,which included 200 logs of each mode,and the timeliness score,the satisfaction score of relevant personnel and the effect of equipment management between the two models were compared. Results:The timeliness scores of matching ratio of equipment,reasonable configuration of equipment,standard arrangement of equipment and equipment maintenance of model management were respectively (9.26±1.21) points,(9.12±0.98) points,(9.26±1.36) points and (9.36±2.03) points for hyperbaric oxygen chamber,which were higher than those of conventional management,and the differences were statistically significant (t=16.107,15.481,18.671,6.971,P<0.05). The satisfaction scores of operators,operation and maintenance personnel and engineers of equipment of model management were respectively (93.62±4.63) points,(92.69±4.33) points and (95.33±4.36) points,which were higher than those of conventional management method,and the differences of them between two methods were statistically significant (t=17.711,10.082,10.197,P<0.05). In the 200 logs of adopting model management,the ratio of complete files and good operation of equipment were respectively 95.0％ and 94.0％,which were higher than those of conventional management method. While the ratio of operation without standard and abnormal operation of equipment were respectively 1.0％ and 1.5％,which were lower than those of conventional management methods,and the differences of them were statistically significant (x2=14.709,12.754,11.402,11.308,P<0.05). Conclusion:The application of the hyperbaric oxygen chamber management system based on the five-dimensional quality management model in the management of hyperbaric oxygen chamber equipment can maximum improve the operating efficiency of hyperbaric oxygen chamber equipment,and effectively increase the quality and effect of equipment management,and enhance the operation satisfaction of relevant personnel.

The nervous system, as the core hub of physiological regulation in the human body, plays a key role in the tumor microenvironment through the neuro-immune-tumor axis. Studies have shown that tumor-infiltrating nerve fibers regulate immune cell functions by releasing neurotransmitters, while immune cells can feedback and modulate neuronal activity, forming a dynamic bidirectional interaction network. The emerging field of cancer neuroimmunology focuses on the complex dialogue mechanisms between the nervous and immune systems in the tumor microenvironment. In-depth analysis of the neuro-immune interaction network not only provides new perspectives for understanding tumor immune escape, but also lays the theoretical foundation for developing novel combination therapies targeting the neuro-immune axis, potentially providing breakthrough strategies to overcome resistance to current immunotherapies.

Objective·To investigate the expression level of O-GlcNAc transferase(OGT)in non-small cell lung cancer(NSCLC)and its impact on lung cancer proliferation,as well as to explore the underlying mechanisms.Methods·The expression of OGT in NSCLC tumors and adjacent normal tissues was detected by immunohistochemistry(IHC).The dataset(GSE31210)from the GEO database was analyzed to assess the correlation between OGT expression and NSCLC patient prognosis.siRNA transfection was performed to knock down OGT expression in H460 and H1299 cells,followed by total RNA extraction and transcriptome sequencing.Pathway enrichment analysis was conducted on differentially downregulated genes in the knockdown group compared with the control group,and Western blotting was used to validate the enrichment results.The effects of OGT knockdown on cell proliferation and colony formation in H460 and H1299 cells were evaluated using the cell counting kit-8(CCK-8)assay and colony formation assay,respectively.The impact of overexpressing downstream genes was also examined.Stable OGT-knockdown cell lines were generated using shRNA and subcutaneously inoculated into nude mice to monitor tumor growth.Results·IHC revealed that OGT expression was significantly upregulated in NSCLC tumor tissues compared to adjacent normal tissues.Patients with high OGT expression exhibited shorter survival times and poorer prognoses than those with low expression.Transcriptome sequencing demonstrated that genes downregulated after OGT knockdown were primarily enriched in the mitogen-activated protein kinase(MAPK)signaling pathway.Western blotting showed that total extracellular regulated protein kinase 1/2(ERK1/2)levels remained unchanged in H460 and H1299 cells after OGT knockdown,while phosphorylated ERK1/2(p-ERK1/2)and its downstream proto-oncogene JUNB protein were markedly reduced.Suppression of OGT expression attenuated the proliferation rate and colony formation capacity of H460 and H1299 cells,whereas JUNB overexpression rescued the proliferation defects induced by OGT knockdown.Notably,H460 cells with stable OGT knockdown formed significantly smaller tumors in nude mice.Conclusion·OGT is highly expressed in NSCLC and correlates with poor prognosis.Knockdown of OGT inhibits NSCLC cell proliferation and clonogenicity in vitro,and tumor growth in vivo.Mechanistically,OGT appears to promote NSCLC progression by activating the ERK/JUNB signaling axis.

Objective To analyze changes in intestinal microbiota composition and metabolites in mice with nitrous oxide poisoning using 16S rDNA sequencing and metabolomics,and to examine correlations between gut microbes and metabolites in order to explore the mechanisms of nitrous oxide poisoning.Methods C57BL/6 mice were randomly divided into a control group and a nitrous oxide poisoning group(n=6).The poisoning group was exposed to 90,000 ppm nitrous oxide twice daily for 1 h over 28 days,while the control group was exposed to air.Fecal samples were collected 24 h after the last exposure.16S rDNA sequencing was used to analyze structural differences in microbial communities and identify significantly different taxa.Metabolomics analysis was performed to detect changes in fecal metabolites and identify differential metabolites.Correlation analysis was conducted between differential microbiota and metabolites.Results 16S rDNA sequencing showed that the poisoning group had increased microbial abundance compared with controls,while species diversity remained unchanged.Significant differences were observed in gut microbiota structure between groups.Metabolomics identified 112 differential metabolites related to nitrous oxide poisoning,mainly involving the cAMP signaling pathway and sphingolipid metabolism.Spearman correlation analysis revealed a strong association between differential microbiota and differential metabolites.Conclusion Nitrous oxide poisoning alters the structure and metabolic profiles of intestinal microbiota.Changes in microbial abundance affect multiple metabolic pathways,which may be related to damage to the nervous and hematological systems.These findings provide a basis for further research on the mechanisms of nitrous oxide poisoning and for clinical treatment.

Objective To analyze the risk factors of neurogenic bladder dysfunction(NB)in patients with spinal cord injury,and establish a risk prediction model of NB in patients with spinal cord injury by decision tree algorithm.Method Clinical data of 176 patients with spinal cord injury admitted from April 2022 to July 2024 were retrospectively analyzed.Patients with spinal cord injury were divided into disorder group and non-disorder group according to whether they were complicated by NB.Multivariate Logistic regression analysis was used to screen the risk factors of NB.Modeler software was used to construct the decision tree model of spinal cord injury patients with concurrent NB,and the 5-fold cross-validation method was used to internally verify the model,and the prediction efficiency of the model was compared.Results Among 176 patients with spinal cord injury,42 patients had concurrent NB,the incidence of NB was 23.86%.Logistic regression analysis showed that the level of spinal cord injury(T10—L2),degree of spinal cord injury(complete injury),course of disease(≥6 months),bladder compliance(abnormal),urinary system infection(yes)and detrusor sphincter disorder(yes)were all independent risk factors for NB in patients with spinal cord injury(P<0.05).Probability forecasting model P=1/[1+e-(-6.008+0.791*X1+3.117*X2+1.492*X3+1.270*X4+1.516*X5+2.158*X6)],models to predict the overall accuracy is 80.5%;The prediction accuracy of the model is 71.7%through the cross-verification of 5 fold.Decision tree model showed that the degree of spinal cord injury had the greatest effect on the complication of NB in patients with spinal cord injury,and the information gain was 0.46.ROC results showed that the AUC values of NB predicted by the two models were close(0.873 vs.0.852,Z=0.875,P=0.469).Conclusion The level of spinal cord injury,degree of spinal cord injury,course of disease,bladder compliance,urinary system infection,detrusor sphincter disorder can all predict the risk of NB.The decision tree model constructed in this study can effectively predict the risk probability of NB in patients with spinal cord injury,and medical staff can make targeted plans according to the above factors to reduce the risk of NB.

Objective·To investigate the expression of protein tyrosine phosphatase receptor type N(PTPRN)in lung adenocarcinoma and its potential molecular mechanisms in promoting lung adenocarcinoma metastasis.Methods·A highly bone-metastatic A549-BM cell line was established through multiple rounds of intracardiac injection.RNA sequencing(RNA-seq),combined with Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analyses,was performed to identify PTPRN as a key metastasis-related gene.Subsequently,The Cancer Genome Atlas(TCGA)database was utilized to evaluate PTPRN expression in patients with lung adenocarcinoma and its correlation with clinical prognosis.Co-expression analysis based on TCGA data was conducted to identify and analyze key genes co-expressed with PTPRN.Small interfering RNA(siRNA)targeting PTPRN(siPTPRN)was transfected into A549-BM cells,and Transwell assays were performed to assess its effects on cell migration and invasion.Western blotting was used to detect the expression of epithelial-mesenchymal transition(EMT)-related proteins and the activation of the PI3K-AKT signaling pathway.siPTPRN-transfected A549-BM cells were injected into a mouse model via intracardiac injection,and in vivo metastasis was assessed.Additionally,multiple database analyses were integrated to predict BCL6 as an upstream transcription factor of PTPRN,and siBCL6 transfection experiments were performed to validate the regulatory effect of BCL6 on PTPRN expression.Results·RNA-seq and GO/KEGG enrichment analyses demonstrated that PTPRN was significantly upregulated in highly metastatic A549-BM cells and enriched in metastasis-associated pathways,including the PI3K-AKT signaling pathway and extracellular matrix(ECM)-receptor interactions.Analysis of the TCGA database further confirmed that PTPRN was highly expressed in lung adenocarcinoma patients and significantly associated with poor prognosis.Co-expression analysis based on TCGA data,combined with GO/KEGG enrichment analyses,revealed that PTPRN-associated genes were mainly enriched in biological processes such as neural signaling,endocrine regulation,cell communication,and ECM-receptor interactions.In vitro experiments demonstrated that siPTPRN transfection significantly inhibited the migration and invasion of A549-BM cells,accompanied by downregulation of EMT-related proteins and reduced activation of the PI3K-AKT signaling pathway.In vivo experiments further showed that PTPRN knockdown markedly suppressed the metastatic potential of A549-BM cells,confirming its pro-metastatic role.Additionally,siBCL6 transfection experiments demonstrated that BCL6 knockdown upregulated PTPRN expression.Conclusion·PTPRN is highly expressed in lung adenocarcinoma tissues and promotes tumor cell migration and metastasis by enhancing EMT and activating the PI3K-AKT signaling pathway.High PTPRN expression is significantly correlated with poor prognosis in lung adenocarcinoma patients,while PTPRN enhances lung adenocarcinoma cell invasiveness and metastatic potential.BCL6 may act as an upstream transcriptional regulator of PTPRN,influencing its expression levels.