Objective: To quantitatively assess the health risk of preservatives from beverages around primary schools in Anshun City, and to provide scientific basis for precise food safety supervision. Methods: From December 2023 to July 2024, 602 beverage samples were randomly collected from within 100 meters of 19 primary schools in Anshun City. The content of benzoic acid, sorbic acid, and dehydroacetic acid was detected according to GB 5009 series standards. Combined with children s physiological parameters (body weight 30 kg, daily intake 0.15 L), the Hazard Quotient (HQ) and Hazard Index (HI) models were used to evaluate health risks. Results: The total detection rate of preservatives from beverages around primary schools was 63.0%, and the total over limit rate was 9.0%. The detection rate of preservatives in flavored beverages was the highest (72.6%), and the highest over limit rate of preservatives in special purpose beverages was the highest (17.2%). The single preservative HQ (benzoic acid up to 0.47 ) and mixed HI (up to 0.55) of all samples were below 1(safety threshold). However, the HQ value of benzoic acid in flavored beverages (0.47) was 2.9 times that of sorbic acid (0.16), contributing significantly to health risk. Sensitivity analysis showed that if the daily consumption increased to 0.3 L, the HI value of flavored beverages would rise to 1.11, exceeding the safety threshold. Enterprise scale analysis showed that the exceedance rate of special purpose beverages in large enterprises reached 30.0%, while micro enterprises, accounting for a dominant market share (52.2%), constituted the main source of children s daily exposure to their products. Conclusions The overall health risk of perservatives in beverages sold near primary schools in Anshun City is controllable, but there is a noticeable risk of gradient. The risk of children’s exposure to preservatives through beverage consumption should not be ignored.

Objective:To investigate the application effect of quadratus lumborum block (QLB) combined with less opioid anesthesia analgesia in laparoscopic total hysterectomy (LTH) in elderly patients with uterine prolapse.Methods:A total of 86 elderly patients with uterine prolapse who received LTH in the Langfang People’s Hospital from Jan. 2021 to Oct. 2023 were prospectively selected and divided into group A ( n=42) and group B ( n=44) according to the random number table method. Group A received transversus abdominis block (TAPB) + general anesthesia, and group B received QLB combined with less opioid anesthesia + general anesthesia. The pain duration at different time points after operation [Numeric Rating Scale (NRS) method to evaluate resting incision and visceral pain] was compared between the two groups. The dosage of opioids and the additional analgesia rate were compared between the two groups. The sleep quality of the two groups before and 72 hours after operation was compared, and the adverse reactions of anesthesia were counted. Results:Compared with 6 h after operation, NRS scores of resting incision pain and visceral pain in the two groups decreased gradually at 12, 24 and 48 h after operation, and it was lower in group B than in group A. There were statistically significant differences between groups ( P<0.05) . Dosage of sufentanil and remifentanil in group B was lower than that in group A, and the postoperative additional analgesia rate in group B (9.09%) was lower than that in group A (28.57%) ( P<0.05) . 72 hours after surgery, the sleep efficiency and total sleep time of patients in both groups were lower than those before surgery, and they were higher in group B than in group A; The awakening time and number of awakenings in both groups were higher than those before surgery, while they were lower in group B than in group A ( P<0.05) . The total incidence of adverse reactions in group B was 4.76% (2/44) , lower than 23.81% (10/42) of group A ( P<0.05) . Conclusion:QLB combined with less opioid anesthesia analgesia can effectively reduce the degree of incision and visceral pain after LTH in elderly patients with uterine prolapse, reduce the amount of opioids used during operation and the rate of additional analgesia, and reduce the incidence of adverse reactions of anesthesia.

Objective To observe the analgesic and rehabilitation effects of non μ-opioids anesthesia/analgesia(NΜOA)based on quadratus lumborum block(QLB)in emergency cesarean section under general anesthesia.Methods The retrospective study method was adopted,50 pregnant women undergoing hysterectomy under emergency general anesthesia in Langfang People's Hospital from January 2023 to December 2024 were selected as the study objects.The patients were divided into μ-opioids anesthesia/analgesia(ΜOA)group and NΜOA group according to different anesthesia/analgesia methods,25 cases in each group.ΜOA group received ΜOA;NΜOA group received NΜOA+QLB.Incisional pain and uterine contraction pain numerical rating scale(NRS)at out of the post-anesthesia care unit(T1),intravenous injection of oxytocin(T2),press the palace bottom 24 hours(T3),out of bed activity after operation(T4)and first analgesic time of incision pain,first analgesic time of uterine contraction pain,first no vomiting eating time,first exhaust time was observed and recorded.The incidence of vasoactive agents during the anesthetic period,rescue analgesia,rescue antiemetic,constipation,sleep disturbance after operation within 48 hours after operation were also recorded.Results The NRS scores at T1,T2,T3 and T4 in ΜOA group were significantly higher than those in NΜOA group(incisional pain 3.36±1.25 vs.1.12±0.97,3.68±1.18 vs.2.00±0.91,5.76±1.67 vs.4.20±1.00,4.48±1.29 vs.3.32±0.95;uterine contraction pain 3.72±1.49 vs.1.24±1.05,4.64±1.60 vs.3.04±1.27,7.56±1.71 vs.5.16±1.37,3.56±0.22 vs.2.56±0.16,all P<0.05).The first analgesic time of incision pain,first analgesic time of uterine contraction pain in ΜOA group were significantly less than that in NΜOA group(hours:3.06±2.02 vs.17.48±10.93,2.68±2.22 vs.15.80±11.39,both P<0.05),the first no vomiting eating time,first exhaust time in ΜOA group were significantly longer than those in NΜOA group(hours:8.56±0.57 vs.6.32±0.14,15.44±1.42 vs.10.16±1.14,both P<0.05),the incidence of vasoactive agents,rescue analgesia,rescue antiemetic,constipation,sleep disturbance after operation within 48 hours in ΜOA group were significantly higher than those in NΜOA group[64.0%(16/25)vs.32.0%(8/25),48.0%(12/25)vs.20.0%(5/25),44.0%(11/25)vs.16.0%(4/25),64.0%(16/25)vs.36.0%(9/25),60.0%(15/25)vs.32.0%(8/25),all P<0.05].Conclusion NΜOA based on QLB safely and effectively reduced side effects of μ-opioids and enhanced recovery compared to ΜOA on emergency cesarean section patients undergoing general anesthesia.

OBJECTIVE To investigate and analyze the protective effect of Huayu Jiedu Decoction(HYJD)on the inflammatory injury of cardiomyocytes induced by bacterial lipopolysaccharide(LPS),and its molecular mecha-nism of inhibitory effect on inflammatory response.METHODS H9c2 cells were cultured in vitro and divided into:the blank control group(Control group),the model control group(LPS group),the drug treatment group(HYJD group)and the combined treatment group(LPS+HYJD group).H9c2 cells were treated with different concentrations of HYJD(2.5,5,10,20 and 40 mg/ml)for 24 h,and the activity of H9c2 cells was detected by MTT assay.Additionally,H9c2 cells were treated with LPS-induced myocardial inflammatory injury cell model after 24 h of HYJD intervention at each concentration gradients to detect the cell proliferation changes,as well as to detect the levels of apoptosis of cardiomyocytes and the levels of interleukin(IL)-1β,IL-6,IL-8,IL-10 and tumor necrosis factor(TNF)-α in the culture supernatant of experimental groups,the changes in the protein ex-pression of NO production and the expression changes of iNOS and TLR4/NF-κB signaling pathway protein,and Real-time fluorescence quantitative PCR(qRT-PCR)was used to detect mRNA expression of IL-7R,P38(MAPK)and CXCR2.RESULTS Compared with the Control group,low-concentration HYJD had no significant effect on H9c2 cell viability and did not induce cytotoxic effect,and HYJD increased the survival rate of H9c2 cells in the LPS-induced myocardial inflammatory injury model,and effectively reversed the inhibitory effect of the pro-liferative activity of H9c2 cells induced by LPS.Compared with the control group,the difference in apoptosis level of H9c2 cells in the HYJD monotherapy group was not statistically significant,while the levels of inflammatory apoptosis of H9c2 cells induced by LPS was elevated(P＜0.05).Compared with the LPS group,HYJD inhibited the levels of inflammatory apoptosis in H9c2 cells induced by LPS(P＜0.05),reduced the production of pro-in-flammatory cytokines such as IL-1β,IL-6,IL-8 and TNF-α in the supernatant of the LPS-induced myocardial in-flammatory injury H9c2 cell culture,and upregulated the anti-inflammatory cytokine IL-10.Additionally,com-pared with the Control group,the LPS group showed an increased level of NO release(P＜0.05),while the difference in NO release in the low-concentration(5 mg/ml)HYJD was not statistically significant.Compared with the LPS group,the NO release levels in each HYJD intervention group showed a concentration-dependent de-crease(all P＜0.05).Furthermore,compared with the control group,whereas the expression levels of iNOS and TLR4/NF-κB signaling pathway proteins in the LPS-induced H9c2 cells were both elevated(P＜0.05).CONCLUSION HYJD exhibits protective effects against LPS-induced septic myocardial injury and can exert an in-hibitory effect on inflammatory response,and the molecular mechanisms may be related to the inhibition of the ac-tivation of the TLR4/NF-κB signaling pathway and the down-regulation of the expression of inflammatory genes,etc.,and it may have a good biological activity in the prevention and treatment of septic myocardial injury.

Metabolic-bariatric surgery(MBS)has become an important treatment for pathological obesity and metabolic diseases.However,common postoperative nutritional complications—such as protein-energy malnutrition,iron deficiency anemia,and vitamin B12 deficiency—significantly affect patients' long-term prognosis.Traditional nutritional management models rely on static monitoring and standardized supplementation,which are insufficient to address individual variability and dynamic postoperative changes.Artificial intelligence(AI),through integrating multimodal data(such as biochemical indicators,imaging information,and wearable device monitoring)and intelligent modeling,offers new approaches for dynamic monitoring,risk prediction,and personalized intervention.Based on literature from 2017 to 2025,this article systematically evaluates the application of AI in perioperative nutritional management for MBS,covering key technologies including machine learning,deep learning,and natural language processing.It also analyzes current challenges in clinical translation,such as data fragmentation,lack of model interpretability,and limited long-term validation.In the future,enhanced multi-center collaboration,the development of standardized databases,and explainable models will be essential to advancing nutritional management in MBS from empirical practice to precision medicine.

Objective To investigate the benefits and challenges of the reform in evidence-based obstetric nursing practice in clinical nursing,therefore to provide a reference for initiating and keeping the reform in evidence-based nursing practices.Methods A method of descriptive phenomenological research was conducted between January and February 2024 in our hospital on 10 selected clinical nurses by purposive sampling.An outline for interviews was developed based on literature review and expert interviews,followed by semi-structured interviews with the nurses.Core themes were extracted with Colaizzi's seven-step analysis.Results Three themes and 12 sub-themes were summarised in this study.The 3 core themes that were identified among the nurses included:acceptance of evidence-based nursing practice reform(with 3 domains regarding knowledge,decision-making and action),perception of the benefits of the reform in evidence-based nursing practice(with 5 domains regarding the professionalism and scientific nature of clinical nursing,improvement of patient experience and nursing outcomes,enhancement of nursing quality and safety,promotion of innovation in on-the-job training and education,and facilitation of collaboration within the nursing team),and perception in the challenges of reform in evidence-based nursing practice(with 4 domains regarding the stress and challenges,doubts and resistance,poor cooperation between doctors and nurses,and risks in clinical decision-making).Conclusion The acceptance regarding reform in evidence-based nursing practice varies among the nurses.It is necessary to promote the acceptance,provide the targeted guidance and intervene in the factors of benefits and challenges among the nurses,hence to facilitate a smooth implementation of the reform in evidence-based nursing practice.

Objective:To investigate the effect of pelvic floor reconstructive surgery on improving sexual func-tion in premenopausal women with pelvic organ prolapse(POP).Methods:Clinical data from 79 premenopausal patients who underwent pelvic floor reconstructive surgery for POP in Affiliated Hospital of Chengde Medical Uni-versity from January 2019 to June 2023 were collected.The patients'sexual function was assessed with the classic Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire(PISQ-12)preoperatively and 12 months post-operatively.The patients'quality of life was assessed with Pelvic Floor Distress Inventory-Short Form 20(PFDI-20).Compare the changes in quality of life and sexual function preoperatively and 12 months postopera-tively,and analyze the related factors of postoperative sexual function improvement.Results:The preoperative PFDI-20 was 53.13(29.17,75.00),while the postoperative PFDI-20 was 8.33(0,16.67),the difference is statisti-cally significant(P＜0.05).The preoperative PISQ-12 was 33.46±7.68,while the postoperative PISQ-12 was 37.20±4.81,the difference is statistically significant(P＜0.05).The postoperative scores in terms of emotional factors,physical factors,and partner factors have all increased(P＜0.05).Univariate analysis of postoperative im-provement of sexual function showed that there were significant difference in age,POP duration and uterine pres-ervation between the improved group and the non-improved group(P＜0.05),while there was no significant differ-ence in surgical methods(P＞0.05).Logistic regression multivariate analysis showed that the duration of pro-lapse＜2 years was an independent factor influencing the improvement of postoperative sexual function(OR 3.689,95％CI 1.355-10.047,P=0.011).Conclusions:The quality of life and sexual life of premenopausal POP patients can be significantly improved after pelvic floor surgery,and the pelvic floor reconstructive surgery with u-terine preservation within 2 years of symptom onset in young patients can improve postoperative sexual function.

Objective:To investigate the application effect of quadratus lumborum block (QLB) combined with less opioid anesthesia analgesia in laparoscopic total hysterectomy (LTH) in elderly patients with uterine prolapse.Methods:A total of 86 elderly patients with uterine prolapse who received LTH in the Langfang People’s Hospital from Jan. 2021 to Oct. 2023 were prospectively selected and divided into group A ( n=42) and group B ( n=44) according to the random number table method. Group A received transversus abdominis block (TAPB) + general anesthesia, and group B received QLB combined with less opioid anesthesia + general anesthesia. The pain duration at different time points after operation [Numeric Rating Scale (NRS) method to evaluate resting incision and visceral pain] was compared between the two groups. The dosage of opioids and the additional analgesia rate were compared between the two groups. The sleep quality of the two groups before and 72 hours after operation was compared, and the adverse reactions of anesthesia were counted. Results:Compared with 6 h after operation, NRS scores of resting incision pain and visceral pain in the two groups decreased gradually at 12, 24 and 48 h after operation, and it was lower in group B than in group A. There were statistically significant differences between groups ( P<0.05) . Dosage of sufentanil and remifentanil in group B was lower than that in group A, and the postoperative additional analgesia rate in group B (9.09%) was lower than that in group A (28.57%) ( P<0.05) . 72 hours after surgery, the sleep efficiency and total sleep time of patients in both groups were lower than those before surgery, and they were higher in group B than in group A; The awakening time and number of awakenings in both groups were higher than those before surgery, while they were lower in group B than in group A ( P<0.05) . The total incidence of adverse reactions in group B was 4.76% (2/44) , lower than 23.81% (10/42) of group A ( P<0.05) . Conclusion:QLB combined with less opioid anesthesia analgesia can effectively reduce the degree of incision and visceral pain after LTH in elderly patients with uterine prolapse, reduce the amount of opioids used during operation and the rate of additional analgesia, and reduce the incidence of adverse reactions of anesthesia.

Objective To investigate the benefits and challenges of the reform in evidence-based obstetric nursing practice in clinical nursing,therefore to provide a reference for initiating and keeping the reform in evidence-based nursing practices.Methods A method of descriptive phenomenological research was conducted between January and February 2024 in our hospital on 10 selected clinical nurses by purposive sampling.An outline for interviews was developed based on literature review and expert interviews,followed by semi-structured interviews with the nurses.Core themes were extracted with Colaizzi's seven-step analysis.Results Three themes and 12 sub-themes were summarised in this study.The 3 core themes that were identified among the nurses included:acceptance of evidence-based nursing practice reform(with 3 domains regarding knowledge,decision-making and action),perception of the benefits of the reform in evidence-based nursing practice(with 5 domains regarding the professionalism and scientific nature of clinical nursing,improvement of patient experience and nursing outcomes,enhancement of nursing quality and safety,promotion of innovation in on-the-job training and education,and facilitation of collaboration within the nursing team),and perception in the challenges of reform in evidence-based nursing practice(with 4 domains regarding the stress and challenges,doubts and resistance,poor cooperation between doctors and nurses,and risks in clinical decision-making).Conclusion The acceptance regarding reform in evidence-based nursing practice varies among the nurses.It is necessary to promote the acceptance,provide the targeted guidance and intervene in the factors of benefits and challenges among the nurses,hence to facilitate a smooth implementation of the reform in evidence-based nursing practice.

Objective:To investigate the methods and skills required for the safe and swift removal of primary or secondary sacral tumors located between the second (inclusive) and fourth sacral vertebrae.Methods:The clinical images, pathology reports, surgical procedures, operation durations, intraoperative bleeding volumes, and postoperative functional follow-up data of 26 patients undergoing sacral tumor resection at the First Affiliated Hospital of Zhengzhou University and Xinjiang Production and Construction Corps Hospital between May 2020 and February 2025 were retrospectively examined. Additionally, the safety measures for sacral tumor resection and techniques for expedited specimen removal were evaluated.Results:According to magnetic resonance imaging (MRI) findings, all 26 patients presented with sacral tumors located between the second (inclusive) and fourth sacral vertebrae. Specifically, 9 patients were diagnosed with primary sacral tumors, pathologically confirmed as chordomas, while 17 patients had secondary sacral tumors. Among the secondary tumor cases, 12 were attributed to recurrent rectal cancer invading the sacrum, and 5 were due to malignant teratomas invading the sacrum. The 26 patients underwent a treatment strategy that began with managing the relationship between the internal iliac artery, vein branches, and the tumor, followed by the resection of the sacrum. During surgery, the bilateral sciatic foramina were accurately positioned, and the presacral fascia was dissected subsequent to the fracture of the sacrum. Among the 26 patients, 9 underwent sacral tumor resection directly through the posterior sacral approach. The average operation time for these patients was (71.1±4.9) minutes, with average blood loss of (186.7±72.8) milliliters. On the other hand, 17 patients underwent sacral tumor resection by transitioning from the supine position to the prone knife position through a combined abdominal and sacral approach. The average operation time for this group was (213.5±19.3) minutes, with average blood loss of (480.0±93.0) milliliters, significantly longer than that of the posterior sacral approach. The follow-up period ranged from 1 to 48 months, with a median of 20 months, ending on March 31, 2025. During this time, 26 patients achieved autonomous defecation with the aid of medication. None of the patients reported any functional movement disorders or pain in their lower limbs. It was observed that two out of the 26 patients developed distant metastasis, while the remaining 24 patients survived without any tumors.Conclusion:By pretreated the relationship between the internal iliac vessels and sacral tumors prior to resecting sacral tumors, utilizing the approach of initially fracturing the sacrum followed by rupturing the presacral fascia, the tumor can be entirely eliminated, resulting in a brief surgical procedure, reduced intraoperative bleeding, and minimal postoperative complications.