Objective:This study aims to explore the optimization needs of the cognitive training tool "Fun Brain" from a professional perspective, providing insights for its enhancement and application.Methods:In April 2024, a qualitative research approach was employed, involving group interviews with 61 elderly health professionals organized into 9 groups. The interviews primarily focused on the user experience and optimization suggestions related to the "Fun Brain" app. Thematic analysis was conducted, with NVivo 14 software utilized for data management and processing. Data analysis followed Braun and Clarke′s six-phase procedure to ensure the scientific and systematic extraction of themes. Furthermore, high-frequency word analysis was performed, offering crucial clues for subsequent thematic analysis.Results:The study identified 12 initial themes and 6 optimization themes, with a primary focus on age-appropriate interfaces, personalized modules, and feedback mechanisms. These themes were refined into three core themes, including adaptation of training content, optimization of interaction design, and enhancement of participant motivation.Conclusion:Optimizing cognitive training tools for elderly users requires careful consideration of their specific needs, particularly regarding functional adaptation, interface design, and interactive experience. Implementing these optimizations can improve user engagement and training effectiveness, offering both scientific and practical guidance for the design and promotion of cognitive training tools.

Objective:To understand the current status of knowledge, attitude, and practice (KAP) of nurses in palliative care under the model of palliative co-care in hospitals of different levels in Zhejiang Province, and to analyze the influencing factors.Methods:This study was a cross-sectional study. Convenience sampling was used to select 541 clinical registered nurses from 3 Class Ⅲ hospitals, 3 Class Ⅱ hospitals, and 2 ClassⅠ hospitals in Hangzhou, Huzhou, and Lishui, Zhejiang Province, from March to April 2023. A general information questionnaire and the KAP Survey Scale of Palliative Care Under the Palliative Co-care Model were used to investigate the subjects. Multiple linear regression analysis was conducted to analyze the influencing factors of nurses' KAP of palliative care under palliative co-care. A total of 541 questionnaires were distributed, and 535 valid questionnaires were recovered, with an effective response rate of 98.89%.Results:The scores of 535 nurses for palliative care knowledge, attitude, and practice were (16.29±1.99), (71.10±9.00), and (32.21±5.89), respectively. Multiple linear regression analysis revealed that hospital level, gender, and whether nurses have participated in on-the-job training on palliative care are influencing factors of nurses' knowledge of palliative care ( P<0.05) ; ethnicity and the duration of palliative care training courses attended within two years are influencing factors of nurses' attitude toward palliative care ( P<0.05) ; department is an influencing factor of nurses' practice of palliative care ( P<0.05) . Conclusions:Under the palliative co-care model in Zhejiang Province, nurses demonstrate a good attitude toward palliative care, while their knowledge and practice levels of palliative care still have room for improvement, with distinct influencing factors for each dimension-hospital level, gender, and on-the-job training participation affect knowledge; ethnicity and training duration within two years affect attitude; and department affects practice.

Objective:To understand the current status of knowledge, attitude, and practice (KAP) of nurses in palliative care under the model of palliative co-care in hospitals of different levels in Zhejiang Province, and to analyze the influencing factors.Methods:This study was a cross-sectional study. Convenience sampling was used to select 541 clinical registered nurses from 3 Class Ⅲ hospitals, 3 Class Ⅱ hospitals, and 2 ClassⅠ hospitals in Hangzhou, Huzhou, and Lishui, Zhejiang Province, from March to April 2023. A general information questionnaire and the KAP Survey Scale of Palliative Care Under the Palliative Co-care Model were used to investigate the subjects. Multiple linear regression analysis was conducted to analyze the influencing factors of nurses' KAP of palliative care under palliative co-care. A total of 541 questionnaires were distributed, and 535 valid questionnaires were recovered, with an effective response rate of 98.89%.Results:The scores of 535 nurses for palliative care knowledge, attitude, and practice were (16.29±1.99), (71.10±9.00), and (32.21±5.89), respectively. Multiple linear regression analysis revealed that hospital level, gender, and whether nurses have participated in on-the-job training on palliative care are influencing factors of nurses' knowledge of palliative care ( P<0.05) ; ethnicity and the duration of palliative care training courses attended within two years are influencing factors of nurses' attitude toward palliative care ( P<0.05) ; department is an influencing factor of nurses' practice of palliative care ( P<0.05) . Conclusions:Under the palliative co-care model in Zhejiang Province, nurses demonstrate a good attitude toward palliative care, while their knowledge and practice levels of palliative care still have room for improvement, with distinct influencing factors for each dimension-hospital level, gender, and on-the-job training participation affect knowledge; ethnicity and training duration within two years affect attitude; and department affects practice.

Objective:This study aims to explore the optimization needs of the cognitive training tool "Fun Brain" from a professional perspective, providing insights for its enhancement and application.Methods:In April 2024, a qualitative research approach was employed, involving group interviews with 61 elderly health professionals organized into 9 groups. The interviews primarily focused on the user experience and optimization suggestions related to the "Fun Brain" app. Thematic analysis was conducted, with NVivo 14 software utilized for data management and processing. Data analysis followed Braun and Clarke′s six-phase procedure to ensure the scientific and systematic extraction of themes. Furthermore, high-frequency word analysis was performed, offering crucial clues for subsequent thematic analysis.Results:The study identified 12 initial themes and 6 optimization themes, with a primary focus on age-appropriate interfaces, personalized modules, and feedback mechanisms. These themes were refined into three core themes, including adaptation of training content, optimization of interaction design, and enhancement of participant motivation.Conclusion:Optimizing cognitive training tools for elderly users requires careful consideration of their specific needs, particularly regarding functional adaptation, interface design, and interactive experience. Implementing these optimizations can improve user engagement and training effectiveness, offering both scientific and practical guidance for the design and promotion of cognitive training tools.

Objective:To investigate the value of fibrinogen to albumin ratio (FAR), creatinine to albumin ratio (CAR) and platelet to lymphocyte ratio (PLR) in predicting the poor prognosis of hyperlipidemic acute pancreatitis (HLAP).Methods:Clinical data of HLAP patients admitted to the hospital from January 2021 to January and December 2023 were retrospectively collected. According to the prognosis, the patients were divided into two groups: good prognosis group and poor prognosis group.The independent risk factors of HLAP in different prognostic groups were obtained by multivariate Logistic regression analysis. Receiver operating characteristic (ROC) curves were plotted to evaluate the prognostic value of FAR, CAR and PLR alone and in combination.Results:A total of 118 patients with HLAP were included, including 69 patients with good prognosis and 49 patients with poor prognosis.The difference of heart rate, lymphocyte, triglyceride, albumin, creatinine, urea nitrogen, blood calcium, blood glucose, C-reactive protein, procalcitonin, fibrinogen, FAR, CAR, PLR, Bedside indicator of acute pancreatitis Severity score, Acute Physiology and Chronic Health status score, hospitalization time assessment between the two groups was statistically significant ( P<0.05). Multivariate Logistic regression analysis showed that FAR (odds ratio ( OR) = 25.949, 95% confidence interval (95% CI):3.190 ~ 211.080, P = 0.002), CAR ( OR = 1.453, 95% CI:1.095 ~ 1.928, P = 0.010) and PLR ( OR = 1.005, 95% CI: 1.001 ~ 1.009, P = 0.020) were independent risk factors for poor prognosis in HLAP patients. ROC curve analysis showed that the area under the ROC curve (AUC) of FAR, CAR and PLR to predict poor prognosis of HLAP patients were 0.823, 0.781 and 0.652, respectively.The AUC of FAR combined with CAR, FAR combined with PLR and CAR combined with PLR were 0.840, 0.845 and 0.849, respectively.The combined ability of FAR, CAR and PLR to predict poor prognosis in HLAP patients was (AUC=0.875,95% CI:0.814 ~ 0.937). When the cut-off value was 0.387, the sensitivity was 83.7%, and the specificity was 79.7%. Conclusions:The prognostic value of FAR, CAR and PLR in HLAP patients is better than that of single or pairwise combination.

Objective:To investigate the efficacy and safety of comprehensive therapy in the treatment of advanced unresectable hepatocellular carcinoma.Methods:Clinical data of 34 patients with primary liver cancer admitted to Peking Union Medical College Hospital from Nov 2018 to Dec 2020 initially evaluated as unresectable were treated firstly by combined therapy and then underwent reevaluation for further management.Results:A total of 34 patients completed the integrative treatment, and no serious adverse events occurred. Among them, 6 patients were evaluated as partial remission, and underwent successful tumor resection, tumors in 7 patients were stable, and 21 patients suffered from disease progression.Conclusion:After comprehensive therapy, unresectable tumors in some patients could reduce and be rendered resection.

The adjacent anatomy of the pelvis is complicated, with digestive, urinary, reproductive and other organs as well as important blood vessels and nerves. Therefore, accurate resection of pelvic tumors and precise reconstruction of defects after resection are extremely difficult. The development of medical 3D printing technology provides new ideas for precise resection and personalized reconstruction of pelvic tumors. The “triune” application of 3D printing personalized lesion model, osteotomy guide plate and reconstruction prosthesis in pelvic tumor limb salvage reconstruction treatment has achieved good clinical results. However, the current lack of normative guidance standards such as preparation and application of 3D printing personalized lesion model, osteotomy guide plate and reconstruction prosthesis restricts its promotion and application. The formulation of this consensus provides normative guidance for 3D printing personalized pelvic tumor limb salvage reconstruction treatment.

Neurodegenerative disease is a kind of degenerative diseases of the central nervous system that seriously endanger human health. The complement 3 (C3)-complement 3a receptor (C3aR) pathway is one of the important pathways for classical complement cascade activation. A large number of studies have shown that the C3-C3aR pathway can mediate and regulate the interaction of astrocyte-microglia axis in neurons, resulting in function changes in central nervous system. In addition, studies in recent years have found that the C3-C3aR pathway is closely related to the occurrence and progress of neurodegenerative diseases, such as Alzheimer's disease, Parkinson's disease, stroke, and epilepsy. This article reviews the progress of C3-C3aR pathway and discuss the role of C3-C3aR pathway in several important neurodegenerative diseases, and it provides a new idea fo treatment of these diseases.

OBJECTIVE: To investigate the surgical efficacy and prognostic factors of T3NxM0 middle-low rectal cancer without neoadjuvant therapy. METHODS: Clinical data of patients with middle-low rectal cancer undergoing TME surgery with T3NxM0 confirmed by postoperative pathology at Colorectal Surgery Department of Changhai Hospital from January 2008 to December 2010 were analyzed retrospectively. INCLUSION CRITERIA: (1)no preoperative neoadjuvant chemoradiotherapy (nCRT); (2) complete preoperative evaluation, including medical history, preoperative colonoscopy or digital examination, blood tumor marker examination, and imaging examination; (3) distance between tumor lower margin and anal verge was ≤ 10 cm; (4) negative circumferential resection margin (CRM-). Finally, a total of 331 patients were included in this study. According to the number of metastatic lymph node confirmed by postoperative pathology, the patients were divided into N0 group without regional lymph node metastasis (190 cases) and N+ group with regional lymph node metastasis (141 cases). The perioperative conditions, local recurrence, distant metastasis and prognostic factors were analyzed. RESULTS: Compared to N0 group in the perioperative data, N+ group had higher ratio of tumor deposit [29.8%(42/141) vs. 0, χ²=64.821, P<0.001] and vascular invasion [7.1%(10/141) vs. 0.5%(1/190),χ²=10.860, P<0.001]. There were no significant differences in tumor diameter, number of lymph nodes detected, positive nerve invasion, degree of tumor differentiation, morbidity of postoperative complication and postoperative adjuvant chemotherapy rate between the two groups (all P>0.05). The median follow-up period was 73.4 months. The merged 5-year local recurrence rate was 2.7%(9/331), 5-year distant metastasis rate was 23.3% (77/331), 5-year disease-free survival (DFS) rate was 73.4%, and 5-year overall survival (OS) rate was 77.2%. Multivariate analysis showed that lymph node metastasis (HR=3.120, 95%CI: 1.918 to 5.075, P<0.001), nerve invasion (HR=0.345, 95%CI: 0.156 to 0.760, P=0.008) and vascular invasion (HR=0.428, 95%CI: 0.189 to 0.972, P=0.043) were independent risk factors for DFS in patients with T3NxM0 rectal cancer after operation. Preoperative carcinoembryonic antigen level (HR=1.858, 95%CI:1.121 to 3.079, P=0.016), lymph node metastasis (HR=3.320, 95%CI: 1.985 to 5.553, P<0.001) and nerve invasion (HR=0.339, 95%CI: 0.156 to 0.738, P=0.006) were independent risk factors for OS in patients with T3NxM0 rectal cancer after operation. CONCLUSIONS Optimal local control rate of middle-low rectal cancer patients with T3NxM0 and CRM- can be achieved by standard TME surgery alone. For patients with preoperative elevated blood carcinoembryonic antigen level, regional lymph node metastasis, or neurovascular invasion confirmed by pathology after surgery, adjuvant chemoradiotherapy should be actively applied after surgery to improve prognosis.
Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; surgery ; Lymphatic Metastasis ; Mesocolon ; surgery ; Neoadjuvant Therapy ; Neoplasm Staging ; Proctectomy ; methods ; Prognosis ; Rectal Neoplasms ; pathology ; surgery ; Retrospective Studies

Objective: To investigate the efficacy and adverse effects of sustained lung inflation (SLI) combined with pulmonary surfactant (PS) in the treatment of neonatal respiratory distress syndrome (NRDS). Methods: This prospective randomized controlled trial included 124 premature infants (gestational age <34 weeks and birth weight <2 000 g) diagnosed with NRDS and in need of PS treatment in Shenzhen Maternity & Child Healthcare Hospital affiliated to Southern Medical University from July 1, 2016 to October 31, 2018. They were randomly divided into experimental or control group, with 62 cases in each. Infants in the experimental group were treated with SLI using T-piece and intratracheal PS, while those in the control group were given PS only. Blood gas analysis and measurement of fraction of inspiration O₂ (FiO₂) and ratio of partial pressure of oxygen (PO₂) over FiO₂ were performed before and 1 h after PS injection. Results of the treatments and incidence of complications were compared. Paired samples t-test, two independent samples t-test, rank-sum test and Chi-square test were used for statistical analysis. Results: There were 56 participants in the experimental group and 54 in the control group who were eventually analyzed. In the experimental group, the pH value, partial pressure of carbon dioxide (PCO₂), FiO₂ and PO₂/FiO₂ at 1 h after PS injection were all improved compared with those before treatment [pH value: 7.26±0.09 vs 7.19±0.09, t=3.814; PCO₂: (51.5±12.6) vs (59.8±16.3) mmHg (1 mmHg=0.133 kPa), t=2.610; FiO₂: 26.0 (21.0-31.5)% vs 40.5 (38.5-51.5)%, U=392.000; PO₂/FiO₂: (284.6±117.9) vs (173.4±59.7) mmHg, t=6.427; all P<0.05]. The overall decrement of FiO₂ after PS injection in the experimental group was more significant than that in the control group [-10.0 (-15.0 to -5.0)% vs -5.0 (-8.0 to 0.0)%, U=706.500, P<0.001]. The experimental group had a higher rate of extubation within 24 h than the control group [80% (45/56) vs 71% (32/54), χ²=5.830, P=0.016]. However, no significant differences were shown in total mechanical ventilation time, non-invasive/high-flow nasal cannula ventilation time, the ratio of re-intubation within 72 h, or the incidence of air leak, bronchopulmonary dysplasia, periventricular-intraventricular hemorrhage, necrotizing enterocolitis or patent ductus arteriosus between the two groups (all P>0.05). Conclusions SLI combined with PS for NRDS babies can increase the rate of extubation within 24 h and promote the down-regulation of FiO₂ without causing significant complications.