To investigate the association between sleep-related phenotypes and the risk of malignancy in pulmonary nodules, and to provide complementary evidence from a general population cohort and genetic analyses.

In order to explore the effects of lipopolysaccharide(LPS)on the repair of bovine endo-metrial stromal cells(BESCs)during inflammatory response,BESCs were treated by LPS in this study.Cell apoptosis rate was detected using flow cytometry,cell viability was measured using the CCK-8 assay,cell migration ability was observed using a scratch assay,and the expression of con-nective tissue growth factor(CTGF),transforming growth factor-beta 3(TGF-β3)and vascular endothelial growth factor(VEGF)mRNA was measured using qRT-PCR.Additionally,the expression of key proteins in the PI3K/AKT and Wnt/β-catenin signaling pathways was assessed using Western blot analysis.The results showed that cell viability of BESCs significantly decreased(P＜0.01),cell migration ability decreased(P＜0.05),apoptosis rate of BESCs increased(P＜0.01),CTGF and TGF-β3 mRNA expression levels decreased(P＜0.01),while VEGF mRNA ex-pression increased after treatment with LPS(P＜0.01).The phosphorylation levels of PI3K,AKT and GSK-3β proteins decreased(P＜0.05),as well as the expression levels of c-Myc and Cyclin-D1 proteins also decreased(P＜0.01).These results indicated that LPS can inhibit the proliferation of BESCs and promote cell apoptosis possibly through the inhibition of the PI3K/AKT and Wnt/β-catenin signaling pathways.

Objective:To construct a risk prediction model based on explainable intelligence(XAI)analysis algorithms for orthopedic consumables in surgery room,and improve the management quality of controlling risk for orthopedic consumables in surgery room.Methods:A risk index system for orthopedic consumables in the surgery room was established through researching literature and using Delphi method.The data of supply and use of consumables were collected to construct a risk prediction model.Risk control paths were formulated from three aspects included formulating preoperative plan,intraoperative dynamic allocation,and postoperative tracking and feedback.A total of 6,572 sets of orthopedic consumables that were used in the surgery room of the 960th Hospital of People's Liberation Army Joint Service Support Force from January 2021 to December 2024 were selected.The 3,185 sets of orthopedic consumables that were used during January 2021 and December 2022 were managed by using conventional method of controlling and managing risk.The 3,387 sets of orthopedic consumables that were used during January 2023 and December 2024 were managed by using intelligent method of controlling and managing risk.The early warning capabilities for risk,and the control quality for risk between the two management methods were compared.A self-made satisfaction survey questionnaire was adopted to investigate the satisfaction scores of medical staffs and managers for consumables in the surgery room for the two management methods.Results:The average accuracy rates of using the intelligent method of controlling and managing risk in predicting formulating preoperative plan,intraoperatively dynamic allocation,and postoperative tracking and feedback for early warning events of risk in 157,247 and 57 consumables were respectively 49.68%(78/157),42.11%(104/247)and 56.14%(32/57),all of which were higher than those of conventional method of controlling and managing risk,and the difference were statistically significant(x2=9.475,23.637,13.035,P<0.05).The average reduction rate of risk events of consumables,the average intervention rate of abnormal use of consumables,and the mean value of enhance degree of turnover efficiency of consumables were respectively(6.25±1.59)%,(87.93±4.44)%and(4.78±1.69)%,all of which were higher than those of conventional method of controlling and managing risk,and the differences were statistically significant(t=4.952,6.257,4.660,P<0.05).The scores of medical staffs and managers in surgery room for acceptance of early warning for risk,support of management decision,satisfaction of using consumables,and assessment results of training by adopting intelligent method of controlling and managing risk were all higher than those by adopting conventional method of controlling and managing risk,and the differences were statistically significant(t=3.368,3.082,3.701,4.558,P<0.05).Conclusion:The application of prediction model based on XAI analysis algorithm for risk of orthopedic consumables in the surgery room can improve the accuracy of early warning for risk of orthopedic consumables in the surgery room,and reduce the incidence of risk events,and enhance the ability of emergent response for risk,and improve the quality of clinical services.

Objective To explore the value of Turbo-Flash mode CT scanning for displaying calcification of ligamentum arteriousum(CLA)in infants and young children.Methods Chest CT data obtained with Turbo-Flash mode scanning of 1 762 infants and young children(aged 1 to 36 months)with suspected lung,trachea or bronchi lesions were retrospectively analyzed.Children were divided into group A to L according to age at 3-month intervals.CLA was evaluated and its CT manifestations were analyzed.The incidence of CLA in each group was counted,the density of CLA was measured,and their correlations with age were observed.Results Among 1 762 children,912 was found with CLA(912/1 762,51.76%).The incidence of CLA in group A—L was 34.29%(12/35)—59.35%(92/155),respectively.All CLA located in the arterial ligaments between the left side of pulmonary trunk and the origin level of left subclavian artery of the aorta and shaped differently.The density of CLA in group A—L was(183.36±50.16)—(295.80±105.91)HU,respectively.The incidence of CLA in group A—F was positively(r=0.945,P=0.002),while in group F—L was negatively correlated with age(r=-0.765,P=0.045).Meanwhile,the density of CLA in group A—F was positively correlated with age(r=0.775,P=0.020),but no significant correlation between CLA density and age was found in G—L group(P=0.593).Conclusion Turbo-Flash mode CT scanning had high clinical application value for displaying CLA in infants and young children.

Objective:To construct a risk prediction model based on explainable intelligence(XAI)analysis algorithms for orthopedic consumables in surgery room,and improve the management quality of controlling risk for orthopedic consumables in surgery room.Methods:A risk index system for orthopedic consumables in the surgery room was established through researching literature and using Delphi method.The data of supply and use of consumables were collected to construct a risk prediction model.Risk control paths were formulated from three aspects included formulating preoperative plan,intraoperative dynamic allocation,and postoperative tracking and feedback.A total of 6,572 sets of orthopedic consumables that were used in the surgery room of the 960th Hospital of People's Liberation Army Joint Service Support Force from January 2021 to December 2024 were selected.The 3,185 sets of orthopedic consumables that were used during January 2021 and December 2022 were managed by using conventional method of controlling and managing risk.The 3,387 sets of orthopedic consumables that were used during January 2023 and December 2024 were managed by using intelligent method of controlling and managing risk.The early warning capabilities for risk,and the control quality for risk between the two management methods were compared.A self-made satisfaction survey questionnaire was adopted to investigate the satisfaction scores of medical staffs and managers for consumables in the surgery room for the two management methods.Results:The average accuracy rates of using the intelligent method of controlling and managing risk in predicting formulating preoperative plan,intraoperatively dynamic allocation,and postoperative tracking and feedback for early warning events of risk in 157,247 and 57 consumables were respectively 49.68%(78/157),42.11%(104/247)and 56.14%(32/57),all of which were higher than those of conventional method of controlling and managing risk,and the difference were statistically significant(x2=9.475,23.637,13.035,P<0.05).The average reduction rate of risk events of consumables,the average intervention rate of abnormal use of consumables,and the mean value of enhance degree of turnover efficiency of consumables were respectively(6.25±1.59)%,(87.93±4.44)%and(4.78±1.69)%,all of which were higher than those of conventional method of controlling and managing risk,and the differences were statistically significant(t=4.952,6.257,4.660,P<0.05).The scores of medical staffs and managers in surgery room for acceptance of early warning for risk,support of management decision,satisfaction of using consumables,and assessment results of training by adopting intelligent method of controlling and managing risk were all higher than those by adopting conventional method of controlling and managing risk,and the differences were statistically significant(t=3.368,3.082,3.701,4.558,P<0.05).Conclusion:The application of prediction model based on XAI analysis algorithm for risk of orthopedic consumables in the surgery room can improve the accuracy of early warning for risk of orthopedic consumables in the surgery room,and reduce the incidence of risk events,and enhance the ability of emergent response for risk,and improve the quality of clinical services.

Objective To explore the value of Turbo-Flash mode CT scanning for displaying calcification of ligamentum arteriousum(CLA)in infants and young children.Methods Chest CT data obtained with Turbo-Flash mode scanning of 1 762 infants and young children(aged 1 to 36 months)with suspected lung,trachea or bronchi lesions were retrospectively analyzed.Children were divided into group A to L according to age at 3-month intervals.CLA was evaluated and its CT manifestations were analyzed.The incidence of CLA in each group was counted,the density of CLA was measured,and their correlations with age were observed.Results Among 1 762 children,912 was found with CLA(912/1 762,51.76%).The incidence of CLA in group A—L was 34.29%(12/35)—59.35%(92/155),respectively.All CLA located in the arterial ligaments between the left side of pulmonary trunk and the origin level of left subclavian artery of the aorta and shaped differently.The density of CLA in group A—L was(183.36±50.16)—(295.80±105.91)HU,respectively.The incidence of CLA in group A—F was positively(r=0.945,P=0.002),while in group F—L was negatively correlated with age(r=-0.765,P=0.045).Meanwhile,the density of CLA in group A—F was positively correlated with age(r=0.775,P=0.020),but no significant correlation between CLA density and age was found in G—L group(P=0.593).Conclusion Turbo-Flash mode CT scanning had high clinical application value for displaying CLA in infants and young children.

In order to explore the effects of lipopolysaccharide(LPS)on the repair of bovine endo-metrial stromal cells(BESCs)during inflammatory response,BESCs were treated by LPS in this study.Cell apoptosis rate was detected using flow cytometry,cell viability was measured using the CCK-8 assay,cell migration ability was observed using a scratch assay,and the expression of con-nective tissue growth factor(CTGF),transforming growth factor-beta 3(TGF-β3)and vascular endothelial growth factor(VEGF)mRNA was measured using qRT-PCR.Additionally,the expression of key proteins in the PI3K/AKT and Wnt/β-catenin signaling pathways was assessed using Western blot analysis.The results showed that cell viability of BESCs significantly decreased(P＜0.01),cell migration ability decreased(P＜0.05),apoptosis rate of BESCs increased(P＜0.01),CTGF and TGF-β3 mRNA expression levels decreased(P＜0.01),while VEGF mRNA ex-pression increased after treatment with LPS(P＜0.01).The phosphorylation levels of PI3K,AKT and GSK-3β proteins decreased(P＜0.05),as well as the expression levels of c-Myc and Cyclin-D1 proteins also decreased(P＜0.01).These results indicated that LPS can inhibit the proliferation of BESCs and promote cell apoptosis possibly through the inhibition of the PI3K/AKT and Wnt/β-catenin signaling pathways.

Objective To develop an expert consensus on subcutaneous injection nursing for allergic asthma in children,standardize nursing practice to reduce the occurrence of related adverse reactions.Methods The clinical guideline,expert consensus,systematic review,evidence summary and original research on subcutaneous injection of monoclonal antibody drug for children with allergic asthma were comprehensively searched in domestic and foreign databases.The time limit for retrieval was from the establishment of databases until August 2023.Combined with clinical practice experience,the first draft of the consensus was formed.From December 2023 to February 2024,27 experts were invited to conduct 2 rounds of expert letter consultation,revise and improve the contents of the first draft,and expert demonstration was conducted,and finally a consensus final draft was formed.Results The effective recovery rate of the 2 rounds of letter consultation questionnaires was 100％;the authority coefficient of experts was 0.88;the judging basis coefficient was 0.93;the familiarity coefficient was 0.83.In the 2 rounds of correspondence,the Kendall concordant coefficients of expert opinions were 0.241 and 0.252,respectively(P＜0.001 for both).The consensus includes 6 parts,including personnel management,environmental layout,indications and contraindications,subcutaneous injection operation norms,identification and treatment of adverse reactions,and health education.Conclusion The consensus is strongly scientific and practical,and can provide guidance for nursing practice of subcutaneous injection of monoclonal antibodies in children with allergic asthma.

Objective To assess effect of ultrasound-guided erector spinae plane block(ESPB)combined with patient controlled intravenous analgesia(PCIA)on postoperative analgesia after cesarean section.Methods A total of 120 full-term singleton pregnant women who underwent cesarean section under spinal anesthesia at Jiaxing Maternal and Child Health Care Hospital from May 2022 to August 2023 were selected.Participants were randomly divided into three groups using a random number table:Group E(ESPB combined with PCIA),group T[transversus abdominis plane(TAP)block combined with PCIA],and control group(PCIA alone),with 40 women in each group.Visual analogue scale(VAS)and Bruggrmann comfort scale(BCS)scores during rest and coughing were recorded at 4h,8h,12h,24h,and 48h postoperatively.Number of effective PCIA presses,total sufentanil dosage,proportion of rescue analgesia and maternal satisfaction were also documented within 48h.Additionally,adverse reactions and neonatal outcomes were observed within the same 48h period.Results Postoperatively,VAS scores for rest and coughing in group E at 8h,12h,24h were significantly lower than those in group T,those in two groups were lower than those in control group(P＜0.05).Postoperatively at 8h,12h,and 24h,BCS scores in group E were significantly higher than those in group T,with both higher than those in control group(P＜0.05).Within 48h after surgery,the number of effective PCIA presses,proportion of rescue analgesia and total sufentanil dosage in group E were lower than those in group T,both lower than those in control(P＜0.05).Moreover,maternal satisfaction score in group E was significantly higher than that in group T,that in two groups was significantly higher than that in control group(P＜0.05).Within 48h after surgery,there were no significant differences in adverse reactions or neonatal outcomes among the three groups(P＞0.05).Conclusion Ultrasound-guided ESPB combined with PCIA outperforms TAP block combined with PCIA,with reducing analgesic dose and enhancing maternal satisfaction and comfort.

Objective:To investigate the status of medical care seeking delay and diagnosis delay of pulmonary tuberculosis (PTB) patients in Tongzhou District and Changping District of Beijing, analyze the related factors and put forward suggestions for early detection and scientific management of PTB patients.Methods:A retrospective epidemiological survey was conducted to collect the incidence data of PTB registered in Tongzhou and Changping from January 1 to December 31, 2021 by using the Chinese Tuberculosis Information Management System, and telephone interview were used for information supplement. Multivariate logistic regression model and decision tree model were used to analyze the influencing factors of medical care seeking delay and diagnosis delay of PTB patients.Results:In 2021, the medical care seeking delay time M( Q1, Q3) in the PTB patients in Tongzhou and Changping was 11 (5, 26) days, with a delay rate of 41.71%. Results from multivariate logistic regression model analysis revealed that factors influencing the medical care seeking delay included regular health check-up ( OR=0.033, 95% CI: 0.008-0.147), coughing for less than 2 weeks or showing any symptom of PTB before medical care seeking ( OR=0.378, 95% CI: 0.215-0.665), showing other symptoms before medical care seeking( OR=2.791, 95% CI: 1.710-4.555), no work or school in medical care seeking ( OR=2.990, 95% CI: 1.419-6.298). The diagnosis delay time M( Q1, Q3) in the PTB patients was 8 (0, 18) days, with a delay rate of 35.20%. Multivariate logistic regression model analysis revealed that the factors influencing the diagnosis delay of PTB included being diagnosed at a specialized tuberculosis hospital ( OR=0.426, 95% CI: 0.236-0.767) or a tuberculosis prevention and control institution ( OR=1.843, 95% CI: 1.061-3.202) and being traced as a source of infection ( OR=2.632, 95% CI: 1.062-6.521). The overall performance of the multivariate logistic regression model was comparable to that of the decision tree model, with the decision tree model exhibiting higher sensitivity but lower specificity. Conclusions:The medical care seeking delay rate and diagnosis delay rate of tuberculosis in Tongzhou and Changping were at low levels in 2021. However, it is still necessary to strengthen the health education and active screening, improve the public awareness of PTB prevention and control, and further improve the level of medical services and medical access to reduce the medical care seeking delay and diagnosis delay of PTB patients.