Objective:To investigate the role of evidence-based clinical guidelines combined with "rain classroom" smart teaching in standardized residency training in endocrinology department.Methods:The 100 trainees who underwent standardized residency training in the Department of Endocrinology at Xiamen Hospital from September 2022 to September 2023 were selected as the research subjects. They were divided into groups based on the parity of their admission batches, with even-numbered batches assigned to the control group and odd-numbered batches to the experimental group, with 50 trainees in each group. The control group received traditional teaching, while the experimental group was taught using evidence-based clinical guidelines combined with "rain classroom" smart teaching. Statistical comparisons were made between the two groups in terms of exit examination scores, teaching effectiveness, teaching satisfaction, and evaluation of trainees by teachers. SPSS 22.0 was used for t test and Chi-square test. Results:The experimental group demonstrated significantly higher scores in theoretical knowledge [(25.62±3.12) vs. (22.71±3.27)], case analysis [(25.18±3.24) vs. (22.24±3.35)], clinical operation [(25.01±3.19) vs. (22.12±3.29)], and daily performance [(8.12±1.01) vs. (7.21±1.13)] compared to the control group in exit examination ( P<0.001). Additionally, the experimental group showed superior performance in self-learning [(8.57±1.12) vs. (7.64±1.24)], clinical thinking [(8.61±1.16) vs. (7.78±1.28)], evidence-based thinking [(8.52±1.13) vs. (7.69±1.26)], clinical skills [(8.49±1.17) vs. (7.61±1.23)], communication skills [(8.53±1.18) vs. (7.67±1.29)], and literature review [(8.59±1.15) vs. (7.71±1.27)], with statistically significant differences ( P<0.05). Teaching satisfaction in the experimental group (96.00%) was significantly higher than that in the control group (82.00%) ( P=0.025). The pass rates rated by teachers were higher in the experimental group in medical history collection (94.00% vs. 80.00%), physical examination (96.00% vs. 82.00%), clinical thinking (92.00% vs. 76.00%), communication skills (94.00% vs. 80.00%), literature review (96.00% vs. 84.00%), specialized skills (94.00% vs. 78.00%), and diagnosis and treatment plan formulation (92.00% vs. 74.00%), with statistically significant differences ( P<0.05). Conclusions:The implementation of evidence-based clinical guidelines combined with "rain classroom" smart teaching in the standardized residency training in endocrinology department can significantly improve the exit examination scores and teaching satisfaction of trainees, teaching effectiveness, and evaluation of trainees by teachers. This teaching method has a positive role in improving the clinical comprehensive ability of trainees such as evidence-based medical thinking and standardized clinical diagnosis and treatment.

Objective:To screen and extract relevant evidence on the management of malnutrition in pediatric cancer patients and provide a best evidence summary.Methods:A systematic search was conducted across multiple websites and databases, including UpToDate, BMJ Best Practice, WHO website, Guidelines International Network, National Institute for Health and Care Excellence, National Guideline Clearinghouse, PubMed, Web of Science Core Collection, Embase, Cochrane Library, China National Knowledge Infrastructure, China Biology Medicine disc, Wanfang Data and others, for evidence on nutritional management of malnutrition in pediatric cancer patients. The search included literature from inception to August 31, 2023. Literature was selected following strict inclusion and exclusion criteria by researchers trained in evidence-based nursing courses. The quality of the selected literature was evaluated, and evidence was extracted and summarized.Results:A total of 11 articles were included, comprising two clinical decision papers, three guidelines, one evidence summary, two systematic reviews, and three expert consensus documents. The evidence was summarized into 24 evidence across five main areas: multidisciplinary team approach, nutritional risk screening and assessment, nutrient intake, dietary and nutritional education, and enteral and parenteral nutrition support.Conclusions:This study provides a best evidence summary for the nutritional management of malnutrition in pediatric cancer patients, offering evidence-based support for clinical practice among healthcare professionals.

Objective:To investigate the role of evidence-based clinical guidelines combined with "rain classroom" smart teaching in standardized residency training in endocrinology department.Methods:The 100 trainees who underwent standardized residency training in the Department of Endocrinology at Xiamen Hospital from September 2022 to September 2023 were selected as the research subjects. They were divided into groups based on the parity of their admission batches, with even-numbered batches assigned to the control group and odd-numbered batches to the experimental group, with 50 trainees in each group. The control group received traditional teaching, while the experimental group was taught using evidence-based clinical guidelines combined with "rain classroom" smart teaching. Statistical comparisons were made between the two groups in terms of exit examination scores, teaching effectiveness, teaching satisfaction, and evaluation of trainees by teachers. SPSS 22.0 was used for t test and Chi-square test. Results:The experimental group demonstrated significantly higher scores in theoretical knowledge [(25.62±3.12) vs. (22.71±3.27)], case analysis [(25.18±3.24) vs. (22.24±3.35)], clinical operation [(25.01±3.19) vs. (22.12±3.29)], and daily performance [(8.12±1.01) vs. (7.21±1.13)] compared to the control group in exit examination ( P<0.001). Additionally, the experimental group showed superior performance in self-learning [(8.57±1.12) vs. (7.64±1.24)], clinical thinking [(8.61±1.16) vs. (7.78±1.28)], evidence-based thinking [(8.52±1.13) vs. (7.69±1.26)], clinical skills [(8.49±1.17) vs. (7.61±1.23)], communication skills [(8.53±1.18) vs. (7.67±1.29)], and literature review [(8.59±1.15) vs. (7.71±1.27)], with statistically significant differences ( P<0.05). Teaching satisfaction in the experimental group (96.00%) was significantly higher than that in the control group (82.00%) ( P=0.025). The pass rates rated by teachers were higher in the experimental group in medical history collection (94.00% vs. 80.00%), physical examination (96.00% vs. 82.00%), clinical thinking (92.00% vs. 76.00%), communication skills (94.00% vs. 80.00%), literature review (96.00% vs. 84.00%), specialized skills (94.00% vs. 78.00%), and diagnosis and treatment plan formulation (92.00% vs. 74.00%), with statistically significant differences ( P<0.05). Conclusions:The implementation of evidence-based clinical guidelines combined with "rain classroom" smart teaching in the standardized residency training in endocrinology department can significantly improve the exit examination scores and teaching satisfaction of trainees, teaching effectiveness, and evaluation of trainees by teachers. This teaching method has a positive role in improving the clinical comprehensive ability of trainees such as evidence-based medical thinking and standardized clinical diagnosis and treatment.

Objective:To screen and extract relevant evidence on the management of malnutrition in pediatric cancer patients and provide a best evidence summary.Methods:A systematic search was conducted across multiple websites and databases, including UpToDate, BMJ Best Practice, WHO website, Guidelines International Network, National Institute for Health and Care Excellence, National Guideline Clearinghouse, PubMed, Web of Science Core Collection, Embase, Cochrane Library, China National Knowledge Infrastructure, China Biology Medicine disc, Wanfang Data and others, for evidence on nutritional management of malnutrition in pediatric cancer patients. The search included literature from inception to August 31, 2023. Literature was selected following strict inclusion and exclusion criteria by researchers trained in evidence-based nursing courses. The quality of the selected literature was evaluated, and evidence was extracted and summarized.Results:A total of 11 articles were included, comprising two clinical decision papers, three guidelines, one evidence summary, two systematic reviews, and three expert consensus documents. The evidence was summarized into 24 evidence across five main areas: multidisciplinary team approach, nutritional risk screening and assessment, nutrient intake, dietary and nutritional education, and enteral and parenteral nutrition support.Conclusions:This study provides a best evidence summary for the nutritional management of malnutrition in pediatric cancer patients, offering evidence-based support for clinical practice among healthcare professionals.

Frontotemporal dementia (FTD) is a neurodegenerative disease characterized by progressive mental and behavioral abnormalities, executive dysfunction, and language impairment. The initial symptoms of FTD are complex and diverse, which can be easily misdiagnosed, and there is an apparent genetic predisposition. Repeated expansion of chromosome 9 open reading frame 72( C9orf72) is a common genetic cause of FTD, but it is rarely reported. In this paper, we report a case of an elderly man with progressive memory loss, initially diagnosed as Alzheimer′s disease. The patient had a definite family history, but whole exome sequencing testing refinement revealed no apparent pathogenic mutation. The patient′s sister exhibited personality changes and language dysfunction, suggesting the possibility of frontotemporal dementia. The patient and her sister were tested for dynamic mutations in the C9orf72, and the results showed that the patient and her sister had an abnormal number of repeats in intron 1, GGGGCC, of the C9orf72. Both were ultimately diagnosed with frontotemporal dementia with C9orf72 mutation. Based on the report of this family, continued refinement of C9orf72 repeat expansion testing is recommended for familial dementia patients if whole exome sequencing is negative.

ObjectiveThe human angiotensin converting enzyme2 （hACE2） transgenic mouse model was used to clarify the antiviral efficacy of BD-77 against a novel coronavirus SARS-CoV-2 and explore the action mechanism of BD-77 against SARS-CoV-2. MethodSARS-CoV-2 Omicron and Delta variant strains-infected VeroE6 cell models were established and administered with BD-77 to observe the antiviral effect of BD-77 in vitro. A kit was used to detect the effect of BD-77 in vitro on the binding of spike S protein of SARS-CoV-2 virus （Delta/Omicron） to angiotensin converting enzyme2 （ACE2）. Chromatography was adopted to detect the binding of BD-77 to the S protein and N protein of the novel coronavirus. hACE2 transgenic C57BL/6 mice were divided into a blank control group， SARS-CoV-2 infection group， BD-77 administration groups of 37.5 mg·kg^-1 and 75 mg·kg^-1， with eight mice in each group. The pneumonia model of SARS-CoV-2-infected hACE2 transgenic mice was built to observe the survival of the mice， detect the virus titer of the lung tissue of the mice， and observe the lesions in the lung tissue. ResultBD-77 had a certain inhibitory effect on Omicron and Delta variant strains in vitro， with median inhibitory concentration （IC₅₀） of 526.3 mg·L^-1 and 653.0 mg·L^-1， respectively. BD-77 had no significant inhibitory effect on the binding of the S protein of WT， Omicron， and Delta variant strains of SARS-CoV-2 to ACE2 and had no binding effect with the S protein and N protein of the novel coronavirus. No mice in the blank group died， while the mortality rate of SARS-CoV-2-infected mice was 75%. There was a large amount of virus replication in the lung tissue of the mice and large areas of inflammatory infiltration in the lung tissue and interstitium. Compared with the model group， BD-77 administration groups of 37.5 mg·kg^-1 and 75 mg·kg^-1 could reduce the mortality of mice， significantly lower the virus titer in the lung tissue of mice （P<0.05）， and improve lung lesions. ConclusionBD-77 demonstrated significant inhibitory effects against SARS-CoV-2 virus in vitro and in vivo. However， its mechanism of action did not involve direct inhibition of the virus itself or intervention in the virus-host binding process. This finding suggests that the mechanism of action of BD-77 needs to be thoroughly investigated and elucidated by further experiments.

Objective:To investigate the distribution and drug resistance of common pathogens causing urinary tract infection (UTI) in children in Beijing, so as to provide reference for clinical rational use of antibiotics.Methods:It was a retrospective cohort study. The results of clinical data, urine culture and drug sensitivity in children with urinary infection treated in the Department of Nephrology, Children's Hospital Affiliated to Capital Institute of Pediatrics from June 2018 to June 2018 were retrospectively analyzed. According to the diagnostic criteria of "Chinese expert consensus on the diagnosis and treatment of UTI (2015 edition) - Complicated urinary tract infection", the children were divided into complex group and simple group according to whether they had complicated factors, and the pathogenic factors of the complex group were analyzed. The χ 2 test was used to compare the distribution of pathogenic bacteria in urine culture and the resistance rate of Escherichia coli to common antibiotics between the two groups. Results:A total of 187 children with UTI were enrolled in this study. The age ranged from 1 month after birth to 17 years old, and the median age was 8 months. There were 88 males (47.1%) and 99 females (52.9%), and the male/female ratio was 1:1.125. Male infants accounted for 79.5% (70/88) of male infants and female infants accounted for 48.5% (48/99) of female infants. There were 45 cases (24.1%) in the simple UTI group and 142 cases (75.9%) in the complicated UTI group. A total of 216 strains of pathogens were isolated, mainly Gram-negative bacteria (151/216, 69.9%), of which Escherichia coli was the most common (86/216, 39.8%). The second was gram-positive bacteria (57/216, 26.4%), among which Enterococcus faecium (37/216, 17.1%) was the most common. The positive rate of Escherichia coli infection in the simple UTI group was significantly higher than that in the complicated UTI group [71.1% (32/45) vs. 31.6% (54/171), χ2=23.234, P<0.001], and the positive rate of Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterococcus faecium and fungal infection in the simple UTI group was significantly lower than those in the complicated UTI group. However, the differences were not statistically significant (all P>0.05). The resistance rate of Escherichia coli to ampicillin was the highest in children with UTI [91.9% (79/86)], and it was sensitive to amikacin, meropenem, imipenem, piperacillin/tazobactam, cefepime, piperacillin, cefazolin, cefoperazone/sulbactam. The drug resistance rates were 5.8% (5/86), 5.8% (5/86), 9.3% (8/86), 10.5% (9/86), 14.0% (12/86), 15.1% (13/86), 18.6% (16/86) and 18.6% (16/86), respectively. The resistance rate of Escherichia coli infection to ceftriaxone in the complicated UTI group was significantly higher than that in the simple UTI group [59.3% (32/54) vs. 24.4% (11/32), χ2=4.977, P=0.026]. Eight fungi (3.7%) were susceptible to fluconazole, voriconazole, itraconazole and amphotericin B. Conclusions:The main pathogens of UTI in children are Gram-negative bacteria, among which Escherichia coli is the most common pathogen, but the proportion of infection has a downward trend in recent years. The resistance rate of ceftazidime and ceftriaxone is relatively low, which can be used as empirical drugs for children with UTI in this region.

Objective:To investigate the distribution and drug resistance of common pathogens causing urinary tract infection (UTI) in children in Beijing, so as to provide reference for clinical rational use of antibiotics.Methods:It was a retrospective cohort study. The results of clinical data, urine culture and drug sensitivity in children with urinary infection treated in the Department of Nephrology, Children's Hospital Affiliated to Capital Institute of Pediatrics from June 2018 to June 2018 were retrospectively analyzed. According to the diagnostic criteria of "Chinese expert consensus on the diagnosis and treatment of UTI (2015 edition) - Complicated urinary tract infection", the children were divided into complex group and simple group according to whether they had complicated factors, and the pathogenic factors of the complex group were analyzed. The χ 2 test was used to compare the distribution of pathogenic bacteria in urine culture and the resistance rate of Escherichia coli to common antibiotics between the two groups. Results:A total of 187 children with UTI were enrolled in this study. The age ranged from 1 month after birth to 17 years old, and the median age was 8 months. There were 88 males (47.1%) and 99 females (52.9%), and the male/female ratio was 1:1.125. Male infants accounted for 79.5% (70/88) of male infants and female infants accounted for 48.5% (48/99) of female infants. There were 45 cases (24.1%) in the simple UTI group and 142 cases (75.9%) in the complicated UTI group. A total of 216 strains of pathogens were isolated, mainly Gram-negative bacteria (151/216, 69.9%), of which Escherichia coli was the most common (86/216, 39.8%). The second was gram-positive bacteria (57/216, 26.4%), among which Enterococcus faecium (37/216, 17.1%) was the most common. The positive rate of Escherichia coli infection in the simple UTI group was significantly higher than that in the complicated UTI group [71.1% (32/45) vs. 31.6% (54/171), χ2=23.234, P<0.001], and the positive rate of Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterococcus faecium and fungal infection in the simple UTI group was significantly lower than those in the complicated UTI group. However, the differences were not statistically significant (all P>0.05). The resistance rate of Escherichia coli to ampicillin was the highest in children with UTI [91.9% (79/86)], and it was sensitive to amikacin, meropenem, imipenem, piperacillin/tazobactam, cefepime, piperacillin, cefazolin, cefoperazone/sulbactam. The drug resistance rates were 5.8% (5/86), 5.8% (5/86), 9.3% (8/86), 10.5% (9/86), 14.0% (12/86), 15.1% (13/86), 18.6% (16/86) and 18.6% (16/86), respectively. The resistance rate of Escherichia coli infection to ceftriaxone in the complicated UTI group was significantly higher than that in the simple UTI group [59.3% (32/54) vs. 24.4% (11/32), χ2=4.977, P=0.026]. Eight fungi (3.7%) were susceptible to fluconazole, voriconazole, itraconazole and amphotericin B. Conclusions:The main pathogens of UTI in children are Gram-negative bacteria, among which Escherichia coli is the most common pathogen, but the proportion of infection has a downward trend in recent years. The resistance rate of ceftazidime and ceftriaxone is relatively low, which can be used as empirical drugs for children with UTI in this region.

Frontotemporal dementia (FTD) is a neurodegenerative disease characterized by progressive mental and behavioral abnormalities, executive dysfunction, and language impairment. The initial symptoms of FTD are complex and diverse, which can be easily misdiagnosed, and there is an apparent genetic predisposition. Repeated expansion of chromosome 9 open reading frame 72( C9orf72) is a common genetic cause of FTD, but it is rarely reported. In this paper, we report a case of an elderly man with progressive memory loss, initially diagnosed as Alzheimer′s disease. The patient had a definite family history, but whole exome sequencing testing refinement revealed no apparent pathogenic mutation. The patient′s sister exhibited personality changes and language dysfunction, suggesting the possibility of frontotemporal dementia. The patient and her sister were tested for dynamic mutations in the C9orf72, and the results showed that the patient and her sister had an abnormal number of repeats in intron 1, GGGGCC, of the C9orf72. Both were ultimately diagnosed with frontotemporal dementia with C9orf72 mutation. Based on the report of this family, continued refinement of C9orf72 repeat expansion testing is recommended for familial dementia patients if whole exome sequencing is negative.

Objective:To evaluate the survival, complications and prognostic factors in patients with stageⅠb2 and Ⅱa2 cervical squamous cell carcinoma treated by primarily radical surgery with or without postoperative adjuvant therapy.Methods:The clinical and pathological data of patients with stageⅠb2 and Ⅱa2 cervical squamous cell carcinoma treated in the Cancer Hospital of the University of Chinese Academy of Sciences from January 2015 to January 2018 were retrospectively analyzed. All patients underwent Querleu-Morrow classification (Q-M classification) C2 radical surgery, including extensive hysterectomy+pelvic lymphadenectomy with or without adjuvant therapy based on postoperative risk factors. Survival rate was calculated by Kaplan-Meier method and survival curve was drawn. Univariate analysis was performed by using the log-rank test to analyze the clinicopathological factors related to the prognosis of patients. Multivariate analysis was performed by using Cox regression method to analyze independent risk factors affecting survival prognosis.Results:(1) The median age of 643 patients with cervical squamous cell carcinoma was 50 years old (45-58 years old). Clinical stage: 260 cases (40.4%, 260/643) of stage Ⅰb2, 383 cases (59.6%, 383/643) of stage Ⅱa2. (2) Among 643 cases underwent Q-M classification C2 surgery, 574 cases (89.3%, 574/643) of them received adjuvant therapy and 184 cases (28.6%, 184/643) of them had grade 3-4 complications after treatment, including 134 cases (20.8%, 134/643) early complications and 66 cases (10.3%, 66/643) late complications. The incidence of grade 3-4 complications in 574 patients received postoperative adjuvant therapy was 30.1% (173/574), which was significantly different from that in 69 patients who received surgery alone (15.9%, 11/69; χ2=6.08, P=0.014). (3) All 643 cases were followed up, and the median follow-up time was 40 months (3-76 months). During the follow-up period, 117 cases (18.2%, 117/643) recurred, including 45 cases (7.0%, 45/643) of local recurrence, 54 cases (8.4%, 54/643) of distant metastasis, and 18 cases (2.8%, 18/643) of local recurrence and distant metastasis. The 5-year progression-free survival (PFS) and 5-year overall survival (OS) rates of patients with stage Ⅰb2 and Ⅱa2 cervical squamous cell carcinoma were 79.9% and 85.5%, respectively. Univariate analysis showed that pelvic lymph node metastasis, para-aortic lymph node metastasis, deep stromal infiltration, and lymph-vascular space invasion were significantly associated with 5-year PFS in patients with stage Ⅰb2 and Ⅱa2 cervical squamous cell carcinoma (all P<0.05). The maximum diameter of tumor, pelvic lymph node metastasis and para-aortic lymph node metastasis were significantly associated with the 5-year OS of cervical squamous cell carcinoma in stages Ⅰb2 and Ⅱa2 (all P<0.05). Multivariate analysis showed that pelvic lymph node metastasis and para-aortic lymph node metastasis were independent factors affecting 5-year PFS and 5-year OS in patients with stage Ⅰb2 and Ⅱa2 cervical squamous cell carcinoma (all P<0.01). Conclusion:Radical surgery is a feasible and effective primary treatment for stagesⅠb2 and Ⅱa2 cervical squamous cell carcinoma, with a high 5-year survival rate and an acceptable complication rate.