ObjectiveTo analyze the microbial culture positivity rate， pathogen spectrum， prevalence of multidrug-resistant organisms （MDROs）， and differences among donor procurement sources in corneas from the Eye Bank of Guangdong Province， and to provide evidence for eye bank quality control and the prevention of post-keratoplasty infections. MethodsThis retrospective study included 7 442 donor corneas procured by the Eye Bank of Guangdong Province and used for keratoplasty at Zhongshan Ophthalmic Center， Sun Yat-sen University， between 2018 and 2025. During surgery， donor corneoscleral rim tissue was excised for bacterial and fungal culture. Culture-positive specimens underwent microbial identification and antimicrobial susceptibility testing （AST）. Culture-positive corneas were compared across study years， pathogen categories， and donor procurement sources. ResultsOf the 7 442 donor corneas， 251 were culture-positive， corresponding to an overall culture positivity rate of 3.37%， with annual rates ranging from 1.50% to 5.31%. Among culture-positive corneas， 178 （70.92%） yielded bacteria alone， 72 （28.68%） yielded fungi alone， and 1 （0.40%） yielded both bacteria and fungi. Candida spp. and Aspergillus spp. were the predominant fungal isolates. Gram-negative bacteria were more frequently isolated than Gram-positive bacteria. The most common bacterial isolates were Acinetobacter baumannii， Staphylococcus epidermidis， Stenotrophomonas maltophilia， Enterococcus faecium， and Pseudomonas fluorescens. MDROs accounted for 75.47% of bacterial isolates， predominantly Acinetobacter baumannii， Staphylococcus epidermidis， and Enterococcus faecium， and demonstrated an increasing trend over the study period. Donor corneas procured through the Hospital Cornea Retrieval Program （HCRP） had a higher culture positivity rate than those obtained through Organ Procurement Organization （OPO） （P＜0.000 1）. Among culture-positive donor corneas， the proportion of fungal culture-positive corneas was significantly higher in the HCRP group than in the OPO group （P=0.001 5）， whereas the proportion of MDROs among bacterial culture-positive corneas was significantly higher in the OPO group than that in the HCRP group （P=0.005 2）. ConclusionsThe overall culture positivity rate of donor corneas from the Eye Bank of Guangdong Province is relatively low， indicating that the risk of microbial contamination is controlled. However， pathogen profiles and antimicrobial resistance patterns varies by procurement source. Ongoing microbiological and antimicrobial resistance surveillance， together with optimized donor risk assessment and timely reporting of culture results， may further improve eye bank quality management and help inform strategies for preventing post-keratoplasty infections.

ObjectiveTo analyze the microbial culture positivity rate， pathogen spectrum， prevalence of multidrug-resistant organisms （MDROs）， and differences among donor procurement sources in corneas from the Eye Bank of Guangdong Province， and to provide evidence for eye bank quality control and the prevention of post-keratoplasty infections. MethodsThis retrospective study included 7 442 donor corneas procured by the Eye Bank of Guangdong Province and used for keratoplasty at Zhongshan Ophthalmic Center， Sun Yat-sen University， between 2018 and 2025. During surgery， donor corneoscleral rim tissue was excised for bacterial and fungal culture. Culture-positive specimens underwent microbial identification and antimicrobial susceptibility testing （AST）. Culture-positive corneas were compared across study years， pathogen categories， and donor procurement sources. ResultsOf the 7 442 donor corneas， 251 were culture-positive， corresponding to an overall culture positivity rate of 3.37%， with annual rates ranging from 1.50% to 5.31%. Among culture-positive corneas， 178 （70.92%） yielded bacteria alone， 72 （28.68%） yielded fungi alone， and 1 （0.40%） yielded both bacteria and fungi. Candida spp. and Aspergillus spp. were the predominant fungal isolates. Gram-negative bacteria were more frequently isolated than Gram-positive bacteria. The most common bacterial isolates were Acinetobacter baumannii， Staphylococcus epidermidis， Stenotrophomonas maltophilia， Enterococcus faecium， and Pseudomonas fluorescens. MDROs accounted for 75.47% of bacterial isolates， predominantly Acinetobacter baumannii， Staphylococcus epidermidis， and Enterococcus faecium， and demonstrated an increasing trend over the study period. Donor corneas procured through the Hospital Cornea Retrieval Program （HCRP） had a higher culture positivity rate than those obtained through Organ Procurement Organization （OPO） （P＜0.000 1）. Among culture-positive donor corneas， the proportion of fungal culture-positive corneas was significantly higher in the HCRP group than in the OPO group （P=0.001 5）， whereas the proportion of MDROs among bacterial culture-positive corneas was significantly higher in the OPO group than that in the HCRP group （P=0.005 2）. ConclusionsThe overall culture positivity rate of donor corneas from the Eye Bank of Guangdong Province is relatively low， indicating that the risk of microbial contamination is controlled. However， pathogen profiles and antimicrobial resistance patterns varies by procurement source. Ongoing microbiological and antimicrobial resistance surveillance， together with optimized donor risk assessment and timely reporting of culture results， may further improve eye bank quality management and help inform strategies for preventing post-keratoplasty infections.

Objective:To explore the mediating effect of frailty between stress perception and kinesiophobia in elderly patients after temporary cardiac pacemaker implantation.Methods:A total of 129 elderly patients who underwent temporary cardiac pacemaker implantation surgery in the Department of Cardiovascular Medicine of the First Affiliated Hospital of Zhengzhou University from February 2023 to April 2024 were selected by convenience sampling method, and were surveyed by the general information questionnaire, the exercise fear scale, the perceived stress scale and the Chinese Tilburg frailty scale.The t test, one-way ANOVA and non parametric test were used to analyze the data by SPSS 29.0 software.The macro program PROCESS was used to construct and test the mediation model. Results:The total score of kinesiophobia was (41.08±2.77), the total score of stress perception was (36.22±3.07), and the total score of frailty was (11.19±1.53) in elderly patients after temporary cardiac pacemaker implantation. The total score of kinesiophobia was positively correlated with the total score of stress perception ( r=0.383, P<0.01), the total score of kinesiophobia was positively correlated with the total score of frailty ( r=0.451, P<0.01), and the total score of stress perception was positively correlated with the total score of frailty ( r=0.289, P<0.01).The total effect of stress perception on motor fear was 0.359 ( P<0.01) and the direct effect was 0.226 ( P<0.01).Frailty played a partial mediating role between stress perception and kinesiophbia in elderly patients after temporary pacemaker implantation, with an indirect effect of 0.133 (95% CI=0.062-0.243), accounting for 37.05% of the total effect. Conclusion:Stress perception not only directly affects kinesiophobia in elderly patients with temporary cardiac pacemaker implantation, but also indirectly affects kinesiophobia through frailty.

Objective:To explore the mediating effect of frailty between stress perception and kinesiophobia in elderly patients after temporary cardiac pacemaker implantation.Methods:A total of 129 elderly patients who underwent temporary cardiac pacemaker implantation surgery in the Department of Cardiovascular Medicine of the First Affiliated Hospital of Zhengzhou University from February 2023 to April 2024 were selected by convenience sampling method, and were surveyed by the general information questionnaire, the exercise fear scale, the perceived stress scale and the Chinese Tilburg frailty scale.The t test, one-way ANOVA and non parametric test were used to analyze the data by SPSS 29.0 software.The macro program PROCESS was used to construct and test the mediation model. Results:The total score of kinesiophobia was (41.08±2.77), the total score of stress perception was (36.22±3.07), and the total score of frailty was (11.19±1.53) in elderly patients after temporary cardiac pacemaker implantation. The total score of kinesiophobia was positively correlated with the total score of stress perception ( r=0.383, P<0.01), the total score of kinesiophobia was positively correlated with the total score of frailty ( r=0.451, P<0.01), and the total score of stress perception was positively correlated with the total score of frailty ( r=0.289, P<0.01).The total effect of stress perception on motor fear was 0.359 ( P<0.01) and the direct effect was 0.226 ( P<0.01).Frailty played a partial mediating role between stress perception and kinesiophbia in elderly patients after temporary pacemaker implantation, with an indirect effect of 0.133 (95% CI=0.062-0.243), accounting for 37.05% of the total effect. Conclusion:Stress perception not only directly affects kinesiophobia in elderly patients with temporary cardiac pacemaker implantation, but also indirectly affects kinesiophobia through frailty.

Objective:To develop a novel, flexible, dual-arm, master-slave digestive endoscopic minimally invasive surgical robot system named dual-arm robotic endoscopic assistant for minimally invasive surgery (DREAMS) and to evaluate its feasibility for endoscopic submucosal dissection (ESD) by using ex vivo porcine stomachs.Methods:A novel endoscopic robot (DREAMS) system was developed which was composed of a flexible two-channel endoscope, two flexible robotic manipulators, a master controller, a robotic arm, and a control system. A total of 10 artificial round-like lesions with diameters ranging from 15 to 25 mm were created (5 in gastric antrum and 5 in gastric body) by using fresh peeled stomach of healthy pigs as the model. Submucosal dissection was performed with the assistance of the DREAMS system by two operators. The main outcome was submucosal dissection speed, and the secondary outcomes included muscular injury rate, perforation rate, and grasping efficiency of the robot.Results:All 10 lesions were successfully dissected en bloc by using the DREAMS system. The diameter of the artificial lesions was 22.34±2.39 mm, dissection time was 15.00±8.90 min, submucosal dissection speed was 141.79±79.12 mm 2/min, and the number of tractions required by each ESD was 4.2 times. Muscular injury occurred in 4/10 cases of ESD. No perforation occurred. Conclusion:The initial animal experiment shows the DREAMS system is safe and effective.

Objective:To explore changes in the illness uncertainty before and after discharge in patients with recurrent hepatocellular carcinoma and its relationship with unmet nursing needs.Methods:From December 2020 to June 2021, 90 patients with recurrent hepatocellular carcinoma treated in the First Affiliated Hospital of Zhengzhou University were selected by convenience sampling method as the research object.A questionnaire was used to collect data such as the supportive care needs, illness uncertainty, demographic sociology, and disease status of patients before discharge (T0, 90 cases) , one month after discharge (T1, 84 cases) , and two months after discharge (T2, 77 cases) . Generalized estimating equations were used to examine the factors influencing the illness uncertainty.Results:Patients' employment status, age, level of unmet nursing needs, and moderate and high uncertainty before discharge were the influencing factors for the change of patients' illness uncertainty at three time points.Conclusions:Changes in illness uncertainty links to unmet nursing needs. For young working patients with a high degree of illness uncertainty before discharge, a personalized discharge education should be developed to meet the patients' nursing needs and improve the patients' illness uncertainty after discharge.

Objective:To explore the influencing factors of the qualified bowel preparation for outpatients undergoing colonoscopy.Methods:A total of 293 outpatients who underwent colonoscopy in the First Affiliated Hospital of Zhengzhou University from January 2020 to May 2021 were selected as research objects by the convenient sampling method. The self-designed questionnaire was used to collect relevant data. Patients were divided into the qualified group ( n=223) and the unqualified group ( n=70) according to the readiness of intestinal. Single factor analysis was used to investigate the factors influencing the qualified rate of intestinal preparation for colonoscopy in outpatients. Results:There were no statistically significant differences in gender, body mass index, education level, drinking, smoking, history of diabetes, history of hypertension and history of abdominal operation between qualified group and unqualified group ( P>0.05) . There were statistically significant differences in age, previous colonoscopy times, preparation tolerance, interval time of oral laxatives and constipation ( P<0.05) . Conclusions:Age, previous colonoscopy times, preparation tolerance, interval time of oral laxatives and constipation are the factors influencing the qualified bowel preparation of outpatient colonoscopy patients. Clinical intervention measures should be given to patients with different characteristics.

Objective:To investigate the functional imaging parameters that effectively distinguish isocitrate dehydrogenase (IDH) gene mutation status in clinical practice with long echo time (TE) point-resolved spectroscopy (PRESS) MRS.Methods:Totally 25 patients with suspected diagnosis of low grade gliomas(LGGs; Grade II) were recruited prospectively and divided into IDH mutation group and IDH wild group according to pathological results in the study. All patients were scanned with long TE PRESS MRS. In addition, IDH mutational status was determined by post-operation Sanger sequencing. The t test or Mann-Whitney U test was used to analyze the differences of 2-hydroxyglutarate (2HG), Glutamate (Glu), Glutamine (Gln) and 2HG/Glu+Gln between the IDH mutation group and the IDH wild group, then ROC curve was plotted with statistically significant indexes to obtain the efficacy of predicting IDH mutation status. Results:Of the 25 patients, 19 had IDH mutant gliomas and 6 had IDH wild-type gliomas. 2HG, Glu, Gln and 2HG/Glu+Gln in IDH mutated group were 1.42 (1.09, 1.93)mmol/L, (1.74±1.31)mmol/L, (1.68±0.66)mmol/L, 0.55 (0.28, 0.77), respectively; while the corresponding values were 0.00 (0.00, 1.30)mmol/L, (3.28±1.02)mmol/L, (2.55±1.47)mmol/L, 0.00 (0.00, 0.26) in IDH gene wild type group, respectively. The differences of 2HG, Glu, and 2HG/Glu+Gln between the two groups were statistically significant ( P values were 0.030, 0.016, 0.004, respectively). The area under the ROC curve of 2HG/Glu+Gln was the largest (0.877), and the sensitivity was the highest (84.2%). Conclusion:The integration of 2HG with Glu and Gln can effectively realize the noninvasive assessment of IDH mutation status.

Objective:To explore the effect of quality management circulation (plan-do-check-act, PDCA) mode combined with clinical pathway nursing on leakage rate and nursing satisfaction in patients with ascites due to cirrhosis.Methods:A total of 418 patients with cirrhotic ascites in hospital infectious department were selected and divided into control group and 209 patients in study group according to random digital table method. The leakage rate, quality of life score and total nursing satisfaction were compared between the two groups.Results:The local leakage rates were 17.22% (36/209), 14.83% (31/209), 12.92% (27/209), 8.61% (18/209), respectively, at 24 hours, 48 hours, 72 hours and 1 week after abdominal tube placement. The control group was 22.01% (46/209), 20.10% (42/209), 23.92% (50/209), 25.84% (54/209). The difference between 72 hours and 1 week was statistically significant ( χ2 values were 8.421, 1.746, P<0.01). Quality of life scores were (3.15±1.15), (1.25±1.10), (1.15±1.08), (2.40±1.45), (2.35±1.50) in the study group and (3.75±1.05), (3.25±1.05), (3.60±1.25), (4.35±1.25), (3.15±1.25) in the control group, and the difference was statistically significant ( t values were 5.570-21.441, P<0.05). The total satisfaction of the study group was 96.65% (202/209), which was significantly higher than that of the control group 85.65% (179/209), and the difference was statistically significant ( χ2 value was 15.686, P<0.01). Conclusion:PDCA mode combined with clinical pathway nursing can reduce the leakage rate of abdominal administration, improve the quality of life score and nursing satisfaction, and improve the quality of nursing, which is a safe and effective nursing mode.

Objective To analyze the change of serum lipids and homocysteine level in patients with ischemic cerebrovascular disease.Methods A total of 150 patients with ischemic cerebrovascular disease (ICVD) were selected as ICVD group,and the patients were divided into short-term cerebral ischemia (TIA) group and cerebral infarction group (CI) group.Another 35 healthy people were selected as control group.Blood lipid index and plasma homocysteine level were compared among 4 groups.Results There was significant difference of Hcy between ICVD group,TIA group,CI group and control group (P<0.05).There was no significant difference of folic acid among the four groups (P>0.05).There were no significant differences in TC,TG and HDL-C between ICVD group,TIA group,CI group and control group (P>0.05),but there was significant difference in LDL-C (P<0.05).There were no significant differences in ApoA1 and ApoB between ICVD group,TIA group,CI group and control group (P>0.05),and there was significant difference in Fg (P<0.05).Conclusion Periodic detections of serum Hcy and blood lip index has a great value in prevention and treatment of patients with ischemic cerebrovascular disease.