Objective To evaluate the protective effect of radiation protection safety education (RPSE) on patients with differentiated thyroid carcinoma (DTC) undergoing iodine-131 (¹³¹I) treatment. Methods The DTC patients who undergo ¹³¹I treatment were divided into the control group and the RPSE group using the convenience sampling method, with 142 patients in each group. Patients in the control group received routine health education, while the RPSE group received routine health education combined with RPSE. Dose equivalent rate (DER) on pillows, bed sheets, quilt covers, and household waste of patients were compared between the two groups upon discharge. Results The median (M) DERs of patients' pillows, bed sheets, quilt covers and household waste were 3.86, 3.63, 3.91 and 56.59 times higher in the control group compared with the environmental background level, respectively. The M DERs of patients' pillows, bed sheets, quilt covers were 2.23, 2.18, and 2.55 times higher in the RPSE group compared with the environmental background level, while the M DER of household waste was equivalent to the environmental background level. The DERs of patients' pillows, bed sheets, quilt covers, and household waste in the RPSE group were significantly lower than those in the control group (all P<0.001). The DERs of the above four items were lower in both male and female patients in RPSE group compared with same-gender patients in the control group (all P<0.001). The patients' DERs of the above indicators had no significant difference among different gender in both control group and RPSE group (all P>0.05), except for higher DER of household waste in female patients than that of male patients in the control group (P<0.05). There were no significant differences in the DERs of pillows, bed sheets, quilt covers, and household waste across subgroups, where patients received different treatment doses, of both the control group and the RPSE group (all P>0.05). Conclusion RPSE for DTC patients treated with ¹³¹I, reduces the DERs of pillows, bed sheets, quilt covers, and particularly household waste.

Morita therapy has been bom for more than 100 years.Inpatient Morita therapy is highly oper-able and easy to master.It can improve many refractory neuroses through four-stage treatment.But more neuroses are treated in outpatient clinics,and Morita therapy cannot be used in hospitalized patients.Therefore,the formula-tion of expert opinions on outpatient operations is particularly important.This paper is based on domestic and for-eign references,and after many discussions by domestic Morita therapy experts,and then drew up the first version of the expert opinions on operation of outpatient Morita therapy.Meanwhile the operation rule of Morita therapy in three stages of outpatient treatment was formulated:in the etiological analysis stage,under the theoretical guidance of Morita therapy,analyze the pathogenic factors,to improve treatment compliance and reduce resistance;during the operating stage,guide patients to engage in constructive and meaningful actions,realizing the achievement of letting nature take its course principle;in the cultivating character and enriching life stage,pay attention to positive infor-mation,expanding the scope and content of actions,improving the ability to adapt to complex life,and preventing recurrence caused by insufficient abilities.It will lay a foundation for the promotion of Morita therapy in domestic outpatient clinics,so that more patients with neurosis and other psychological diseases could receive characteristic Morita therapy treatment in outpatient clinics.

Objective To systematically evaluate the efficacy of different analgesic methods in re-lieving the pain in hip and femoral shaft fractures patients during spinal anesthesia position by using network meta-analysis.Methods The articals of randomized controlled trials(RCTs)that analgesia was performed in patients with hip and femoral shaft fractures during the spinal anesthesia position placement were retrieved from the following database from the establishment of the database to August 2022,PubMed,the Cochrane Library,Web of Science,EMbase,China Biology Medicine(CBM),CNKI,VIP,and Wanfang databases.Literature screening,data extraction and bias risk assessment were conducted by two researchers separately.Stata 17.0 and RevMan 5.3 software were used for statistical analysis.Results A total of 28 RCTs with 1 773 patients were included.The surface under the cumulative ranking(SUCRA)curve showed that and PENG block(94.4%)had the best effect on reducing the VAS pain score of placement position,followed by FIBcombinedwith IVA(83.8%)and FIB(71.1%),and PENG block(98.2%)had the best effect on reducing VAS pain score during spinal anesthesia,followed by FIB(71.1%)and FNB(55.6%),and PENG block(84.1%)had the best effect on shortening the time of spinal anesthesia operation,followed by FNB(70.7%)and FIB(68.5%),and PENG block(99.1%)had the best effect on improving the quality of positioning,followed by FIB(73.1%)and FNB(52.9%).Conclusion Nerve blocks or the combina-tion with IVA can reduce pain scores during position placement and spinal anesthesia,shorten anesthesia operation time,and improve quality of position placement in patients with hip and femoral shaft fractures.PENG block has the best analgesic effect in patients with hip or femoral shaft fractures during positioning and spinal anesthesia.

BACKGROUND:After the internal fixation of cannulated screws in femoral neck fractures,because the affected limb is often unable to bear weight in the short term and the implants with high stiffness have a stress shielding effect on the fracture end,it is easy to cause osteoporosis of the affected limb and changes in the biomechanical distribution of the proximal femur,the incidence of osteonecrosis of the femoral head is high after surgery.At present,few studies have been conducted on the biomechanical effects of osteoporosis at the proximal end of the femur occurring after femoral neck fracture surgery on femoral neck fracture treated with cannulated screws. OBJECTIVE:Using finite element analysis,to investigate the biomechanical effects of osteoporosis occurring after femoral neck fracture surgery on femoral neck fracture treated with cannulated screws and explore the role of biomechanical factors in osteonecrosis of the femoral head. METHODS:Based on the obtained CT scan data of the femur in a patient with a femoral neck fracture,a proximal femoral model for internal fixation for femoral neck fracture was established by Mimics 19.0,3-Matic,UG 11.0,Hypermesh 14.0,and Abaqus software.One finite element model of the proximal femur without osteoporosis and three finite element models of the proximal femur with osteoporosis were analyzed using Abaqus software.The stress,contact pressure,displacement peak and cloud map under different components of the four models were measured and analyzed,and the internal stress changes and distribution of the femoral head were compared and analyzed. RESULTS AND CONCLUSION:The stresses and contact pressures of the femoral head and lower anterior cannulated screws varied more with the degree of osteoporosis.The peak displacement of the four models increased slowly with the degree of osteoporosis.By one-way analysis of variance,there was no significant effect of the degree of osteoporosis on the peak stress,contact pressure,and displacement of the different components.The internal stress distribution of the femoral head changed with the degree of osteoporosis.Changes in the biomechanical environment of the proximal femur have an important impact on osteonecrosis of the femoral head.

To describe and evaluate the clinical studies of postoperative pain sensitization caused by sleep deprivation through the evidence map system, understand the distribution of evidence in this field, and provide reference for subsequent evidence research.

Objective To evaluate the efficacy of preoperative electroacupuncture intervention in promoting postoperative gastrointestinal functional recovery by meta-analysis.Methods The databases of PubMed,Cochrane Library,Web of Science,Embase,CBM,CNKI,VIP,and WanFang were searched systematically.The search period ranged from the inception of the databases to March 2024.Two researchers screened the literature independently,extracted the data,used Cochrane Risk of Bias tools to evaluate the quality of the inclusion study,and used RevMan 5.3 software for meta-analysis.Results Twelve RCTs were included,with 773 patients.There were 421 patients in the preoperative electroacupuncture group and 352 patients in the control group.The results of the meta-analysis showed that,time to first flatus(SMD=-0.56,95%CI-0.84 to-0.28,P＜0.001),time to first defecation(MD=-6.40 hours,95%CI-9.27 to-3.53,P＜0.001),time to bowel sound recovery(MD=-8.45 hours,95%CI-10.37 to-6.52,P＜0.001),time to first oral feeding(MD=-16.88 hours,95%CI-23.92 to-9.83,P＜0.001),the incidence of PONV(RR=0.75,95%CI 0.57 to 0.98,P=0.04)and length of hospital stay(MD=-0.78 d,95%CI-1.38 to-0.19,P=0.010)were significantly lower than the control group.Conclusion Electroacupuncture intervention before operation can effectively promote the recovery of post-operative exhaust,defecation,and bowel sound,shorten the time of fasting and drinking,reduce the inci-dence of PONV,shorten the length of hospital stay,and has good clinical value in promoting the recovery of postoperative gastrointestinal function.

Objective To systematically evaluate the effect of transcutaneous electrical acupoint stimulation(TEAS)in the treatment of postoperative nausea and vomiting(PONV)after laparoscopic non-gastrointestinal surgery.Methods Databases such as PubMed,Cochrane library,Web of Science,Embase,CNKI,Wanfang,and Chinese biomedical database(CBM)were searched to find and screen ran-domized controlled trials(RCTs)of TEAS in the prevention and treatment of PONV after laparoscopic non-gastrointestinal surgery.The retrieval time was from the establishment of the database to July 2023.Meta-a-nalysis was performed using RevMan 5.3 software.Results Twenty-two RCTs involving 3 538 patients were included,including 1 799 in the TEAS group and 1 739 in the control group.The results of meta-analysis showed that the total incidence of PONV in the TEAS group was significantly lower than that in the control group 0-24 hours after operation(RR=0.54,95％CI 0.44-0.68,P＜0.001),and the incidence of postoperative remedial antiemetic was significantly reduced(RR=0.54,95％CI 0.38-0.77,P＜0.001).There was no significant difference in the incidence of postoperative acupoint stimulation-related adverse reactions between the two groups(RR=0.62,95％CI 0.15-2.51,P=0.500).Conclusion TEAS has good clinical efficacy and safety in the treatment of PONV after laparoscopic non-gastrointestinal surgery.

Objective To systematically review the efficacy of acupuncture in the treatment of post-operative gastroparesis syndrome.Methods Computer searches were conducted on PubMed,Embase,Web of Science,Cochrane Library,CNKI,Wanfang,VIP,and Chinese biomedical literature database.The ran-domized controlled trial(RCT)on postoperative gastroparesis syndrome after acupuncture treatment was in-cluded.The retrieval time was from the establishment of the database to May 2023.Meta-analysis was per-formed using RevMan 5.3 software.Results Fifteen RCTs involving 1 072 patients were included,545 pa-tients in the acupuncture group and 527 patients in the control group.Compared with the control group,the effective rate of treatment in the acupuncture group was significantly increased(RR=1.08,95％CI 1.09 to 1.27,P＜0.01),the levels of gastrin(SMD=1.86,95％CI 1.40 to 2.32,P＜0.01)and motilin(SMD=1.53,95％CI 0.99 to 2.06,P＜0.01)after operation were significantly increased,the recovery time of postoperative gastrointestinal function was significantly shortened(MD=-4.53 d,95％CI-6.51 to-2.55 d,P＜0.01).Conclusion Acupuncture can improve the effective rate of PGS treatment,in-crease the levels of Gastrin and motilin after operation,and promote the recovery of gastric motility after op-eration.

The clinical practice guidelines for prevention and treatment of postoperative gastrointestinal disorder with Integrated Traditional Chinese and Western Medicine (2023) issued by the Anaesthesia Committee and Perioperative Medicine Committee of the Chinese Society of Integrative Medicine is the first evidence-based guideline for postoperative gastrointestinal disorder in China. It covers the definition, aetiology and pathogenesis, diagnosis and treatment of postoperative gastrointestinal disorder. Compared with previous expert consensus, this guideline has advantages in terms of scientific and rigorous methodology and is quite representative. Interpreting this guideline can help strengthen clinicians′ understanding of postoperative gastrointestinal disorder and enhance clinical practitioners′ understanding of the methodology of this guideline, thus enabling a better integration of recommendations and evidence for clinical practice and hastening the implementation of the guidelines. It also accelerates the dissemination of the methodological development of guidelines in China, helps clinicians understand the connotation and value of the guidelines, and provides methodological guidance and references for formulating clinical practice guidelines based on the current situation in China and involving other clinical disciplines.

OBJECTIVE To explore the effects of trichloroisocyanuric acid(TCCA)on the prolifera-tion of spermatogonia by inducing oxidative stress and ferroptosis.METHODS GC-1 cells were cultured in DMEM-F12 medium,and cell proliferation was plotted according to the growth curve.GC-1 cells were treated with TCCA at concentrations of 0(cell control),97,194,and 387 μmol·L-1 for 24 h.Cell viability was detected using the CCK-8 method,apoptosis cells were stained with Hoechst 33342,cell cycle was examined by PI staining method,RT-qPCR was performed to measure the mRNA expres-sion levels of apoptosis-related genes Bax,Fas,oxidative stress-related genes superoxide dismutase 2(SOD2),glutathione peroxidase 4(GPX4),nuclear factor erythroid 2-related factor 2(Nrf2),solute carrier family 7 member 11(SLC7A11),dihydroorotate dehydrogenase(DHODH),DNA methyltransferase 3A(DNMT3A),and DNA methyltransferase 3L(DNMT3L).The Griess method was used to determine the nitric oxide(NO)content,colorimetric method for the malondialdehyde(MDA)level,DCFH-DA fluores-cence probe method for the reactive oxygen species(ROS)level,DNTB colorimetric method for the reduced glutathione(GSH)content,and WST-8 method for the reduced coenzymeⅡ(NADPH)content.RESULTS Compared with the cell control group,the cell survival rates in the TCCA 194 and 387 μmol·L-1 groups decreased significantly(P<0.01),accompanied by nuclear condensation and fragmentation,a significant increase in apoptosis rate(P<0.01),and cell arrest in the G2/M phase(P<0.05).Additionally,in the TCCA 387 μmol·L-1 group,the levels of NO,MDA and ROS increased(P<0.01),while the levels of GSH and NADPH decreased(P<0.01).Moreover,the mRNA expressions of SOD2,GPX4,Nrf2,SLC7A11,and DHODH decreased(P<0.05,P<0.01),while the expressions of Bax,Fas,DNMT3L,and DNMT3A increased(P<0.05,P<0.01).CONCLUSION TCCA exposure reduces the viability of GC-1 cells,inhibits cell proliferation,induces apoptosis of GC-1 cells.The mechanism may be related to the ability of TCCA to enhance oxidate stress,induce ferroptosis,and interfere with the methylation of GC-1 cells.