Objective: To investigate the emotional and behavioral problems among preschool children and the correlations with maternal parenting competence and family rearing environment, so as to provide a scientific basis and practical guidance for the physical and mental health development of preschool children. Methods: In June 2025, 660 preschool children aged 3-6 years old were selected from 10 kindergartens in Hefei, Anqing, and Tongling in Anhui Province by using a stratified cluster random sampling method. A questionnaire survey was conducted among all parents of preschool children using the Parent version of the Strengths and Difficulties Questionnaire, the Child Family Rearing Environment Scale, and the Chinese version of the Parenting Sense of Competence Scale. Pearson correlation analysis and multiple linear regression analysis were used to analyze the related factors of emotional and behavioral problems among preschool children. SPSS macro program Process 4.1 and Bootstrap method were used to test the mediating effect of family parenting environment between emotional and behavioral problems among preschool children and maternal parenting competence. Results: The detection rate of emotional and behavioral problems among preschool children was 20.15%. The total scores of family rearing environment and maternal parenting competence were negatively correlated with emotional and behavioral problems among preschool children ( r =-0.45,-0.79), and the total score of family rearing environment was positively correlated with the total score of maternal parenting competence ( r =0.43) (all P <0.01). Multiple linear regression showed that, after controlling whether being only child, parents educational level, registered residence location and other variables, family rearing environment, self efficacy and satisfaction were all negative predictors of emotional and behavioral problems among preschool children ( B =-0.07, -0.42, -0.42, all P <0.01). The mediation effect results showed that maternal parenting competence could positively predict the family rearing environment ( B =0.75), while maternal parenting competence and family rearing environment could both negatively predict emotional and behavioral problems among preschool children ( B =-0.49, -0.06 ) (all P <0.05). The Bootstrap sampling method test results showed that the effect value of the indirect effect of maternal parenting competence on emotional and behavioral problems through the family rearing environment was -0.04, and the effect proportion was 8.21 %. Conclusion Preschool children with a better family rearing environment and stronger maternal parenting competence are less likely to have emotional and behavioral problems, among which the family rearing environment has a mediating effect.

Objective To investigate the status of cardiometabolic comorbidity among elderly patients with chronic diseases, analyze its influencing factors, and construct a model based on cross-sectional data to identify a set of key characteristics associated with cardiometabolic comorbidity. Methods A cross-sectional investigation was conducted among 443 elderly patients with chronic diseases to determine the incidence of cardiometabolic comorbidity. Patients were divided into the comorbidity group and the non-comorbidity group based on the presence or absence of cardiometabolic comorbidity. The prevalence of cardiometabolic comorbidity was compared between patients of different genders and ages. The influencing factors for cardiometabolic comorbidity in elderly patients with chronic diseases were analyzed. A model for identifying cardiometabolic comorbidity in elderly patients with chronic diseases was constructed and its application value was evaluated. Results Among the 443 elderly patients with chronic diseases, the prevalence rate of cardiometabolic comorbidity was 68.62% (304/443), and the prevalence rate increased significantly with age (P<0.05). Logistic regression analysis identified age, smoking history, insufficient sleep, poor dietary habits, and family history of chronic diseases as independent risk factors. The model constructed based on these factors demonstrated good discriminative efficacy (AUC=0.808), and its visualized nomogram had high clinical discriminative value. Conclusion Elderly patients with chronic diseases have a high risk of cardiometabolic multimorbidity. Factors such as age, smoking history, and insufficient sleep are independent influencing factors. The nomogram model constructed based on these factors shows good discriminative efficacy.

Objective:To design an auxiliary device based on embedded microcontroller system for venipuncture,which can adjust posture,so as to resolve the problem that occurs failure in puncture due to insufficient exposure of the puncture site in various scenarios.Methods:The device consisted of a support component,an air ring,a component with lifting and angle adjustment,and a pedestal.By advanced embedded microcontroller technique,it can precisely regulate the posture of the support structure of patient's limbs,and fully expose the targeted puncture site,and create more favorable conditions for nurses in performing punctures.A total of 2,482 patients who underwent blood collection at emergency department of the 305th Hospital of the People's Liberation Army from September to October 2024 were selected.The 1,204 patients were enrolled in September were divided into control group(without using the auxiliary device for venipuncture),and the 1,278 patients were enrolled in October were divided into observation group(using the auxiliary device for venipuncture).The puncture's one-time success rates of junior nurses(experience≤3 years)for both groups were compared.Each group respectively selected 150 patients by using the random number table method to conduct investigate,and satisfaction scores for success rate of puncture,and comfort degree of puncture for position,as well as the pain,process and efficiency,were investigated Results:The puncture's one-time success rates of junior nurses for the patients of control and observation groups were respectively 85.05%and 89.36%,with a statistically significant difference(x2=10.35,P<0.05).The satisfaction scores of patients in the observation group were significantly higher than those in the control group,with a statistically significant difference(t=-5.529,P<0.05).Conclusion:This device is simple and convenient in operation,and has favorable stability.It is beneficial to adjust position and exposure puncture site for patients who undergo peripheral venipuncture.It can improve puncture's success rate and patients'satisfaction.

Objective:To analyze the risk factors for fat liquefaction after surgery for pediatric appendiceal abscess and to construct and validate a predictive model for post-operative fat liquefaction.Methods:The training set collected clinical data from 60 children who developed fat liquefaction after appendiceal abscess surgery and 60 children who did not develop fat liquefaction for comparison.The validation set collected data from 97 children during the same period ac-cording to the same criteria to test the model's efficacy.LASSO logistic regression was used to screen potential diag-nostic factors,and a Logistic regression model was employed for univariate analysis.Collinearity diagnostic tests were conducted among the risk factors.The stepwise regression method using the training dataset was applied to evaluate the importance of each risk factor for fat liquefaction.A multivariate Cox proportional hazards model was used to calcu-late the concordance index of the risk factors in both the training and validation sets.A predictive model was constructed using Logistic regression,and the clinical value of the predictive model was evaluated using ROC curves,calibration curves,and decision curves.Results:Compared with the non-liquefaction group,the liquefaction group had higher val-ues in terms of body weight,heart rate,diameter of the tender mass in the right lower abdomen,degree of appendiceal thickening,body temperature upon admission,fasting plasma glucose(FPG)level,surgical duration,intraoperative blood loss,wound healing time,length of hospital stay,volume of abdominal drainage fluid,and infection status(P<0.05).LASSO logistic regression analysis identified potential factors including body temperature upon admission,heart rate,body weight,diameter of the tender mass in the right lower abdomen,degree of appendiceal thickening,FPG level,sur-gical duration,and intraoperative blood loss.Univariate analysis revealed that body weight,diameter of the tender mass in the right lower abdomen,FPG level,surgical duration,and intraoperative blood loss were influencing factors for fat lique-faction after appendectomy(P<0.05).Body weight and FPG factors were mutually independent with no multicollinearity,while there was multicollinearity among the diameter of the tender mass in the right lower abdomen,surgical duration,and intraoperative blood loss.The risk model combining the diameter of the tender mass in the right lower abdomen,in-traoperative blood loss,FPG,surgical duration,and body weight had the highest concordance index in both the training and validation sets,with values of 0.811 and 0.814,respectively.The Logistic regression model established the predictive model as Logit(P)=-1.136+0.664×(diameter of the tender mass in the right lower abdomen)+0.449×(surgical duration)+0.622×(intraoperative blood loss)+0.200×(body weight)+0.578×(FPG).The area under the ROC curve was 0.920(95%CI:0.869～0.942),with a sensitivity of 93.14%and a specificity of 85.73%.The calibration curve of the predictive model showed good fit with the ideal curve.The predictive model had a high net benefit.Conclusion:Body weight,diameter of the tender mass in the right lower abdomen,FPG level,surgical duration,and intraoperative blood loss are risk factors for fat liquefaction after appendectomy and have good predictive value for the occurrence of fat liquefaction.

Objective:To construct an evaluation index system for the operational management capability in tertiary public hospitals and validate its feasibility,providing a reference for accurately assessing the operational management capability of public hospitals.Methods:A literature review and Delphi method were employed to construct the index system.The Analytic Hierarchy Process was used to calculate weights,and a weighted comprehensive index method was applied to evaluate the operational management capability of sample hospitals.Results:A hierarchical indicator system was established,comprising 6 first-level indicators,16 second-level indicators,and 40 third-level indicators,covering the dimensions of resource allocation,service efficiency,economic operation,risk prevention and control,development capacity,and social benefits.Empirical results indicated that the composite score of the sample hospital decreased from 71.5 in 2019 to 53.8 in 2020 and rebounded to 57.9 by 2023.Conclusions:The empirical outcomes align well with the operational capacity as understood by the operational management personnel of the sample hospital,demonstrating that the indicator system is scientifically sound and rational,possessing a high evaluative capability.

Objective To compare the fifth-generation total-etch adhesive system,the sixth-generation self-etching adhesive system and the eighth-generation universal adhesive system in terms of the bonding effectiveness for sclerotic dentin.Methods A total of 150 patients with caries in the occlusal surface of the mandibular right first molar who were examined between January 2022 and June 2022 at the dental department of some hospital were selected prospectively,and then enrolled into an ASB group,a SEB group and a SBU group and underwent Class Ⅰ cavity restorations on the mandibular right first molar,with 50 affected teeth in each group.The adhesives involved in included 3MTM AdperTM Single Bond 2(the fifth-generation total-etch adhesive system)for the ASB group,ClearfilTM SE Bond(the sixth-generation self-etching adhesive system)for the SEB group and 3MTM Single Bond Universal(the eighth-generation universal adhesive system)for the SBU group.Postoperative sensitivity was evaluated using a visual analog scale(VAS)1 week,6 months,1 year and 2 years after the operation in the three groups,and clinical performance—including color match,anatomic form,surface texture,marginal adaptation,marginal discoloration and secondary caries—was assessed based on the modified United States Public Health Service(USPHS)criteria at the same follow-up intervals.SPSS 27.0 software was used for data analysis.Results All the three groups showed a 100％restoration retention rate over the 2-year follow-up period.At 1 week postoperatively,2 cases of mild allergic reactions occurred in both the ASB group and the SEB group;these reactions resolved by 6 months postoperatively.No allergic reactions were observed in the SBU group.The three groups showed no statistically significant differences in sensitivity(P>0.05)and color match,anatomic form,surface texture,marginal adaptation,marginal discoloration and secondary caries(P>0.05).Conclusion The eighth-generation universal adhesive 3MTM Single Bond Universal demonstrates comparable clinical effectiveness to the fifth-and sixth-generation adhesives in Class Ⅰ cavity restorations,and can be used for dental restorations with high requirements for operational efficiency and universal adaptability.[Chinese Medical Equipment Journal,2025,46(8):72-78]

Objective:To design an auxiliary device based on embedded microcontroller system for venipuncture,which can adjust posture,so as to resolve the problem that occurs failure in puncture due to insufficient exposure of the puncture site in various scenarios.Methods:The device consisted of a support component,an air ring,a component with lifting and angle adjustment,and a pedestal.By advanced embedded microcontroller technique,it can precisely regulate the posture of the support structure of patient's limbs,and fully expose the targeted puncture site,and create more favorable conditions for nurses in performing punctures.A total of 2,482 patients who underwent blood collection at emergency department of the 305th Hospital of the People's Liberation Army from September to October 2024 were selected.The 1,204 patients were enrolled in September were divided into control group(without using the auxiliary device for venipuncture),and the 1,278 patients were enrolled in October were divided into observation group(using the auxiliary device for venipuncture).The puncture's one-time success rates of junior nurses(experience≤3 years)for both groups were compared.Each group respectively selected 150 patients by using the random number table method to conduct investigate,and satisfaction scores for success rate of puncture,and comfort degree of puncture for position,as well as the pain,process and efficiency,were investigated Results:The puncture's one-time success rates of junior nurses for the patients of control and observation groups were respectively 85.05%and 89.36%,with a statistically significant difference(x2=10.35,P<0.05).The satisfaction scores of patients in the observation group were significantly higher than those in the control group,with a statistically significant difference(t=-5.529,P<0.05).Conclusion:This device is simple and convenient in operation,and has favorable stability.It is beneficial to adjust position and exposure puncture site for patients who undergo peripheral venipuncture.It can improve puncture's success rate and patients'satisfaction.

Objective To analyze the research status,hotspots,and trends of wearable devices in nursing applications both domestically and internationally.Methods Using China National Knowledge Infrastructure,Wanfang Data Knowledge Service Platform,and Embase core databases as data sources,VOSviewer was used to visualize and analyze the publication time,keywords,and other relevant literature.Results Total of 428 articles were included,including 196 Chinese articles and 232 English articles.The overall publication volume showed an upward trend.Domestic research focuses on chronic diseases,artificial intelligence,and nursing,with the main research subjects being the elderly;Foreign research focuses on smart devices,self-monitoring,and quality of life,with the main research subjects being adults.Conclusion Currently,the number of publications on the application of wearable devices in nursing is relatively small,but the overall research heat is on the rise,mainly used for chronic diseases and self-monitoring.In the future,the application scope of wearable devices should be expanded and their potential value should be explored to promote the innovation and progress of nursing models.

Pasteurella is a genus of zoonotic pathogens that are widely distributed in both healthy and diseased ani-mals.Reports of human infections caused by wild animal bites are rare.This paper reports the first case of Pasteu-rella multocida infection caused by a snow leopard bite in China.The strains were identified using the DL-96 Ⅱ bac-terial identification system,BRUKER automatic microbial mass spectrometer,and Autof ms 1000 mass spectrome-ter.Antimicrobial susceptibility testing was performed using the DL-96 Ⅱ bacterial assay system.After wound de-bridement,surgical incision and drainage,and combined antimicrobial treatment,the patient recovered and was dis-charged from the hospital.This paper aims to improve clinical health care workers'understanding on this bacterium.

Objective:To explore differences in dose-adjusted plasma concentrations of valproic acid between different valproate formulations in patients with mental disorders based on therapeutic drug monitoring data.Methods:A retrospective analysis was performed; clinical data, including demographic characteristics, therapeutic drug monitoring results, comorbidities, medication details (daily valproic acid dose, concomitant medications), and liver and kidney function indicators, were collected from 633 patients with bipolar disorder or schizophrenia who were hospitalized at Xi'an Mental Health Center and received different valproates from January 2024 to June 2024 (98 patients receiving sodium valproate and 535 receiving magnesium valproate). Clinical data between a sodium valproate group and a magnesium valproate group were compared. Multivariate linear regression was used to identify independent influencing factors for dose-adjusted plasma concentration of valproic acid. Valproic acid daily doses, and plasma concentrations and dose-adjusted plasma concentrations of valproic acid were compared between the two groups, with subgroup analyses conducted by gender and age categories.Results:A total of 658 measurements of plasma valproic acid concentration were obtained in 633 patients, including 104 measurements in the sodium valproate group and 554 in the magnesium valproate group. Significant differences in proportions of comorbidities and concomitant use of olanzapine, quetiapine and clozapine were observed between the sodium valproate group and magnesium valproate group ( P<0.05). After adjusting for age, gender, body mass index, comorbidities, concomitant medications, and liver and kidney function indicators, the type of valproates remained an independent influencing factor for dose-adjusted plasma concentration of valproic acid (adjusted unstandardized B coefficient=13.814, 95% CI: 8.090-19.540, P<0.001). Daily dose in the sodium valproate group (1.0[1.0, 1.0] g/d) was significantly higher than that in the magnesium valproate group (0.5[0.5, 1.0] g/d), and dose-adjusted plasma concentration of valproic acid in the magnesium valproate group (93.00 [75.60, 117.40] [μg/mL]/[g·d]) was statistically higher than that in the sodium valproate group (78.55 [57.90, 90.00][μg/mL]/[g·d], P<0.05). Subgroup analysis revealed that, among patients stratified by genders and ages (<40 years vs. ≥40 years), the daily dose in the sodium valproate group was significantly higher than that in the magnesium valproate group, while the dose-adjusted plasma concentration of valproic acid in the magnesium valproate group was significantly higher than that in the sodium valproate group ( P<0.05). Conclusion:Significant differences in dose-adjusted plasma concentrations of valproic acid are observed among different valproate formulations for the treatment of mental disorders; therefore, therapeutic drug monitoring should be performed in patients when switching valproates to facilitate precise individualized dosage adjustment.