OBJECTIVES: Verrucous epidermal nevus (VEN), seborrheic keratosis (SK), verruca plana (VP), verruca vulgaris (VV), and nevus sebaceous (NS) are common verrucous proliferative skin diseases with similar clinical appearances, often posing diagnostic challenges. Dermoscopy and reflectance confocal microscopy (RCM) can aid in their differentiation, yet their specific features under these tools have not been systematically described. This study aims to summarize and analyze the dermoscopic and RCM features of VEN, SK, VP, VV, and NS. METHODS: A total of 121 patients with histopathologically confirmed verrucous proliferative skin diseases were enrolled. Dermoscopy and RCM imaging was used to observe and analyze the microscopic features of these conditions. RESULTS: Under dermoscopy, the 5 diseases displayed distinct characteristics: VEN typically showed gyriform structures; SK was characterized by gyriform structures, comedo-like openings, and milia-like cysts; VP and VV featured dotted vessels and frogspawn-like structures; NS presented as brownish-yellow globules. RCM revealed shared features such as hyperkeratosis and acanthosis across all 5 diseases. Specific features included gyriform structures and elongated rete ridges in VEN; pseudocysts and gyriform structures in SK; evenly distributed ring-like structures in VP; vacuolated cells and papillomatous proliferation in VV; and frogspawn-like structures in NS. CONCLUSIONS These 5 verrucous proliferative skin conditions exhibit distinguishable features under both dermoscopy and RCM. The combination of these 2 noninvasive imaging modalities holds significant clinical value for the differential diagnosis of verrucous proliferative skin diseases.
Humans ; Dermoscopy/methods* ; Diagnosis, Differential ; Microscopy, Confocal/methods* ; Male ; Female ; Adult ; Middle Aged ; Adolescent ; Keratosis, Seborrheic/pathology* ; Young Adult ; Warts/diagnosis* ; Child ; Aged ; Skin Diseases/pathology* ; Nevus, Sebaceous of Jadassohn/diagnosis* ; Skin Neoplasms/diagnosis* ; Child, Preschool

Objective To retrieve,analyze and synthesize evidence on post-transplant diabetes mellitus(PTDM)in lung transplant patients,providing reference for clinical healthcare professionals in preventing and managing PTDM in lung transplant patients.Methods Based on the"6S"evidence model,systematic searches were conducted across guideline websites,professional associations,and Chinese/English databases regarding post-transplant diabetes mellitus(PTDM)in lung transplant patients.The search period spanned from data-base inception to January 2025.Two researchers independently completed literature screening,quality assess-ment,and evidence extraction.Results A total of 14 articles were included,comprising 1 clinical decision,2 guidelines,5 expert consensuses,2 specifications,1 evidence summary,and 3 systematic reviews.Twenty-four pieces of best evidence were synthesized from seven aspects:risk factors,diagnosis,screening,prevention,treatment,glycemic control targets,and health education.Conclusion The best evidence for preventing and managing post-transplant diabetes mellitus in lung transplant patients provides an evidence-based foundation for clinical practice among healthcare professionals.Evidence should be selected and applied according to spe-cific clinical situations and patient needs.

Objective:The aim was to analyze key indicators for the diagnosis and treatment of chronic hepatitis B（CHB），including virus detection rate，standardized treatment rate，and loss to follow-up rate，in order to provide a basis for optimizing diagnosis and treatment plans，improve the diagnosis and treatment level of CHB，and improve patient prognosis.Methods:Patients with CHB admitted to the Guangzhou Eighth People′s Hospital Affiliated to Guangzhou Medical University from January 2024 to January 2025 were enrolled. The datas were collected and organized using Excel. Statistical analysis was conducted using SPSS 26.0 software，with a focus on evaluating core indicators such as virus detection rate，standardized treatment rate，and loss to follow-up rate.Results:The positive rate of hepatitis B surface antigen（HBsAg）in non-specific patients was 28.95%，the antiviral treatment rate in specialized patients was 90.78%，and the standardized antiviral drug conversion treatment rate in low-level viremia（LLV）patients was 61.45%. The standardized antiviral drug conversion treatment rates for high-risk patients with combined kidney/bone injuries were 72.75% and 74.40%，respectively. The overall dropout rate was 10.47%，with a dropout rate of 13.80% for LLV patients.Conclusions:The antiviral treatment coverage rates in CHB patients were over 90%，but in certain groups（such as LLV patients and those with kidney or bone injuries），the standardized treatment rates were still low and loss to follow-up rates were high，suggesting the need to improve HBV screening，treatment for special populations，and patient adherence.

Objective:A novel grass-root community screening and management model of hepatitis B was developed in order to improve the diagnosis and treatment rate of hepatitis B in Guangzhou city.Methods:A three-tier collaborative framework［tertiary hospitals-center for disease control and prevention（CDC）-primary care clinics］implemented dual-track screening（fixed-site+mobile units）using rapid hepatitis B surface antigen（HBsAg）testing and structured surveys. Digital closed-loop management integrated screening，referral，and follow-up. Data were analyzed via SPSS 26.0.Results:Among 30 012 community-dwelling adults screened（Male∶Female=1∶1.68），overall HBsAg positive rate was 5.21%（1 565/30 012），peaking in the 50-59-year cohort（ χ2=271.80， P<0.001）. Hepatitis B knowledge awareness was critically low（39.24%）. Of 140 referred HBsAg-positive individuals，15 chronic carriers required no immediate antiviral therapy per guidelines. Treatment linkage surged from 32.8%（41/125）to 86.4%（108/125）post-intervention. aMAP hepatocellular carcinoma（HCC）risk stratification（n=82）revealed low（36.6%），intermediate（32.9%），and high-risk（30.5%）profiles. Conclusions:This coordinated，digitally-enhanced strategy significantly improved hepatitis B detection and treatment access. However，persistent knowledge gaps underscore the imperative for targeted community education and adherence support.

Objective To investigate the status of feeding intolerance in patients with enteral nutrition after lung transplantation and analyze its influencing factors,to provide a reference for formulating a reasonable enteral nutrition plan and improving patients'nutritional status.Methods Convenient sampling method was used to retrospectively collect the clinical data of 115 patients who received enteral nutrition support after lung transplantation and were hospitalized in the ICU of a tertiary hospital in Guangdong Province from August 2022 to November 2023.According to the occurrence of feeding intolerance during ICU hospitalization,the patients were divided into a feeding tolerance group and a feeding intolerance group.Univariate and logistic regression analysis were used to analyze the influencing factors of feeding intolerance patients with enteral nutrition after lung transplantation.Results Within 7 days of initiating enteral nutrition,a total of 63 patients developed feeding intolerance,with an incidence of 54.78％.Among them,the incidence of feeding intolerance was relatively high within 1 to 3 days after initiating enteral feeding.The clinical manifestations of feeding intolerance were diarrhea,bloating,gastric retention,vomiting/regurgitation,among which the diarrhea was the highest incidence(87.30％).Logi-stic regression analysis showed that intraoperative net balance volume(OR=0.999),intraoperative blood transfusion(OR=1.001)volume and diabetes history(OR=0.170)were independent influencing factors for feeding intolerance in patients with enteral nutrition after lung transplantation(P＜0.05).Conclusion There was a high incidence of feed-ing intolerance in patients with enteral nutrition after lung transplantation.Patients undergoing lung transplantation who have a high net intraoperative fluid balance,receive a low volume of intraoperative blood transfusions,and have a history of diabetes are at a lower risk of developing feeding intolerance when receiving postoperative enteral nutrition.When starting enteral nutrition,medical staff should dynamically evaluate the risk factors of feeding intolerance,screen high-risk patients as early as possible,and formulate reasonable enteral nutrition programs to improve the nutritional status of patients and promote their rehabilitation.

Objective:To explore the effect of nursing scheme based on self-regulation theory (SRT) on self-efficacy and quality of life of patients with chronic pancreatitis, and to provide basis for better promoting patients′ rehabilitation.Methods:Using a non-random historical control study, 55 patients with chronic pancreatitis admitted to The Fifth Affiliated Hospital of Southern Medical University from November 2021 to October 2022 were classified as the control group, and 55 patients with chronic pancreatitis admitted from November 2022 to October 2023 were classified as the research group. The control group received routine nursing intervention, while the research group received SRT-based nursing intervention. Both groups received a 3-month intervention. The General Self-Efficacy Scale, Exercise of Self-Care Agency Scale, Self Rated Abilities for Health Practices Scale, and Gastrointestinal Quality of Life Index were used to evaluate the self-efficacy, self-care ability, health behavior, and quality of life of two groups before and after the intervention, and statistical comparisons were made.Results:Both groups of patients completed the study. There were 28 males and 27 females in the control group. The age was (45.33 ± 12.26) years old. There were 30 males and 25 females in the research group. The age was (45.48 ± 12.61) years old. After the intervention, the score of the self-efficacy in the research group was (29.32 ± 2.88) points, which was higher than that in the control group (19.28 ± 1.95) points, the difference was significant ( t=21.41, P<0.05). The scores of self-care skills, self-responsibility, self-concept, health knowledge and the total score of the self-care ability in the research group were (35.32 ± 2.31), (22.85 ± 1.42), (25.88 ± 1.93), (64.32 ± 5.22), (148.34 ± 8.33) points respectively. They were all higher than those of the control group (28.66 ± 1.77), (17.22 ± 1.23), (18.67 ± 1.86), (60.08 ± 4.52), (124.56 ± 8.92) points. The differences were significant ( t values were 4.55-22.23, all P<0.05). The scores of exercise, nutrition, health responsibility, psychological comfort and the total score of the health behavior in the research group were (25.58 ± 1.41), (25.02 ± 2.03), (24.31 ± 2.34), (25.16 ± 1.63), (100.05 ± 7.36) points respectively. They were all higher than those of the control group (22.31 ± 2.03), (20.15 ± 2.82), (20.16 ± 2.89), (21.15 ± 2.17), (83.79 ± 7.84) points. The differences were significant ( t values were 8.28-11.21, all P<0.05). The scores of social activity, psychological state, physiological function, self-conscious symptoms and the total score of the quality of life in the research group were (16.78 ± 1.26), (17.03 ± 1.85), (22.43 ± 1.96), (17.09 ± 0.88), (73.41 ± 4.22) points respectively. They were all higher than those of the control group (15.32 ± 1.15), (15.34 ± 1.76), (20.86 ± 1.59), (16.03 ± 0.75), (67.52 ± 4.18) points. The differences were significant ( t values were 4.61-7.35, all P<0.05). Conclusions:SRT-based nursing scheme can effectively improve the self-efficacy and self-care ability of patients with chronic pancreatitis, and improve their health behavior and quality of life.

Objective:To evaluate the short-term efficacy of surgical treatment for severe pulmonary stenosis(PS) in infants and young children, and to clarify the impact of different surgical timings on the efficacy of PS treatment.Methods:A retrospective analysis was conducted on 24 infants and young children who underwent surgical treatment for severe PS at the General Hospital of Northern Theater Command, PLA, from January 1, 2020, to October 1, 2024. Among them, 13 were males and 11 were females. The average weight of the patients was(9.2±3.6) kg, the average gestational age was(39.3±1.7) weeks, and the average age was(15.0±13.5) months. Preoperative clinical symptoms and signs(e.g., cyanosis, shortness of breath), transpulmonary valve pressure gradient(TPVPG), right ventricular systolic pressure(RVSP), and Em/Am were recorded. The patients were divided into two groups based on surgical timing: the infant group(under 1 year old, n=12) and the toddler group(1-3 years old, n=12).Results:There were no deaths among all patients. The postoperative ICU stay was significantly longer in the infant group compared to the toddler group( P<0.05). Compared to preoperative values, surgical treatment significantly improved TPVPG, reduced RVSP, and enhanced right ventricular diastolic function, which stabilized by 3 months postoperatively( P<0.05). Intergroup comparisons revealed that the infant group had significantly lower TPVPG at 6 months postoperatively compared to the toddler group. Additionally, right ventricular diastolic function improved significantly in the infant group postoperatively, while no significant improvement was observed in the toddler group. Younger age and reduced right ventricular diastolic function were identified as major risk factors for prolonged mechanical ventilation(>24 hours). Conclusion:Surgical treatment for PS during infancy and early childhood is safe and effective. Comprehensive preoperative evaluation is crucial, and early surgical intervention is recommended for patients with impaired right ventricular function to improve prognosis.

Objective To investigate the status of feeding intolerance in patients with enteral nutrition after lung transplantation and analyze its influencing factors,to provide a reference for formulating a reasonable enteral nutrition plan and improving patients'nutritional status.Methods Convenient sampling method was used to retrospectively collect the clinical data of 115 patients who received enteral nutrition support after lung transplantation and were hospitalized in the ICU of a tertiary hospital in Guangdong Province from August 2022 to November 2023.According to the occurrence of feeding intolerance during ICU hospitalization,the patients were divided into a feeding tolerance group and a feeding intolerance group.Univariate and logistic regression analysis were used to analyze the influencing factors of feeding intolerance patients with enteral nutrition after lung transplantation.Results Within 7 days of initiating enteral nutrition,a total of 63 patients developed feeding intolerance,with an incidence of 54.78％.Among them,the incidence of feeding intolerance was relatively high within 1 to 3 days after initiating enteral feeding.The clinical manifestations of feeding intolerance were diarrhea,bloating,gastric retention,vomiting/regurgitation,among which the diarrhea was the highest incidence(87.30％).Logi-stic regression analysis showed that intraoperative net balance volume(OR=0.999),intraoperative blood transfusion(OR=1.001)volume and diabetes history(OR=0.170)were independent influencing factors for feeding intolerance in patients with enteral nutrition after lung transplantation(P＜0.05).Conclusion There was a high incidence of feed-ing intolerance in patients with enteral nutrition after lung transplantation.Patients undergoing lung transplantation who have a high net intraoperative fluid balance,receive a low volume of intraoperative blood transfusions,and have a history of diabetes are at a lower risk of developing feeding intolerance when receiving postoperative enteral nutrition.When starting enteral nutrition,medical staff should dynamically evaluate the risk factors of feeding intolerance,screen high-risk patients as early as possible,and formulate reasonable enteral nutrition programs to improve the nutritional status of patients and promote their rehabilitation.

Objective:To evaluate the short-term efficacy of surgical treatment for severe pulmonary stenosis(PS) in infants and young children, and to clarify the impact of different surgical timings on the efficacy of PS treatment.Methods:A retrospective analysis was conducted on 24 infants and young children who underwent surgical treatment for severe PS at the General Hospital of Northern Theater Command, PLA, from January 1, 2020, to October 1, 2024. Among them, 13 were males and 11 were females. The average weight of the patients was(9.2±3.6) kg, the average gestational age was(39.3±1.7) weeks, and the average age was(15.0±13.5) months. Preoperative clinical symptoms and signs(e.g., cyanosis, shortness of breath), transpulmonary valve pressure gradient(TPVPG), right ventricular systolic pressure(RVSP), and Em/Am were recorded. The patients were divided into two groups based on surgical timing: the infant group(under 1 year old, n=12) and the toddler group(1-3 years old, n=12).Results:There were no deaths among all patients. The postoperative ICU stay was significantly longer in the infant group compared to the toddler group( P<0.05). Compared to preoperative values, surgical treatment significantly improved TPVPG, reduced RVSP, and enhanced right ventricular diastolic function, which stabilized by 3 months postoperatively( P<0.05). Intergroup comparisons revealed that the infant group had significantly lower TPVPG at 6 months postoperatively compared to the toddler group. Additionally, right ventricular diastolic function improved significantly in the infant group postoperatively, while no significant improvement was observed in the toddler group. Younger age and reduced right ventricular diastolic function were identified as major risk factors for prolonged mechanical ventilation(>24 hours). Conclusion:Surgical treatment for PS during infancy and early childhood is safe and effective. Comprehensive preoperative evaluation is crucial, and early surgical intervention is recommended for patients with impaired right ventricular function to improve prognosis.

Objective:To explore the effect of nursing scheme based on self-regulation theory (SRT) on self-efficacy and quality of life of patients with chronic pancreatitis, and to provide basis for better promoting patients′ rehabilitation.Methods:Using a non-random historical control study, 55 patients with chronic pancreatitis admitted to The Fifth Affiliated Hospital of Southern Medical University from November 2021 to October 2022 were classified as the control group, and 55 patients with chronic pancreatitis admitted from November 2022 to October 2023 were classified as the research group. The control group received routine nursing intervention, while the research group received SRT-based nursing intervention. Both groups received a 3-month intervention. The General Self-Efficacy Scale, Exercise of Self-Care Agency Scale, Self Rated Abilities for Health Practices Scale, and Gastrointestinal Quality of Life Index were used to evaluate the self-efficacy, self-care ability, health behavior, and quality of life of two groups before and after the intervention, and statistical comparisons were made.Results:Both groups of patients completed the study. There were 28 males and 27 females in the control group. The age was (45.33 ± 12.26) years old. There were 30 males and 25 females in the research group. The age was (45.48 ± 12.61) years old. After the intervention, the score of the self-efficacy in the research group was (29.32 ± 2.88) points, which was higher than that in the control group (19.28 ± 1.95) points, the difference was significant ( t=21.41, P<0.05). The scores of self-care skills, self-responsibility, self-concept, health knowledge and the total score of the self-care ability in the research group were (35.32 ± 2.31), (22.85 ± 1.42), (25.88 ± 1.93), (64.32 ± 5.22), (148.34 ± 8.33) points respectively. They were all higher than those of the control group (28.66 ± 1.77), (17.22 ± 1.23), (18.67 ± 1.86), (60.08 ± 4.52), (124.56 ± 8.92) points. The differences were significant ( t values were 4.55-22.23, all P<0.05). The scores of exercise, nutrition, health responsibility, psychological comfort and the total score of the health behavior in the research group were (25.58 ± 1.41), (25.02 ± 2.03), (24.31 ± 2.34), (25.16 ± 1.63), (100.05 ± 7.36) points respectively. They were all higher than those of the control group (22.31 ± 2.03), (20.15 ± 2.82), (20.16 ± 2.89), (21.15 ± 2.17), (83.79 ± 7.84) points. The differences were significant ( t values were 8.28-11.21, all P<0.05). The scores of social activity, psychological state, physiological function, self-conscious symptoms and the total score of the quality of life in the research group were (16.78 ± 1.26), (17.03 ± 1.85), (22.43 ± 1.96), (17.09 ± 0.88), (73.41 ± 4.22) points respectively. They were all higher than those of the control group (15.32 ± 1.15), (15.34 ± 1.76), (20.86 ± 1.59), (16.03 ± 0.75), (67.52 ± 4.18) points. The differences were significant ( t values were 4.61-7.35, all P<0.05). Conclusions:SRT-based nursing scheme can effectively improve the self-efficacy and self-care ability of patients with chronic pancreatitis, and improve their health behavior and quality of life.