Objective: To explore the effects of intergenerational parent-child separation on internalizing and externalizing behavioral problems among rural preschoolers aged 3-6 years, so as to provide empirical evidence for formulating targeted intervention strategies and blocking the intergenerational transmission of parent-child separation. Methods: From March to June, 2024, ten kindergartens were selected from rural areas of Nanling County, Wuhu City, Anhui Province, and 2 279 preschool children aged 3- 6 years, along with their fathers, mothers and primary caregivers, were recruited for survey by cluster convenient sampling method. Children s fathers and mothers reported their own childhood parent-child separation information separately. Information on the children s history of psychological and behavioral problems was reported by the primary caregivers. Information of internalizing and externalizing behavioral problems in preschool children was reported with Strengths and Difficulties Questionnaire (SDQ).The Chi square test was used to compare the differences in the detection rates of psychological and behavioral problems among children with different intergenerational continuity of parent-child separation. Binary Logistic regression model was applied to analyze the association between intergenerational continuity of parent-child separation and internalizing and externalizing behavioral problems in preschool children. Results: The detection rate of internalizing behavioral problems was 27.5% and externalizing behavioral problems was 19.1% among rural preschool children. There were significant differences in internalization behavior, externalization behavior, hyperactivity impulse and peer communication problems among preschool children in different types of parent-child separation groups( χ 2=14.29, 8.80, 17.26, 13.84, all P <0.05). Binary Logistic regression analysis showed that after adjusting for covariates such as children s gender, birth weight, and delivery mode, compared with children without separation, intergenerational continuity of parent-child separation group( OR =1.95), only child separation( OR =1.74) were associated with significant higher risk of conduct problems(both P ＜0.05). Parent-child separation intergenerational continuation groups( OR =1.68), only child separation( OR = 1.47) were associated with significant higher risk of peer problems(both P ＜0.05). Both types of parent-child separation experiences significantly increased the risk of children s prosocial behavior problems，among them, the intergenerational continuation group was 1.99 times that of the control group ( OR =1.99), and the childhood only separation group was 2.09 times that of the control group ( OR =2.09)(both P ＜0.05). Compared with children whose parents and children had no experience of parent-child separation, children in the intergenerational continuation group of parent-child separation had increased risks of both internalizing and externalizing behavior problems ( OR =1.53, 1.65, both P <0.05). Conclusion All types of parent-child separation are associated with internalizing and externalizing behavioral problems among rural children aged 3 to 6 years.

Anti-leucine-rich glioma-inactivated 1 （anti-LGI1） antibody autoimmune encephalitis is a relatively common type of limbic encephalitis，and its etiology remains unclear. It is rare for two individuals with a blood relationship to both suffer from encephalitis with positive anti-LGI1 antibodies. This article reports two sisters who lived in different counties and were diagnosed with anti-LGI1 antibody autoimmune encephalitis successively. The two sisters were diagnosed at an age of 64 and 65 years， respectively. During the course of the disease， both patients had epileptic seizures and slow response， but with different clinical manifestations. They had similar results of cranial magnetic resonance imaging and positive anti-LGI1 antibodies in cerebrospinal fluid and serum. The two patients were treated with glucocorticoid shock therapy and gamma globulin infusion during hospitalization，and both patients had a good prognosis. Recent studies have shown that anti-LGI1 antibody encephalitis is associated with genetic susceptibility.For patients with anti-LGI1 antibody encephalitis， it is necessary to inquire about family history and summarize the features of this type of disease， in order to provide better help for clinical practice.

Objective To systematically evaluate the efficacy and safety of traditional Chinese medicine (TCM) compound in treating pulmonary nodules, providing evidence-based medical evidence for TCM intervention in pulmonary nodules. Methods Computer search of PubMed, CNKI, Wanfang, VIP, and SinoMed was conducted to select randomized controlled trials (RCTs) of TCM compound intervention in pulmonary nodules, with the retrieval time from the inception to November 29, 2023. The Cochrane bias risk assessment tool was used to evaluate the quality of the included studies, and Review Manager 5.4 was used for Meta-analysis. Results A total of 18 RCTs were included, covering 8 provinces across the country, with a total sample size of 1301 patients. The TCM compounds used in the included studies all incorporated the method of dissolving phlegm and dissipating nodules. There was a high risk of bias uncertainty in the included studies. Meta-analysis results suggested that TCM compound could significantly reduce the diameter of pulmonary nodules [MD=−1.41, 95%CI (−1.70, −1.13), P<0.001], decrease the number of nodules [MD=−0.37, 95%CI (−0.73, −0.01), P=0.05], alleviate clinical symptoms [MD=−4.84, 95%CI (−6.04, −3.64), P<0.001], and improve lung function [forced expiratory volume in one second (FEV1), MD=0.55, 95%CI (0.09, 1.01), P=0.02; FEV1/forced vital capacity, MD=6.12, 95%CI (4.47, 7.78), P<0.001]. However, there was no statistically significant difference in the probability of malignancy between the experimental group and the control group [MD=−0.01, 95%CI (−0.01, 0.00), P=0.09]. Conclusion TCM compound can significantly reduce the diameter of pulmonary nodules, decrease the number of nodules, alleviate clinical symptoms, and improve lung function, but future multicenter, large-sample, high-quality RCTs are still needed to further explore and verify this conclusion.

Objective: The CT/MRI Liver Imaging Reporting and Data System (LI-RADS) demonstrates high specificity with relatively limited sensitivity for diagnosing hepatocellular carcinoma (HCC) in high-risk patients. This study aimed to explore the possibility of improving sensitivity by combining CT/MRI LI-RADS v2018 with second-line contrast-enhanced ultrasound (CEUS) LI-RADS v2017 using sulfur hexafluoride (SHF) or perfluorobutane (PFB). Materials and Methods: This retrospective analysis of prospectively collected multicenter data included high-risk patients with treatment-naive hepatic observations. The reference standard was pathological confirmation or a composite reference standard (only for benign lesions). Each participant underwent concurrent CT/MRI, SHF-enhanced US, and PFB-enhanced US examinations. The diagnostic performances for HCC of CT/MRI LI-RADS alone and three combination strategies (combining CT/ MRI LI-RADS with either LI-RADS SHF, LI-RADS PFB, or a modified algorithm incorporating the Kupffer-phase findings for PFB [modified PFB]) were evaluated. For the three combination strategies, apart from the CT/MRI LR-5 criteria, HCC was diagnosed if CT/MRI LR-3 or LR-4 observations met the LR-5 criteria using LI-RADS SHF, LI-RADS PFB, or modified PFB. Results: In total, 281 participants (237 males; mean age, 55 ± 11 years) with 306 observations (227 HCCs, 40 non-HCC malignancies, and 39 benign lesions) were included. Using LI-RADS SHF, LI-RADS PFB, and modified PFB, 20, 23, and 31 CT/MRI LR-3/4 observations, respectively, were reclassified as LR-5, and all were pathologically confirmed as HCCs. Compared to CT/MRI LI-RADS alone (74%, 95% confidence interval [CI]: 68%–79%), the three combination strategies combining CT/MRI LI-RADS with either LI-RADS SHF, LI-RADS PFB, or modified PFB increased sensitivity (83% [95% CI: 77%–87%], 84% [95% CI: 79%–89%], 88% [95% CI: 83%–92%], respectively; all P < 0.001), while maintaining the specificity at 92% (95% CI: 84%–97%). Conclusion The combination of CT/MRI LI-RADS with second-line CEUS using SHF or PFB improved the sensitivity of HCC diagnosis without compromising specificity.

Objective:To develop a training program for emergency airway management capabilities of anesthesia nurses based on a virtual simulation platform and to validate its effectiveness, providing a reference for airway training of anesthesia nurses.Methods:A quasi-experimental study was conducted. A total of 60 anesthesia nurses in Nanjing Drum Tower Hospital from August 2022 to August 2023 were selected as the research objects by convenience sampling method. According to the random number table method, they were divided into the control group and the experimental group, with 30 nurses in each group. The two groups had the same theoretical training. As for the operational training, the control group was taught by case combined with ordinary simulator, and the experimental group was taught by case combined with virtual simulation platform. The theoretical scores, skill operation scores, and satisfaction degree with airway management emergency response training were compared between the two groups of anesthesia nurses.Results:There were 4 males and 26 females in the control group, aged (24.37 ± 1.45) years. There were 6 males and 24 females in the experimental group, aged (24.20 ± 1.22) years.The theoretical scores and skill operation scores of the experimental group were 89.20 ± 3.99 and 90.10 ± 4.45, respectively, both higher than those of the control group, which were 84.83 ± 4.64 and 85.30 ± 5.64, showing statistically significant differences ( t=-3.91, -3.66, both P<0.05). In the self-evaluation of satisfaction degree with airway management emergency response training, the experimental group scored (16.67±1.79) for theoretical knowledge mastery, 18.37 ± 1.73 for skill operation mastery, 19.07 ± 1.17 for enthusiasm in airway training, 18.43 ± 1.48 for initiative in self-learning, and 18.00 ± 1.51 for the engagement of course design, all higher than 13.67 ± 2.17, 14.37 ± 2.34, 13.37 ± 2.63, 12.30 ± 3.51, and 12.77 ±2.71 in the control group, respectively. The differences were statistically significant ( t values were -10.83 to -5.84, all P<0.05). Conclusions:The airway management emergency training curriculum for nurse anesthetists developed based on a virtual simulation platform improved their theoretical knowledge and practical skills in airway emergency management. Additionally, satisfaction across various aspects of the training was markedly enhanced, providing a valuable reference for airway management training of nurse anesthetists and demonstrating considerable potential for clinical implementation.

Autoimmune oophoritis is a rare cause of primary ovarian insufficiency(POI), and some patients may also have concurrent adrenal insufficiency. This condition significantly impairs reproductive function and is often difficult to distinguish from common causes of POI, leading to missed or incorrect diagnoses. This paper reports a case of autoimmune oophoritis treated in our department and provides an updated summary of recent advances in the understanding of this condition, with the aim of raising clinical awareness and improving diagnostic accuracy among healthcare professionals.

Objective:To evaluate the effect of acupuncture on postoperative delirium (POD) in diabetic patients undergoing surgery under general anesthesia.Methods:In this randomized controlled trial, 92 diabetic patients of either sex, aged 30-80 yr, with a body mass index of 18-28 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, scheduled for elective surgery under general anesthesia, were divided into 2 groups ( n=46 each) using a table of random numbers: control group (group C) and acupuncture group (group A). Group A received acupuncture at the Baihui (GV20), Shenting (GV24) and Sishencong (EX-HN1) acupoints before anesthesia. The needles were retained for 30 min, with manual stimulation applied every 10 min for 10 s each time. After 4 stimulations, routine anesthesia was carried out. Group C received routine anesthesia only. Regional cerebral oxygen saturation was recorded on admission to the operating room (T 0), after anesthesia induction (T 1), at the start of surgery (T 2), at the end of surgery (T 3), and immediately after tracheal extubation (T 4). The POD developed within 3 days after surgery was assessed. The occurrence of needle-related adverse effects such as fainting, subcutaneous bleeding, and local paresthesia was recorded. Results:Compared with group C, the incidence of POD was significantly reduced, and the regional cerebral oxygen saturation was increased at T 1, 4 in group A ( P<0.05). Conclusions:Acupuncture can decrease the development of POD in diabetic patients undergoing surgery under general anesthesia, which is related to an increase in regional cerebral oxygen saturation.

Autoimmune oophoritis is a rare cause of primary ovarian insufficiency(POI), and some patients may also have concurrent adrenal insufficiency. This condition significantly impairs reproductive function and is often difficult to distinguish from common causes of POI, leading to missed or incorrect diagnoses. This paper reports a case of autoimmune oophoritis treated in our department and provides an updated summary of recent advances in the understanding of this condition, with the aim of raising clinical awareness and improving diagnostic accuracy among healthcare professionals.

Objective To explore the prediction value of peripheral blood circular RNA_0001449 combined with ABCD3-Ⅰ score on cerebral infarction after TIA.Method According to the occurrence of cerebral infarction 90 days after TIA,204 patients diagnosed with TIA for the first time were divided into cerebral infarction progression group and non-cerebral infarction group.The clinical data,ABCD3-Ⅰ score and peripheral blood circular RNA_0001449 expression level of the two groups were compared.The Logistic multivariate regression model analyzed the risk factors of cerebral infarction in TIA patients.ROC curve was used to analyze the predictive value of ABCD3-Ⅰscore and peripheral blood circular RNA_0001449 expression level on cerebral infarction of TIA patients.Results The fasting blood glucose level,ABCD3-Ⅰ score and peripheral blood circular RNA_0001449 expression of cerebral infarction progression group were significantly higher than those of non-cerebral infarction group(all P＜0.05).Logistic multivariate regression analysis showed that increased ABCD3-Ⅰ score and increased peripheral blood circular RNA_0001449 expression were risk factors for cerebral infarction of TIA patients(OR=1.975,95％CI:1.352-2.883,P＜0.001;OR=22.475,95％CI:1.460-345.868,P=0.026).ROC curve analysis showed that the area under the curve(AUC)of ABCD3-Ⅰ score and peripheral blood RNA_0001449 expression independently predict cerebral infarction of TIA patients were 0.805 and 0.840,respectively(all P＜0.05),the AUC of combination prediction was 0.881(P＜0.05).The AUC of combination prediction was significantly higher than that of ABCD3-Ⅰ score and peripheral blood RNA_0001449 expression independent prediction(Z=4.851,P=0.011;Z=4.236,P=0.018).Conclusion Peripheral blood circular RNA_0001449 combined with ABCD3-Ⅰscore has predictive value for cerebral infarction 90 d after the onset of TIA.

Lung cancer is one of the malignant tumours with the highest morbidity and mortality rates worldwide today, posing a major threat to human health. Accurate diagnosis and standardised treatment play a crucial role in improving the survival rate of lung cancer patients. In recent years, the rapid rise of artificial intelligence (AI) has brought about significant changes in the medical field, providing a new diagnostic and treatment model for lung cancer, and making a series of breakthroughs in lung cancer diagnostic imaging, pathological diagnosis, surgical oncology, radiotherapy, and drug development and treatment. This article introduces the current status of AI application in the field of lung cancer diagnosis and treatment, and extensively discusses the current challenges and future prospects, hoping to provide references and suggestions for future clinical practice.