Objective To explore the application effect of the dual-track nursing intervention model in the treatment process of children with lobar pneumonia.Methods A total of 186 children with lobar pneumonia were selected and randomly divided into control group and intervention group u-sing a double-blind method,with 93 cases in each group.The control group received conventional nursing intervention,while the intervention group implemented the dual-track nursing intervention model on the basis of conventional nursing.This model included the establishment and training of nurs-ing teams,personalized nursing plans,health education,and psychological support.Outside the hos-pital,it emphasized family support,regular follow-up guidance,and community-based collaborative ed-ucation.Both groups received a 3-week intervention.The improvement times of clinical symptoms,hos-pital stay,pulmonary function indicators before and after nursing,treatment compliance,and family members' satisfaction with nursing were compared and analyzed between the two groups.Results The fever resolution time[(3.89±0.96)d],cough relief time[(6.21±1.34)d],disappearance time of pulmonary rales[(7.89±1.56)d],and hospital stay duration[(9.45±1.89)d]in the intervention group were all shorter than those in the control group[(5.23±1.14),(7.45±1.67),(9.32±2.01),and(11.28±2.35)d,respectively],with statistically significant differences(P＜0.05).After nursing,the forced expiratory volume in one second(FEV1)[(1.51±0.22)L],forced vital capacity(FVC)[(1.75±0.25)L],and FEV1/FVC[(94.12±5.65)％]in the intervention group were all higher than those in the control group[(1.42±0.15)L,(1.66±0.22)L,and(85.73±8.41)％,respectively],with statistically significant differences(P＜0.05).The scores for exami-nation cooperation[(23.91±3.82)points],nursing cooperation[(24.19±4.03)points],standardized medication use[(24.26±3.94)points],and rational diet[(23.77±3.62)points]in the intervention group were higher than those in the control group[(20.16±3.53),(19.64±3.46),(23.05±3.68),and(18.85±3.41)points,respectively],with statistically significant differences(P＜0.05).The satisfaction rate of family members with nursing work in the intervention group was higher than that in the control group,with a statistically significant difference(98.92％versus 89.25％,P＜0.05).Conclusion The dual-track nursing intervention model has a signifi-cant application effect in children with lobar pneumonia.It can accelerate their recovery process,improve treatment compliance,promote pulmonary function improvement,and enhance family mem-bers' satisfaction.

Objective:To describe the clinical characteristics of a possible rare syndrome, the granulomatous mastitis(GM), erythema nodosum and arthritis syndrome (GMENA syndrome), by retrospective analyzing patients with both GM and erythema nodosum, with or without arthritis, and provide clinical evidence for further researchstudy.Methods:This study analyzed the demographic general information, clinical manifestations, laboratory tests results, medications, operations, and the first visits of cases collected from the Affiliated Hospital of Qingdao University between January 2015 and February 2024. All patients were diagnosed with both GM and erythema nodosum, with or without arthritis. The frequency, means and standard deviation were used to perform descriptive analysis.Results:Among the 22 cases, all of the GM were unilateral, and nodular erythema mainly appeared in both lower limbs 17 (77%). Eight (67%) patients had arthritis. Sixteen cases (80%) were reported forwith elevated white blood cells count, and 16 (84%) with elevated C-reactive protein level, 12(86%) patients were with elevated erythrocyte sedimentation rate. Two cases were associated with hyperprolactinemia. In the bacterial tests of the breast abscess, C orynebacterium kroppenstedtii, and one Staphylococcus epidermidis were detected in 1 case respectively. The department of breast surgery was the most frequently first visit (86%) medical service, and 14 cases (64%) visited the department of rheumatology and immunology. Four cases (18%) underwent abscess incision and drainage after ineffective medication and none of them were treated with glucocorticoids. Five cases with glucocorticoids and followed-up by the department of rheumatology and immunology were not operated and four in of them without recurrenc. Conclusion:GMENA syndrome may be a syndrome characterized by high inflammatory activity, cytokine activation, and often involves the breast, skin, and joint. The pathogenesis and treatment of this syndrome need to be investigated further.

Objective:To describe the clinical characteristics of a possible rare syndrome, the granulomatous mastitis(GM), erythema nodosum and arthritis syndrome (GMENA syndrome), by retrospective analyzing patients with both GM and erythema nodosum, with or without arthritis, and provide clinical evidence for further researchstudy.Methods:This study analyzed the demographic general information, clinical manifestations, laboratory tests results, medications, operations, and the first visits of cases collected from the Affiliated Hospital of Qingdao University between January 2015 and February 2024. All patients were diagnosed with both GM and erythema nodosum, with or without arthritis. The frequency, means and standard deviation were used to perform descriptive analysis.Results:Among the 22 cases, all of the GM were unilateral, and nodular erythema mainly appeared in both lower limbs 17 (77%). Eight (67%) patients had arthritis. Sixteen cases (80%) were reported forwith elevated white blood cells count, and 16 (84%) with elevated C-reactive protein level, 12(86%) patients were with elevated erythrocyte sedimentation rate. Two cases were associated with hyperprolactinemia. In the bacterial tests of the breast abscess, C orynebacterium kroppenstedtii, and one Staphylococcus epidermidis were detected in 1 case respectively. The department of breast surgery was the most frequently first visit (86%) medical service, and 14 cases (64%) visited the department of rheumatology and immunology. Four cases (18%) underwent abscess incision and drainage after ineffective medication and none of them were treated with glucocorticoids. Five cases with glucocorticoids and followed-up by the department of rheumatology and immunology were not operated and four in of them without recurrenc. Conclusion:GMENA syndrome may be a syndrome characterized by high inflammatory activity, cytokine activation, and often involves the breast, skin, and joint. The pathogenesis and treatment of this syndrome need to be investigated further.

Objective:To classify and analyze the immunological indicators of patients with unexplained recurrent pregnancy failure, and explore whether the immunological indicators of these patients were related to pregnancy failure.Methods:We retrospectively studied 91 patients who visited the Rheumatology and Immunology Department of the Affiliated Hospital of Qingdao University from January 2022 to June 2022 due to recurrent pregnancy failures, including recurrent spontaneous abortion and recurrent implantation failures (RIF). We adopted case-control study method. Analysis was conducted from two different perspectives: antinuclear antibody (ANA) positivity and natural killer (NK) cell elevation. Among them, there were 34 ANA positive patients and 57 ANA negative patients; 32 patients had normal NK cells and 59 had elevated NK cell. Clinical data, duration of infertility, number of miscarriages, number of biochemical pregnancies, number of recurrent implant failures, and other information from patients were collected. Immunological indicators included ANA, anti-extractable nuclear antigen antibody, antiphospholipid antibodies, peripheral blood lymphocyte subsets, complement, immunoglobulin, rheumatism, etc. Routine laboratory tests included blood routine, urine routine, liver and kidney function, etc. The results were statistically analyzed.Results:There were no statistically significant differences between the ANA-positive and negative groups in terms of the number of spontaneous abortion, the number of post-transplantation abortions, the total number of pregnancy failures, and previous gynecological and chronic diseases (all P>0.05). The number of no-implanting after transplantation in the ANA-positive group was 3.20±2.04, which was significantly higher than that in the ANA-negative group (1.47±0.96, P=0.004). The proportion of CD19 +B cells [(12.96±4.26)%] and CD3 -HLA -DR + activated B/NK cells [(14.58±5.45)%] in the ANA negative group were significantly higher than those in the ANA positive group [(10.23±3.54)%, P=0.007; (11.34±4.11)%, P=0.009]. There were no significant differences in the number of spontaneous abortion, the number of fetal abortion after transplantation and the total number of pregnancy failure between the normal NK cell group and the increased NK cell group (all P>0.05). Conclusion:The number of RIF in ANA positive patients is significantly increased. The relationship between NK cells and pregnancy failure is not clear yet.

Objective:To classify and analyze the immunological indicators of patients with unexplained recurrent pregnancy failure, and explore whether the immunological indicators of these patients were related to pregnancy failure.Methods:We retrospectively studied 91 patients who visited the Rheumatology and Immunology Department of the Affiliated Hospital of Qingdao University from January 2022 to June 2022 due to recurrent pregnancy failures, including recurrent spontaneous abortion and recurrent implantation failures (RIF). We adopted case-control study method. Analysis was conducted from two different perspectives: antinuclear antibody (ANA) positivity and natural killer (NK) cell elevation. Among them, there were 34 ANA positive patients and 57 ANA negative patients; 32 patients had normal NK cells and 59 had elevated NK cell. Clinical data, duration of infertility, number of miscarriages, number of biochemical pregnancies, number of recurrent implant failures, and other information from patients were collected. Immunological indicators included ANA, anti-extractable nuclear antigen antibody, antiphospholipid antibodies, peripheral blood lymphocyte subsets, complement, immunoglobulin, rheumatism, etc. Routine laboratory tests included blood routine, urine routine, liver and kidney function, etc. The results were statistically analyzed.Results:There were no statistically significant differences between the ANA-positive and negative groups in terms of the number of spontaneous abortion, the number of post-transplantation abortions, the total number of pregnancy failures, and previous gynecological and chronic diseases (all P>0.05). The number of no-implanting after transplantation in the ANA-positive group was 3.20±2.04, which was significantly higher than that in the ANA-negative group (1.47±0.96, P=0.004). The proportion of CD19 +B cells [(12.96±4.26)%] and CD3 -HLA -DR + activated B/NK cells [(14.58±5.45)%] in the ANA negative group were significantly higher than those in the ANA positive group [(10.23±3.54)%, P=0.007; (11.34±4.11)%, P=0.009]. There were no significant differences in the number of spontaneous abortion, the number of fetal abortion after transplantation and the total number of pregnancy failure between the normal NK cell group and the increased NK cell group (all P>0.05). Conclusion:The number of RIF in ANA positive patients is significantly increased. The relationship between NK cells and pregnancy failure is not clear yet.

OBJECTIVE To compare the phar macokinetics o f ligustrazine hydrochlori de，salvianic acid and rosemarinic acid from Shenxiong glucose injection （SGI）in normal and acute myocardial ischemia （AMI）rats. METHODS Male SD rats were randomly divided into normal group and model group ，with 9 rats in each group. AMI model was established by isoproterenol hydrochloride modeling method. Three rats in each group were selected for model verification. The remaining 6 rats in each group were given SGI （1.2 mL/kg）or equal volum of normal saline via tail vein ；0.3 mL blood was collected through orbital venous bush 0.083，0.167，0.333，0.5，0.75，1，1.5，2，3，5 h after administration. Using luteoloside as internal standard ，the plasma concentrations of ligustrazine hydrochloride ，salvianic acid and rosemarinic acid were determined by ultra performance liquid chromatography-tandem mass spectrometry. Pharmacokinetic parameters were fitted by WinNonlin 8.1 software，and statistical analysis was performed by SPSS 18.0 software. RESULTS The linear ranges of ligustrazine hydrochloride ，salvianic acid and rosmarinic acid were 0.06-29.96，0.01-5.15 and 0.006-3.09 μ g/mL（all r＞0.99），respectively. The results of methodological investigation were all in line with the requirements of Chinese Pharmacopoeia （2020 edition）. Compared with normal rats ，CLz of ligustrazine hydrochloride in AMI model rats was significantly increased （P＜0.05）；t1/2 and Vz of salvianic acid were significantly prolonged or increased （P＜0.05）；but the cmax and AUC 0－5 h were significantly decreased （P＜0.05）；AUC0－5 h of rosmarinic acid was significantly decreased （P＜0.05）. CONCLUSIONS The exposure levels of salvianic acid and rosmarinic acid in SGI are lower in AMI model rats than in normal rats ，and the elimination of ligustrazine hydrochloride in AMI model rats is stronger than that in normal rats.

Objective:To observe the clinical effect of four-point fixation in patients with posterior chamber intraocular lens dislocation.Methods:A retrospective case series study was adopted.Sixteen patients (16 eyes) with posterior chamber intraocular lens dislocation who underwent suture suspension techniques with four-point fixation in Changzhou No.2 people's Hospital from January 2015 to January 2018 were enrolled.Postoperative effects were observed during follow-up, ranging from 6 to 13 months.The preoperative and 6-month postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), corneal endothelium cell count and astigmatism were measured and the differences were compared, and the relationships between total astigmatism and corneal astigmatism or intraocular lens induced astigmatism were analyzed, and the postoperative position of intraocular lens and complications were observed.This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of Changzhou No.2 People's Hospital (No.2015-C-012-01).Written informed consent was obtained from each patient before surgery.Results:The mean preoperative UCVA (LogMAR) and BCVA (LogMAR) were 1.09±0.24 and 0.48±0.20, respectively, which were significantly improved to 0.30±0.12 and 0.26±0.13 at 6 months after operation, respectively.And the differences were statistically significant ( t=11.782, 3.795; both at P<0.01).The preoperative and 6-month postoperative corneal endothelium cell count were (2 270±360)/mm 2 and (2 032±327)/mm 2, respectively, and the difference was not significant ( t=1.921, P=0.074).The 6-month postoperative mean total astigmatism, corneal astigmatism and intraocular lens induced astigmatism were (-1.47±0.82)D, (-1.34±0.61)D and (-0.22±0.35)D, respectively.There was a highly positive correlation between total astigmatism and corneal astigmatism ( r=0.885, P<0.05), but there was no significant correlation between total astigmatism and intraocular lens induced astigmatism ( r=-0.432, P=0.095).No dislocation, deviation or torsion of intraocular lens were observed during the follow-up.Varying degree of symptoms of iridocyclitis were observed during early stage after operation, which disappeared after treatment.There were two cases of high intraocular pressure, which were normal after treatment.No retinal detachment, choroidal detachment, expulsive suprachoroidal hemorrhage, endophthalmitis, corneal endothelial decompensation or other complications occurred during and after operation. Conclusions:There is a stable position of intraocular lens, good visual acuity and few complications after four-point fixation with suture and suspension, which is a feasible method to treat dislocated intraocular lens.

OBJECTIVE：To provide reference for improving the quality standard of Rhizoma Bego niae from Guizhou . METHODS：Five batches of Rhizoma Begoniae from Guizhou were collected ，and the microscopic characteri stics of the Rhizoma Begoniae powder were observed. According to the corresponding methods in 2015 edition of Chinese Pharmacopoeia （part Ⅳ）， potent adenosine 50-triphosphate competitive phosphati - dylinositol-3-kinase/mammalian target of rapamycin inhibitors：discovery of compound 26（PKI-587），a highly effi cacious dual inhibitor Morpholine as a privileged structure ：a review on the me - dicinal chemistry and pharmacological activity of morpho - line containing bioactive molecules[J]. Med Res Rev ， qq.com 2019. DOI ：10.1002/med.21634. qualitative identification of Rhizoma Begoniae was conducted by TLC ，and the contents of moisture ，total ash and water-soluble extract in Rhizoma Begoniae were determined. The contents of rutin were determined by HPLC. RESULTS ：The powder of Rhizoma Begoniae medicinal materials was brown ，stone cells were square ，polygonal-like or irregular. There were many starch grains and few complex grains. The conduit ，calcium oxalate square crystal/cluster crystal were visible. The same fluorescence spots were found in the same location of TLC atlas of Rhizoma Begoniae control herb. The moisture ，total ash ，water-soluble extract contents were 10.15％-11.41％，8.70％-12.59％ and 16.91％-19.58％，respectively. The linear range of rutin were 18.47-147.8 μg/mL （r＝0.999 8）；RSDs of reproducibility ，intermediate precision and stability tests （8 h）were all lower than 3.0％；the average recoveries were 99.39％-100.29％（RSDs were 0.23％-2.59％，n＝3）；the contents of rutin in 5 batches of Rhizoma Begoniae were 0.102％-0.198％. CONCLUSIONS ：The contents of moisture and total ash shall not exceed 13.0％ and 14.0％ respectively， and the contents of water-soluble extract and rutin shall not be less than 15.0％ and 0.080％. The quality standard established in this study can be used for the quality control of Rhizoma Begoniae from Guizhou.

Objective? To define the difficulty coefficient of Operating Room nursing items which is suitable for difficulty evaluation and can represent the workload of Operating Room nursing. Methods? From January 2017 to March 2018, through literature review, questionnaire survey and expert demonstration meeting, the nursing work items and operational difficulty indicators suitable for difficulty evaluation in Operating Room were determined. The weight of difficulty indicators was determined by analytic hierarchy process. Fifteen experts were selected for three rounds of Delphi inquiry. The coefficients of difficulty were determined by weighted linear method. Results? Finally, the difficulty coefficients of 68 operating room nursing items were obtained. The top three difficulty coefficients were "position placement and observation of lateral traction bed (7.268 7)", "position placement and observation of fixed skull (7.254 0)" and "position and observation of skull-brain frame lateral decubitus position (7.243 3)"; the last three difficulty coefficients were "horizontal supine position placement and observation (2.178 2)" and "sterile sheet laying (2.046 0)" , "no-contact wearing of sterile gloves (1.000 0)". Conclusions? This study defines 68 difficulty coefficients of operating room nursing work items which are suitable for difficulty evaluation and can represent the workload of Operating Room nursing. It can quantify the difficulty of Operating Room nursing work items and enhance the rationality of Operating Room nursing workload counting.

Objective To analyze the precision and stability of optical surface imaging system for patients who received radiotherapy with active breath control. Methods Eighteen radiotherapy patients with lung metastasis were managed by active breath control (ABC).The difference error detected by optical surface imaging system and CBCT were defined as the precision of optical surface imaging system. The variation among the error of optical surface imaging positioning the value of correction of treatment position and the error detected by optical surface imaging again were defined as the stability of optical surface imaging system. Intrafractional errors were analyzed by optical surface imaging system through whole treatment process (including breath hold and free breath). Results The optical surface imaging system had precision (systematic (Σ) and random errors (σ)) of 1.78/3.42 mm 2.54/6.57 mm and 2.79/3.22 mm respectively and stability of2.12/2.54 mm 3. 09/4.02 mm and 1.37/3.55 mm respectively in lateral-medial superior-inferior and anterior-posterior directions. The intrafractional errors (Σ and σ) were 0.42/0.85 mm 0.41/1.47 mm and 0.41/1.47 mm respectively for breath hold duration and 4.76/4.16 mm 6.54/7.78 mm and 3.13/5.92 mm for free breath duration in lateral-medial superior-inferior and anterior-posterior directions. Conclusions As an effective method for validate breath hold;Optical surface imaging system can improve the precision and safety of active breath control. However,the factors that affect the accuracy and stability of the optical surface imaging system in patients undergoing radiotherapy with ABC are not clear;it cannot replace the CBCT for positioning verification.