Objective To explore the impact of enteral nutrition formula containing slow-release starch on blood glucose variability and prognosis in patients with severe acute pancreatitis(SAP).Methods A total of 204 SAP patients were enrolled and randomly divided into control group and ob-servation group using a random number table method,with 102 patients in each group.The control group received early enteral nutrition support with a standard enteral nutrition formula,while the ob-servation group received early enteral nutrition support with an enteral nutrition formula containing slow-release starch.Blood glucose variability indicators[largest amplitude of glycemic excursions(LAGE),standard deviation of blood glucose(SDBG),blood glucose coefficient of variation(BGCV),mean blood glucose(MBG),mean amplitude of glycemic excursions(MAGE),and time in range(TIR)]were compared between the two groups after treatment,along with clinical indicators during hospitalization,inflammatory markers[procalcitonin,C-reactive protein,interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)],and nutritional indicators(albumin,prealbumin)levels.Kaplan-Meier analysis was conducted to assess the prognosis of the two groups,and multivariate Cox regression analysis was performed to identify factors influencing prognosis.Results After treat-ment,the observation group exhibited lower levels of MBG,LAGE,SDBG,BGCV,MAGE,and a higher TIR compared with the control group(P＜0.05).During hospitalization,the observation group had a shorter duration of enteral nutritiontherapy,lower insulin usage,and lower incidence rates of multiple organ failure and infectious pancreatic necrosis compared with the control group(P＜0.05).After treatment,the observation group had lower levels of procalcitonin,C-reactive protein,IL-6,and TNF-α compared with the control group(P＜0.05);however,there were no statistically significant differences in albumin and prealbumin levels between the two groups(P＞0.05).Kaplan-Meier analysis showed that the cumulative mortality rate in the observation group was 12.75％,which was lower than the 17.65％in the control group(Log-rank x2=4.361,P=0.037).Multivariate Cox regression analysis revealed that TIR after treatment(HR=0.920;95％CI,0.869 to 0.974)was an independent protective factor for prognosis in SAPpatients(P＜0.05),while infectious pancreatic necrosis(HR=4.269;95％CI,1.922 to 9.482)was an inde-pendent risk factor for prognosis in SAP patients(P＜0.05).Conclusion Enteral nutrition formu-la containing slow-release starch helps stabilize blood glucose variability,control inflammatory mark-er levels,improve nutritional status,and prognosis in SAP patients.Both TIR and infectious pancre-atic necrosis are closely related to the prognosis of SAP patients.

Medical ultrasound technology is widely used for diagnosis and therapy in clinical practice.Ultrasound probes,which are directly contact with patients,pose a potential risk of pathogen transmission.This expert consen-sus was developed by a multidisciplinary team based on international guidelines,standards in China,and the results of a national survey,aiming to reduce the risk of healthcare-associated infection through standardizing reprocessing of medical ultrasound probes,and formulating consensus recommendations with the Delphi method.The consensus clarifies the reprocessing principles for three types of ultrasound probes of different infection risks:external-use ul-trasound probes,interventional percutaneous ultrasound probes,and internal-use ultrasound probes,puts forward systematic suggestions on the reprocessing standards and disinfection levels of ultrasound probe isolation covers and coupling agents,the reprocessing procedures and methods of ultrasound probes,as well as architectural layout and management of reprocessing,so as to provide a scientific prevention and control framework for ensuring ultrasound diagnosis and therapy safety.

Medical ultrasound technology is widely used for diagnosis and therapy in clinical practice.Ultrasound probes,which are directly contact with patients,pose a potential risk of pathogen transmission.This expert consen-sus was developed by a multidisciplinary team based on international guidelines,standards in China,and the results of a national survey,aiming to reduce the risk of healthcare-associated infection through standardizing reprocessing of medical ultrasound probes,and formulating consensus recommendations with the Delphi method.The consensus clarifies the reprocessing principles for three types of ultrasound probes of different infection risks:external-use ul-trasound probes,interventional percutaneous ultrasound probes,and internal-use ultrasound probes,puts forward systematic suggestions on the reprocessing standards and disinfection levels of ultrasound probe isolation covers and coupling agents,the reprocessing procedures and methods of ultrasound probes,as well as architectural layout and management of reprocessing,so as to provide a scientific prevention and control framework for ensuring ultrasound diagnosis and therapy safety.

Objective:To construction the risk factors associated with prolonged hospitalization in patients with severe acute pancreatitis (SAP) and develop a prediction model for assessing these risks.Methods:SAP patients admitted to the department of emergency of Hebei Province Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2015 to December 2023 were retrospectively selected as the study subjects. The 75% of hospital stay was used as the cut-off point, and the patients were categorized into a normal group and an extended group. Clinical indicators of patients were collected, and independent risk factors for prolonged hospital stay in SAP patients were analyzed using multifactor Logistic regression. A prediction model was established, and a nomogram was created. The efficiency of the prediction model was evaluated using a receiver operator characteristic curve (ROC curve). The accuracy of the model was assessed using Hosmer-Lemeshow goodness-of-fit test. Decision curve analysis (DCA) was employed to evaluate the clinical applicability of the model. Finally, internal validation of the model was conducted using Bootstrap method.Results:A total of 510 patients with SAP were included, and the length of hospital stay was 18 (6, 44) days, including 400 cases in the normal group (<24 days) and 110 cases in the extended group (≥24 days). Multivariate Logistic regression analysis showed that abdominal effusion [odds ratio ( OR) = 4.163, 95% confidence interval (95% CI) was 2.105-8.234], acute physiology and chronic health evaluation Ⅱ (APACHEⅡ; OR = 1.320, 95% CI was 1.185-1.470), C-reactive protein (CRP; OR = 1.006, 95% CI was 1.002-1.011), modified CT severity index (MCTSI; OR = 1.461, 95% CI was 1.213-1.758), procalcitonin (PCT; OR = 1.303, 95% CI was 1.095-1.550) and albumin ( OR = 0.510, 95% CI was 0.419-0.622) were independent risk factors for prolonged hospital stay in SAP patients (all P < 0.01). ROC curve analysis showed that the area under the curve (AUC) of the model was 0.922 (95% CI was 0.896-0.947), the optimal cut-off value was 0.726, the sensitivity was 87.3%, and the specificity was 85.3%. Hosmer-Lemeshow test showed that χ 2 = 5.79, P = 0.671. It showed that the prediction model had good prediction efficiency and fit degree. The DCA curve showed that the prediction probability of the model could bring more clinical benefits to patients at 0.1 to 0.7. Bootstrap internal verification showed that the model had a high consistency (AUC = 0.916). Conclusions:Abdominal effusion, high APACHEⅡ score, high CRP, high MCTSI, high PCT and low albumin level are significantly associated with prolonged hospital stay in SAP patients. The prediction model can help clinicians make more scientific clinical decisions for SAP patients.

Objective To investigate the effect of semaglutide on the prognosis in patients with unstable angina complicated with diabetes after percutaneous coronary intervention.Methods A total of 178 patients with unstable angina complicated with diabetes diagnosed in Zhengzhou Cardiovascular Hospital from September 1,2022 to March 31,2023 were included.The patients were divided into a study group(43 patients)and a control group(135 patients)according to whether they received semiglutide or not.Changes in HbA1c,fasting blood glucose,body weight,blood pressure and blood lipid were observed before and after treatment.Baseline data and differences in postoperative adverse cardiovascular events including cardiovascular death,all-cause death,acute myocardial infarction,acute ischemic stroke,re-hospitalization due to unstable angina,and coronary revasculariza-tion were compared between the two groups.Results After 12 weeks of treatment,fasting blood-glucose levels in the study group and the control group were(6.0±0.9),(8.5±1.3)mmol/L,HbA1c levels were(6.5±0.7)%,(7.9±0.5)%,BMI was(22.8±3.0),(25.0±2.4)kg/m2,systolic blood pressure was(135.3±9.7),(141.5±8.3)mmHg,respectively,with significant differences(P＜0.05 for all comparisons).Diastolic blood pressure showed a trend of improvement(84.7±7.7),(86.6±7.7)mmHg,but there was no statistical difference.Conclu-sions For patients with unstable angina complicated with diabetes after percutaneous coronary intervention,the application of semaglutide can effectively control blood glucose,body weight,systolic blood pressure,and reduce the risk of cardiovascular events.

Objective To explore the mediating effect of self-efficacy on the relationship between coping styles and care burden among primary caregivers of elderly patients after hip replacement surgery.Methods A convenient sampling method was employed to enrol the primary caregivers of patients who received hip replacement surgery in a Grade ⅢA hospital between October 2022 and July 2023.A total of 260 caregivers were surveyed using the general self-efficacy scale,simple coping style questionnaire and Zarit care burden scale.A structural equation model was used to analyse the mediating effect of self-efficacy on the relationship between coping style and care burden.Results Toally 253 caregivers completed the study.The study had found that the mean self-efficacy among the primary caregivers scored(27.7±5.6),the positive coping score was(33.7±7.7),and the total care burden score was(34.4±10.2).Self-efficacy exhibited a positive correlation with the positive coping styles(r=0.550,P<0.05)and a negative correlation with the care burden(r=-0.427,P<0.05).The Bootstrap test revealed that self-efficacy mediated the relationship between coping styles and care burden,with a mediating effect of-0.232(95％CI:-0.359,-0.121),accounting for 47.02％of the total effect.Conclusion The self-efficacy of primary caregivers is moderate.It predominantly characterised by positive coping strategies.The coping strategies of primary caregivers work through their self-efficacy.

Objective To investigate the effect of semaglutide on the prognosis in patients with unstable angina complicated with diabetes after percutaneous coronary intervention.Methods A total of 178 patients with unstable angina complicated with diabetes diagnosed in Zhengzhou Cardiovascular Hospital from September 1,2022 to March 31,2023 were included.The patients were divided into a study group(43 patients)and a control group(135 patients)according to whether they received semiglutide or not.Changes in HbA1c,fasting blood glucose,body weight,blood pressure and blood lipid were observed before and after treatment.Baseline data and differences in postoperative adverse cardiovascular events including cardiovascular death,all-cause death,acute myocardial infarction,acute ischemic stroke,re-hospitalization due to unstable angina,and coronary revasculariza-tion were compared between the two groups.Results After 12 weeks of treatment,fasting blood-glucose levels in the study group and the control group were(6.0±0.9),(8.5±1.3)mmol/L,HbA1c levels were(6.5±0.7)%,(7.9±0.5)%,BMI was(22.8±3.0),(25.0±2.4)kg/m2,systolic blood pressure was(135.3±9.7),(141.5±8.3)mmHg,respectively,with significant differences(P＜0.05 for all comparisons).Diastolic blood pressure showed a trend of improvement(84.7±7.7),(86.6±7.7)mmHg,but there was no statistical difference.Conclu-sions For patients with unstable angina complicated with diabetes after percutaneous coronary intervention,the application of semaglutide can effectively control blood glucose,body weight,systolic blood pressure,and reduce the risk of cardiovascular events.

Objective To explore the mediating effect of self-efficacy on the relationship between coping styles and care burden among primary caregivers of elderly patients after hip replacement surgery.Methods A convenient sampling method was employed to enrol the primary caregivers of patients who received hip replacement surgery in a Grade ⅢA hospital between October 2022 and July 2023.A total of 260 caregivers were surveyed using the general self-efficacy scale,simple coping style questionnaire and Zarit care burden scale.A structural equation model was used to analyse the mediating effect of self-efficacy on the relationship between coping style and care burden.Results Toally 253 caregivers completed the study.The study had found that the mean self-efficacy among the primary caregivers scored(27.7±5.6),the positive coping score was(33.7±7.7),and the total care burden score was(34.4±10.2).Self-efficacy exhibited a positive correlation with the positive coping styles(r=0.550,P<0.05)and a negative correlation with the care burden(r=-0.427,P<0.05).The Bootstrap test revealed that self-efficacy mediated the relationship between coping styles and care burden,with a mediating effect of-0.232(95％CI:-0.359,-0.121),accounting for 47.02％of the total effect.Conclusion The self-efficacy of primary caregivers is moderate.It predominantly characterised by positive coping strategies.The coping strategies of primary caregivers work through their self-efficacy.

OBJECTIVE: To explore the clinical and genetic characteristics of two children with developmental delay. METHODS: Two children who had presented at the Children's Hospital Affiliated to Shandong University on August 18, 2021 were enrolled as the study subjects. Clinical and laboratory examination, chromosomal karyotyping and high-throughput sequencing were carried out for both children. RESULTS: Both children had a 46,XX karyotype. High-throughput sequencing showed that they have respectively carried a c.489delG (p.Q165Rfs*14) and a c.1157_1158delAT (p.Y386Cfs*22) frameshifting variant of the CTCF gene, both had a de novo origin and were unreported previously. CONCLUSION The CTCF gene variants probably underlay the development delay in the two children. Above discovery has enriched the mutational spectrum of the CTCF gene and has important implications for revealing the genotype-phenotype correlation for similar patients.
Child ; Humans ; Developmental Disabilities/genetics* ; High-Throughput Nucleotide Sequencing ; Intellectual Disability/genetics* ; Karyotyping ; Mutation

Objective:To observe any therapeutic effect of combining botulinum toxin type A (BTX-A) with rehabilitation training in treating Parkinson′s disease (PD) patients with striatal foot deformity (SFD).Methods:A total of 68 PD patients with SFD were randomly divided into a control group and a treatment group. Both groups were given routine medication with pramipexole and dopamine receptor agonists and received lower limb rehabilitation training, including passive activity training, strength training and walking training. The treatment group was additionally injected with BTX-A. Sciatic pain was quantified using a visual analogue scale. The Unified Parkinson′s Disease Rating Scale-lower limb motor lower limb motor function (UPDRS-LLM) scale, the Berg balance scale and the modified Barthel index were applied to test all of the participants before the experiment and on the 7th, 14th and 30th day of the treatment.Results:The average scores of the control group on all of measures at were significantly better than those of the control group at the same time points, and by the 14th and 30th day had improved significantly compared with those before treatment.Conclusion:Supplementing rehabilitation training with BTX-A can significantly improve foot deformity and relieve the muscle tension and spastic pain of PD patients with SFD, promoting the motor functioning of their lower limbs, their balance and their performance in the activities of daily living.