Objectives: . Considerable research has been focused on independent predictors of difficult laryngeal exposure (DLE) during suspension laryngoscopy. However, previous studies have yielded inconsistent results and conclusions. Consequently, we performed a meta-analysis of the existing literature with the aim of identifying significant parameters for a standardized preoperative DLE prediction system. Methods: . We systematically retrieved articles from the PubMed, Embase, Web of Science, China National Knowledge Infrastructure, and Wanfang databases up to October 2022. Data from eligible studies were extracted and analyzed using the R programming language. The effect measures included odds ratios (ORs) with 95% confidence intervals (CIs) for dichotomous variables and mean differences (MDs) with 95% CIs for continuous variables. Results: . The search yielded 1,574 studies, of which 18 (involving a total of 2,263 patients) were included. Pooled analysis demonstrated that patients with DLE during microsurgery tended to be male (OR, 1.73; 95% CI, 1.16–2.57); were older (MD, 5.47 years, 95% CI, 2.44–8.51 years); had a higher body mass index (BMI; MD, 1.19 kg/m2; 95% CI, 0.33–2.05 kg/m2); had a greater neck circumference (MD, 2.50 cm; 95% CI, 1.56–3.44 cm); exhibited limited mouth opening (MD, −0.52 cm; 95% CI, −0.88 to −0.15 cm); had limited neck flexibility (MD, −10.05 cm; 95% CI, −14.10 to −6.00 cm); displayed various other anatomical characteristics; and had a high modified Mallampati index (MMI) or test score (OR, 3.37; 95% CI, 2.07–5.48). Conclusion . We conducted a comprehensive and systematic analysis of the factors relevant to DLE. Ultimately, we identified sex, age, BMI, neck circumference, MMI, inter-incisor gap, hyomental distance, thyromental distance, sternomental distance, and flexion-extension angle as factors highly correlated with DLE.

Objective To explore the mediating effect of sleep duration on the relationship between qi stagnation constitution and anxiety/depression in junior high school students.Methods From March 20 to March 31,2020,a total of 10,325 students from 6 junior high schools in Henan,Liaoning,Shaanxi,Shandong,and Fujian provinces were sampled by cluster sampling.Firstly,the general conditions(age,gender,grade,hometown,whether they are an only child)and sleep duration were collected,and their qi stagnation constitution,depression and anxiety status were evaluated by using the Qi Stagnation Subscale in the"TCM Constitution Classification and Judgment Scale",the Patient Health Questionnaire(PHQ-9)and the Generalized Anxiety Disorder(GAD-7).Secondly,Spearman correlation analysis was used to explore the correlation between qi stagnation constitution,sleep duration,and anxiety/depression.Then,linear regression analysis and mediating effect test were used to explore the relationship between qi stagnation constitution and anxiety/depression in junior high school students,and the mediating effect of sleep duration was analyzed,and the results were verified.Results(ⅰ)The detection rate of anxiety in non-only children was higher than that of only children(x2=11.198,P=0.001);The detection rate of anxiety(x2=106.967,P＜0.001)or depression(x2=84.692,P＜0.001)was higher among senior students than those in lower grades,while those of girls with anxiety(x2=100.441,P＜0.001)or depression(x2=71.418,P＜0.001)were higher than those of boys.The detection rates of anxiety(x2=1 092.298,P＜0.001)and depression(x2=866.740,P＜0.001)in qi stagnation constitution students were higher than those of non-qi stagnation constitution students,and the detection rates of anxiety(x2=1 076.716,P＜0.001)and depression(x2=1 099.725,P＜0.001)in students whose sleep duration less than 8 h were higher than those of whose sleep duration more than 8 h,and the shorter the sleep duration,the higher the detection rate.(ⅱ)Qi stagnation constitution positively predicted anxiety/depression(β=0.679,P＜0.001;β=0.718,P＜0.001),and sleep duration had a negative predictive effect on anxiety/depression(β=-0.403,P＜0.001;β=-0.439,P＜0.001).(ⅲ)Sleep duration played a partial mediating role in the relationship between qi stagnation constitution and anxiety/depression in junior high school students,and the mediating effect accounted for 13.40％and 13.79％of the total effect,respectively.Conclusion Although qi stagnation constitution mainly affects anxiety/depression through direct effect,it can still be partially indirectly realized through the mediating variable of sleep duration,that is,the shorter the sleep duration,the higher the risk of anxiety/depression in junior high school students.Therefore,the mental health problems of junior high school students can be prevented and improved by regulating qi stagnation constitution and ensuring adequate sleep duration.

Objective To develop and evaluate a questionnaire in knowledge,attitude and practices for the patients with dry eye disease in order to provide an evaluation tool for investigation of the status about the knowledge,attitude and practices among the patients. Methods Between January and May 2022,an initial questionnaire item pool was established through literature review and analysis,together with the group discussions based on the theoretic model of knowledge,attitude and practices. A total of 12 medical and nursing experts participated in the two rounds of Delphi expert consultations. Based on the results of consultation,an initial questionnaire was modified and developed. Between June and December 2022,190 patients with dry eye disease in our hospital were selected by convenience sampling to evaluate the reliability and validity of the questionnaire. Results Based on the included 9 pieces of literature and the results from the 3 group discussions,a preliminary questionnaire was developed with 3 dimensions and 44 items. After the first round of consultation,five items were revised,and 10 items were omitted. The second round of consultation achieved consensus among the experts. A predictive pilot questionnaire containing 34 items across three dimensions of knowledge,attitude and practice was then formulated. The Kendall's concordance coefficients in the two rounds of consultation were 0.346 and 0.413,respectively (both P<0.001),with an authority coefficient of 0.90. 176 patients completed the survey in the discrimination analysis by high and low score groups,one entry that did not meet the criteria was removed. Structural validity was then analysed by exploratory factor analysis. Five common factors with eigenvalue>1 were extracted by principal component analysis,and the cumulative contribution rate of variance was 65.677％. Item 8 of the knowledge dimension was removed due to a double load. In the content validity analysis,the item level validity was 0.92-1.00,and the scale level validity was 0.94-1.00. The Cronbach's α coefficient was 0.894,and the test-retest reliability was 0.987. The finalised evaluation questionnaire consisted of 32 items,including knowledge sub-dimension 1 (knowledge about dry eye disease),knowledge sub-dimension 2 (risk factors of dry eye disease),attitude sub-dimension 1 (prevention and control attitude for dry eye disease),and attitude sub-dimension 2 (self-management attitude of dry eye disease),as well as the behaviour dimension (prevention and control behaviour for dry eye disease). Conclusion The questionnaire developed by Delphi method demonstrates good reliability and validity. Therefore,it can be used as a tool in the investigation of the status of knowledge,attitude and practice of the patients with dry eye disease.

Objective To develop and evaluate a questionnaire in knowledge,attitude and practices for the patients with dry eye disease in order to provide an evaluation tool for investigation of the status about the knowledge,attitude and practices among the patients. Methods Between January and May 2022,an initial questionnaire item pool was established through literature review and analysis,together with the group discussions based on the theoretic model of knowledge,attitude and practices. A total of 12 medical and nursing experts participated in the two rounds of Delphi expert consultations. Based on the results of consultation,an initial questionnaire was modified and developed. Between June and December 2022,190 patients with dry eye disease in our hospital were selected by convenience sampling to evaluate the reliability and validity of the questionnaire. Results Based on the included 9 pieces of literature and the results from the 3 group discussions,a preliminary questionnaire was developed with 3 dimensions and 44 items. After the first round of consultation,five items were revised,and 10 items were omitted. The second round of consultation achieved consensus among the experts. A predictive pilot questionnaire containing 34 items across three dimensions of knowledge,attitude and practice was then formulated. The Kendall's concordance coefficients in the two rounds of consultation were 0.346 and 0.413,respectively (both P<0.001),with an authority coefficient of 0.90. 176 patients completed the survey in the discrimination analysis by high and low score groups,one entry that did not meet the criteria was removed. Structural validity was then analysed by exploratory factor analysis. Five common factors with eigenvalue>1 were extracted by principal component analysis,and the cumulative contribution rate of variance was 65.677％. Item 8 of the knowledge dimension was removed due to a double load. In the content validity analysis,the item level validity was 0.92-1.00,and the scale level validity was 0.94-1.00. The Cronbach's α coefficient was 0.894,and the test-retest reliability was 0.987. The finalised evaluation questionnaire consisted of 32 items,including knowledge sub-dimension 1 (knowledge about dry eye disease),knowledge sub-dimension 2 (risk factors of dry eye disease),attitude sub-dimension 1 (prevention and control attitude for dry eye disease),and attitude sub-dimension 2 (self-management attitude of dry eye disease),as well as the behaviour dimension (prevention and control behaviour for dry eye disease). Conclusion The questionnaire developed by Delphi method demonstrates good reliability and validity. Therefore,it can be used as a tool in the investigation of the status of knowledge,attitude and practice of the patients with dry eye disease.

Objective:To explore the research trends, research advances and future orientations in the field of inflammatory bowel disease (IBD), so as to inform future researches.Methods:Web of Science database was searched from 2000 to 2021. CiteSpace software was used for visual and quantitative analysis.Results:A total of 3 582 articles were included. Publications on nutrition science in IBD showed a rising trend. The United States ranked first according to number of publications by country, the University of Toronto ranked first by institution, Inflammatory Bowel Diseases ranked first by journal and Li J from Nanjing University was the very author with the highest number of relevant publications. Research hotspots mainly focused on risk, gut microbiota and pediatric population. Research fronts mainly focused on the gut microbiota. Conclusion:Visual analysis shows the research trend in the field of nutrition in IBD, with gut microbiota as the research hotspots in the future.

Objective:To evaluate the reporting quality of diagnostic radiological imaging case reports published in Chinese science citation database (CSCD) imaging journals.Methods:This study was a cross-sectional survey. We searched CSCD to include imaging journals from 2021 to 2022, from which we retrieved diagnostic radiological imaging case reports published in 2020, and evaluated their reporting quality using case reports (CARE) reporting criteria.Results:A total of five imaging CSCD journals were searched, with 161 final diagnostic imaging case reports included. The median and interquartile range reporting rate of the included studies was 33.5% (7.5%, 93.3%), and patient perspective and informed consent were not reported in all studies. Items with reporting rates below 10% included 3a (abstract-introduction), 3c (abstract-diagnoses, therapeutic interventions, and outcomes), 8b (diagnostic challenges), and 8d (prognosis where applicable), with reporting rates of 2.5% (4/161), 0.6% (1/161), 0.6% (1/161), and 4.3% (7/161), respectively. Reporting rates for items between 10% and 50% included 3b (abstract-main symptoms and/or important clinical findings), 4 (introduction), 5c (medical, family, and psycho-social history), 7 (timeline), 10 (follow-up and outcomes), and 11a (a scientific discussion of the strengths and limitations), with reporting rates of 16.8% (27/161), 30.4% (49/161), 34.2% (55/161), 24.8% (40/161), 32.9% (53/161), and 31.7% (51/161), respectively; The reporting rates for item 1 (title), item 2 (keywords), item 5a (identified patient specific information), item 5b (primary concerns and symptoms of the patient), item 8a (diagnostic testing), and item 11c (the scientific rationale for any conclusions) were all over 90%. Moreover, the number of authors as well as the number of disciplines were not associated with the quality of diagnostic imaging case reports.Conclusions:The overall adherence to CARE items in radiographic diagnostic case reports published in the CSCD imaging journals is low. Editors of the imaging journals, radiologists and the researchers of the reporting standard should emphasize the guidelines for drafting case reports and improve the quality of reporting of case reports.

Hepatocellular carcinoma (HCC) is the most common malignant tumors of liver. Rational treatment in early stage of HCC can significantly increase the survival rate of patients. Detection of early-stage liver lesions through diffusion-weighted imaging, diffusion kurtosis imaging, incoherent motion within voxels, magnetic resonance spectroscopy imaging, dynamic contrast-enhanced imaging, or other functional imaging can accurately evaluate grade of malignancy and guide towards the curative effect of different treatment schemes. Volumetric interpolated breath-hold examination (VIBE) with three techniques, namely, CAIPIRINHA, Dixon, and TWIST, i.e., CDT-VIBE sequence can provide multiple sets of arterial phase images in a short time, and detect small foci transient enhancement that cannot be detected by other examinations, and the differences in initial enhancement phase of apparent lesions are of great significance for suggesting hemodynamic characteristics. In addition, magnetic resonance imaging predicts microvascular invasion of HCC, i.e., indirectly predicts HCC lesions recurrence rate, and overall survival time after liver transplantation. This article reviews the current research progress of magnetic resonance imaging technology in HCC.

Objective To determine the relationship among structural empowerment, occupational benefit and job embeddedness of nurses, and to analysis the role of occupational benefit in structural empowerment and job embeddedness. Methods A total of 422 nurses recruited from five tertiary hospitals in Tianjin. They were investigated with General Information Questionnaire, Condition of the Work Effectiveness Condition Questionnaire, Nurses' Occupational Benefit Scale and the Work Embedded Scale. Results The mean scores of nurses' work efficiency condition questionnaire, occupational benefit, and job embeddedness were (3.14 ± 0.88), (4.27 ± 0.53), (3.64 ± 0.677) points respectively. Structural empowerment, occupational benefit and job embeddedness were positively correlated (r=0.646, 0.536, 0.521, P<0.01);The nurses structural empowerment had significant prediction effect on work engagement (β=0.646, P<0.01),occupational benefit was a partial intermediary between structural empowerment and job embedding. Conclusion Through reasonable authorization, nursing managers actively guide nurses' sense of benefit, improve the close integration of nurses and organizations, then improve the level of nurses' work embedding.

Objective To understand the current situation of pediatric nurses' perceived stress,coping style and professional burnout,analyze the influence of pediatric nurses' perceived stress and coping styles on professional burnout,and to provide references for reducing pediatric nurses' professional burnout.Methods A questionnaire survey was conducted on 415 pediatric nurses from 9 tertiary level A hospitals in Tianjin using general information questionnaires,Chinese Perceived Stress Scale(CPSS),Simplified Coping Style Questionnaire (SCSQ),and Maslach Burnout Inventory(MBI).Results Pediatric nurses'MBI scores were divided into emotional exhaustion score (25.19 ± 9.98) points,depersonalization total score (10.70 ± 4.65) points,personal achievement sense (29.72 ± 9.62) points,and higher degree of burnout.Correlation analysis showed that the perceived stress was positively correlated with emotional exhaustion and depersonalization dimensions,and negatively correlated with the dimension of personal accomplishment (r =0.398,0.236,-0.388,P ＜0.01);positive coping dimensions were negatively correlated with emotional exhaustion and depersonalization dimensions,and positively correlated with the dimension of personal accomplishment(r =-0.544,-0.205,0.608,P＜0.01);negative coping dimensions and emotional depletion and depersonalization dimensions were positively correlated,and negatively correlated with individual achievement dimension (r =0.559,0.298,-0.652,P ＜0.01).Multiple stepwise regression analysis showed that perceived stress and negative coping style had influence on emotional exhaustion,depersonalization,and individual achievement dimension.Positive coping style had influence on emotional exhaustion and personal achievement dimension (R2=0.105-0.501,P＜0.01).Conclusions Pediatric nurses have higher professional burnout.Perceived stress and coping styles have an impact on professional burnout.Pediatric nurses should take more active measures to relieve perceived stress and reduce burnout.

Objective To evaluate the reliability and validity of hepatocellular carcinoma (HCC)using the liver imaging reporting and data system (LI-RADS).Methods By using the LI-RADS v2013.1,two radiologists evaluated 1 62 patients with cirrhosis or with a risk of HCC according to an inclusion criteria.The Kappa value was used to evaluate the consistency between two different diagnoses and was compared with pathological and follow-up results.The accuracy of the LI-RADS was assessed including sensitivi-ty,specificity,positive predictive value,negative predictive value,positive likelihood ratio,negative likelihood ratio and accuracy rating.Results In all 1 62 patients,there were HCCs in 97 patients including 7 patients belonging to the LR3,benign diseases in 50,and other kinds of malignancy in 1 5.The Kappa value was 0.882 (P =0.000)between two observers on LI-RADS grading. The sensitivity,specificity and accuracy rating of LI-RADS grading in diagnosing HCC was 100.00%,91.30%,and 97.06%,re-spectively.Conclusion The LI-RADS has high consistency and stability in evaluation and diagnosis of HCC by enhanced CT.LR3 di-agnosis should be cautious because of a susceptible development to HCC,which can be improved through the combination of clinic and laboratory examination.