Objective: To analyze the characteristics of pediatric pesticide poisoning cases admitted to a children s hospital in Jiangxi Province, so as to provide references for the prevention and treatment of pediatric pesticide poisoning. Methods: Medical records of 349 pesticide poisoning hospitalized cases from 2009 to 2023 in a children s hospital in Jiangxi Province were retrospectively reviewed to summarized clinical features, categories of pesticides involved, therapeutic interventions, and prognostic outcomes. Results: Among the cases of pesticide poisoning in children, there were 217 boys and 132 girls with an average age of 4 years and 8 months; 35.82% of cases occurred during April-June, followed by 27.22% during July-September, during October-December accounting for 22.35%, with 14.61% during January-March. There were 75 (21.49%), 148 (42.41%), 126 cases ( 36.10% ) during 2009-2013, 2014-2018, 2019-2023. In terms of pesticide type, insecticides ranked first (166 cases, 47.56% ), followed by herbicides (116 cases, 33.24%) and rodenticides (58 cases, 16.62%). The average hospitalization time was 4 days, and a total of 73 cases (20.92%) required admission to the intensive care unit among pesticide poisoning cases. There were 11 deaths, including 6 cases who were associated with paraguat esposure of paraquat. Self poisoning accounted for 34 cases, with an average age of 12 years and 2 months; 50.00% (17 cases) were concentrated in 2022-2023, accounting for 64.71% (22 cases) in girls; 8 cases of self poisoning resulted in death, accounting for 72.73% of the total number of deaths. Conclusions The period of April to June repesents the peak time for pediatric pesticide poisoning cases, and the proportion of accidental ingestion is relatively high. It is necessary to strictly prevent child poisoning.

Object:To explore the feasibility of using artificial intelligence for quality control of echocardiographic images.Methods:Retrospectively，5 000 two-dimensional echocardiographic video images within the period from 2021 to 2023 were randomly retrieved from the echocardiography database of Nanjing Drum Tower Hospital，Affiliated Hospital of Medical School，Nanjing University. Among these selected images，1 559 of them were apical views. The physician team formulated the scoring rules，which specifically included four scoring criteria：gain，scaling ratio，cardiac axis angle，and structure. Subsequently，the data were labeled with view classification and image quality scores. The labeled data were further partitioned into the training set（ n = 643），the validation set（ n = 276），and the test set（ n = 640）. The training and validation sets were utilized for constructing the models for view classification and quality assessment，while the test set was employed to verify the models' effectiveness. The view classification module was implemented using the SlowFast model，and the quality assessment module involved algorithms such as ResNet，Video Swin Transformer，SSD，and U-Net. Results:The average accuracy，precision，recall rate and F1 score of the classification model in identifying each apical view were 0.987 1，0.983 0，0.987 1 and 0.984 9 respectively，and the inference time was（333.4 ± 105.4）ms. The average accuracies of the quality assessment module in terms of gain，scaling ratio，cardiac axis angle and display of main structures were 0.915 1，0.928 2，0.938 7 and 0.965 6 respectively，and the overall scoring accuracy was 0.912 7.Conclusions:The echocardiogram quality control system developed in this research can effectively classify and evaluate the quality of two-dimensional images of the apical views in echocardiograms. Moreover，it guarantees the objectivity，timeliness and high-efficiency of quality control，which has reference value for the establishment of the echocardiogram quality control system.

Objective:To construct a functional exercise intervention programme for breast cancer surgery patients and investigate the application effect, in order to provide a reference for improving patients′ postoperative functional exercise adherence based on the Patient Health Engagement (PHE) model.Methods:Using a randomised controlled trial method, 122 breast cancer surgery patients admitted to the First People′s Hospital of Tai′an were selected by convenience sampling from December 2023 to April 2024, and were divided into 61 cases each in the control group and the intervention group using the random number table method. The control group received routine intervention, while the intervention group received functional exercise intervention based on the PHE model on the basis of the control group, and the patients were observed on postoperative days 7, 30, and 60 days for the functional exercise adherence, health literacy, shoulder joint mobility and edema of the affected limb.Results:Each of the 2 groups eventually completed the study with 58 female cases with 3 cases fell off. The patients in the control group aged (54.84 ± 9.47) years. The patients in the intervention group aged (55.66 ± 7.29) years. After the intervention, the postoperative adherence scores of patients in the control group were (50.48 ± 4.87), (45.45 ± 4.44), and (41.93 ± 4.34) at 7, 30, and 60 days after surgery, respectively, which were lower than those of the intervention group (55.84 ± 3.98), (50.62 ± 3.87), (45.91 ± 4.09), the difference between two groups was significant ( t=-6.49, -6.69, -5.09, all P<0.05). There were statistically significant differences in adherence scores between groups, time and interactions ( F=40.48, 1 096.00, 7.14, all P<0.05). As for the healthy belief, the control group scored (80.22 ± 8.28), (82.84 ± 11.56), (86.79 ± 11.42), and (88.05 ± 11.06) before intervention, at 7, 30, and 60 days after surgery, and the difference in time was statistically significant when compared with the scores of the intervention group at the same time, which were (80.26 ± 9.08), (84.55 ± 9.52), (87.66 ± 7.97), and (89.31 ± 7.09) ( F=31.60, P<0.05). Shoulder mobility scores in the control group were (5.02 ± 1.16), (7.16 ± 1.23), (8.91 ± 1.08) at 7, 30, and 60 days after surgery, respectively, which were lower than those in the intervention group (6.02 ± 1.03), (7.69 ± 1.14), and (10.10 ± 1.05), the difference between two groups was significant ( t=-4.90, -2.43, -6.00, all P<0.05), and the differences in shoulder mobility scores among groups, time, and interaction were all statistically significant ( F=34.19, 558.40, 3.98, all P<0.05). At 60 days after surgery, a total of 2 cases (3.45%) of patients in the control group developed moderate or severe affected limb lymphedema and 0 cases in the intervention group, and the difference was statistically significant in comparison ( χ2=6.03, P<0.05). Conclusions:The functional exercise intervention based on the PHE model can effectively improve the functional exercise compliance and healthy belief of patients undergoing breast cancer surgery, reduce postoperative limb edema, improve shoulder joint motion, and promote postoperative recovery.

Objective:To construct a functional exercise intervention programme for breast cancer surgery patients and investigate the application effect, in order to provide a reference for improving patients′ postoperative functional exercise adherence based on the Patient Health Engagement (PHE) model.Methods:Using a randomised controlled trial method, 122 breast cancer surgery patients admitted to the First People′s Hospital of Tai′an were selected by convenience sampling from December 2023 to April 2024, and were divided into 61 cases each in the control group and the intervention group using the random number table method. The control group received routine intervention, while the intervention group received functional exercise intervention based on the PHE model on the basis of the control group, and the patients were observed on postoperative days 7, 30, and 60 days for the functional exercise adherence, health literacy, shoulder joint mobility and edema of the affected limb.Results:Each of the 2 groups eventually completed the study with 58 female cases with 3 cases fell off. The patients in the control group aged (54.84 ± 9.47) years. The patients in the intervention group aged (55.66 ± 7.29) years. After the intervention, the postoperative adherence scores of patients in the control group were (50.48 ± 4.87), (45.45 ± 4.44), and (41.93 ± 4.34) at 7, 30, and 60 days after surgery, respectively, which were lower than those of the intervention group (55.84 ± 3.98), (50.62 ± 3.87), (45.91 ± 4.09), the difference between two groups was significant ( t=-6.49, -6.69, -5.09, all P<0.05). There were statistically significant differences in adherence scores between groups, time and interactions ( F=40.48, 1 096.00, 7.14, all P<0.05). As for the healthy belief, the control group scored (80.22 ± 8.28), (82.84 ± 11.56), (86.79 ± 11.42), and (88.05 ± 11.06) before intervention, at 7, 30, and 60 days after surgery, and the difference in time was statistically significant when compared with the scores of the intervention group at the same time, which were (80.26 ± 9.08), (84.55 ± 9.52), (87.66 ± 7.97), and (89.31 ± 7.09) ( F=31.60, P<0.05). Shoulder mobility scores in the control group were (5.02 ± 1.16), (7.16 ± 1.23), (8.91 ± 1.08) at 7, 30, and 60 days after surgery, respectively, which were lower than those in the intervention group (6.02 ± 1.03), (7.69 ± 1.14), and (10.10 ± 1.05), the difference between two groups was significant ( t=-4.90, -2.43, -6.00, all P<0.05), and the differences in shoulder mobility scores among groups, time, and interaction were all statistically significant ( F=34.19, 558.40, 3.98, all P<0.05). At 60 days after surgery, a total of 2 cases (3.45%) of patients in the control group developed moderate or severe affected limb lymphedema and 0 cases in the intervention group, and the difference was statistically significant in comparison ( χ2=6.03, P<0.05). Conclusions:The functional exercise intervention based on the PHE model can effectively improve the functional exercise compliance and healthy belief of patients undergoing breast cancer surgery, reduce postoperative limb edema, improve shoulder joint motion, and promote postoperative recovery.

Object:To explore the feasibility of using artificial intelligence for quality control of echocardiographic images.Methods:Retrospectively，5 000 two-dimensional echocardiographic video images within the period from 2021 to 2023 were randomly retrieved from the echocardiography database of Nanjing Drum Tower Hospital，Affiliated Hospital of Medical School，Nanjing University. Among these selected images，1 559 of them were apical views. The physician team formulated the scoring rules，which specifically included four scoring criteria：gain，scaling ratio，cardiac axis angle，and structure. Subsequently，the data were labeled with view classification and image quality scores. The labeled data were further partitioned into the training set（ n = 643），the validation set（ n = 276），and the test set（ n = 640）. The training and validation sets were utilized for constructing the models for view classification and quality assessment，while the test set was employed to verify the models' effectiveness. The view classification module was implemented using the SlowFast model，and the quality assessment module involved algorithms such as ResNet，Video Swin Transformer，SSD，and U-Net. Results:The average accuracy，precision，recall rate and F1 score of the classification model in identifying each apical view were 0.987 1，0.983 0，0.987 1 and 0.984 9 respectively，and the inference time was（333.4 ± 105.4）ms. The average accuracies of the quality assessment module in terms of gain，scaling ratio，cardiac axis angle and display of main structures were 0.915 1，0.928 2，0.938 7 and 0.965 6 respectively，and the overall scoring accuracy was 0.912 7.Conclusions:The echocardiogram quality control system developed in this research can effectively classify and evaluate the quality of two-dimensional images of the apical views in echocardiograms. Moreover，it guarantees the objectivity，timeliness and high-efficiency of quality control，which has reference value for the establishment of the echocardiogram quality control system.

Background: and Purpose Previous studies suggested increased visit-to-visit variability of total cholesterol (TC) is associated with stroke. This study aimed to investigate the associations of various lipids measurements variability and the risk of stroke and stroke type (ischemic and hemorrhagic stroke). Methods: Fifty-one thousand six hundred twenty participants in the Kailuan Study without history of myocardial infarction, stroke, and cancer who underwent three health examinations during 2006 to 2010 were followed for incident stroke. Variability in TC, triglycerides, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) measurements were measured using the coefficient of variation (CV), standard deviation (SD), variability independent of the mean (VIM), and average real variability (ARV). Results: During a median of 6.04 years of follow-up, 1,189 incident stroke (1,036 ischemic and 160 hemorrhagic stroke) occurred. In the multivariable-adjusted model, the hazard ratio (HR) comparing participants in the highest versus lowest quartile of CV of HDL-C were 1.21 (95% confidence interval [CI], 1.02 to 1.45; P for trend=0.013) for ischemic stroke. The highest quartile of CV of LDL-C was associated with 2.17-fold risk of hemorrhagic stroke (HR, 2.17; 95% CI, 1.25 to 3.75; P for trend=0.002) compared with the lowest quartile. We did not observe any significant association between TC and triglycerides variability with any of stroke. Consistent results were obtained when calculating variability index using SD, VIM, or ARV. Conclusions These findings suggest the high visit-to-visit HDL-C and LDL-C variability were associated with an increased incidence of ischemic and hemorrhagic stroke, respectively.

Objective To investigate the detection rates of cervical cancer and cervical precancerous lesions in rural women in Jiangsu province and to provide evidence for the prevention and treatment of cervical cancer.Methods According to the differences in economic geography,and the allocation of health resources,according to the project implementation status,data integrity and cervical cancer screening methods,two cancer screening program were randomly selected from rural women in Liuhe in south of Jiangsu,Qidong in center of Jiangsu,and Sihong in north of Jiangsu,the detection rate of cervical precancerous lesions,and the project of cervical cancer screeningdata were analyzed from 2014 to 2015.Results The average detection rate of cervical cancer among rural women in Jiangsu province from 2014 to 2015 was 35.23/10 million,the average detection rate of cervical precancerous lesions of 49.20/10 million.The detection rate of cervical carcinoma was the highest in Sihong(58.65/10 million),the minimum was six county (18.72/10 million),and cervical cancer detection rate was 26.02/10 million in Qidong.Conclusion The average detection rate of cervical cancer among rural women in Jiangsu province is higher than that of some provinces and cities,but is still lower than high incidence provinces.The detection rate of cervical cancer in Sihong county is relatively high,which may be related with underdeveloped economic in the region,and the spread of cervical cancer screening work is late and women~ health awareness is weak.

Objective To investigate the detection rates of cervical cancer and cervical precancerous lesions in rural women in Jiangsu province and to provide evidence for the prevention and treatment of cervical cancer.Methods According to the differences in economic geography,and the allocation of health resources,according to the project implementation status,data integrity and cervical cancer screening methods,two cancer screening program were randomly selected from rural women in Liuhe in south of Jiangsu,Qidong in center of Jiangsu,and Sihong in north of Jiangsu,the detection rate of cervical precancerous lesions,and the project of cervical cancer screeningdata were analyzed from 2014 to 2015.Results The average detection rate of cervical cancer among rural women in Jiangsu province from 2014 to 2015 was 35.23/10 million,the average detection rate of cervical precancerous lesions of 49.20/10 million.The detection rate of cervical carcinoma was the highest in Sihong(58.65/10 million),the minimum was six county (18.72/10 million),and cervical cancer detection rate was 26.02/10 million in Qidong.Conclusion The average detection rate of cervical cancer among rural women in Jiangsu province is higher than that of some provinces and cities,but is still lower than high incidence provinces.The detection rate of cervical cancer in Sihong county is relatively high,which may be related with underdeveloped economic in the region,and the spread of cervical cancer screening work is late and women~ health awareness is weak.

Objective To investigate the effects of penehyclidine hydrochloride(PHC)precon-ditioning on hepatic ischemia-reperfusion injury (HIRI)in rats.Methods Fifty-four male Sprague-Dawley rats,weighing 230-250 g,were randomly divided into three groups (n =18 each):sham op-eration group (group S),HIRI group (group HR)and penehyclidine hydrochloride group (group PHC).In group S,the hepatoduodenal ligaments of rats were only pulled and separated,then abdo-mens were closed.In group HR,an atraumatic vascular clip was placed on the vessels blocking the portal venous blood supply to the median and left lateral lobes of the liver for 45 minutes,which re-sulted in approximately 70% rat liver ischemia injury.In group PHC,the rats were treated with 0.45 mg/kg penehyclidine hydrochloride at 30 minutes before the portal venous and hepatic arterial were blocked like group HR.Animals were killed at 2 h (T1 ,n =6),4 h (T2 ,n =6),24 h (T3 ,n =6) after HIRI or sham surgery.Liver tissues and blood samples were taken for analysis.The serum con-centration of ALT and AST were measured as the markers of hepatic functional damage.The TNF-a and IL-1βconcentration were measured by the enzyme linked immunosorbent assay (ELISA)tech-nique.The endothelial nitric oxide synthase (eNOS ) and hypoxia-inducible factor (HIF-1α) expression were measured by immunohistochemical staining.Results Compared with group S,the expressions of ALT,AST,TNF-αand IL-1βin groups HR and PHC increased at T1-T3 (P <0.05), which were similar to the change trend of HIR-1αand eNOS expressions (P <0.05).Compared with group HR,the expression of ALT,AST,TNF-αand IL-1βin group PHC decreased at T1-T3 (P <0.05).Nevertheless expression of HIF-1αand eNOS of groups HR and HPC were increased than that of group S,and experssion of HIF-1αand eNOS of group HPC were increased than that of group HR at T1 and T2 (P < 0.05 ).Conclusion PHC preconditioning can protect the liver from HIRI.The mechanism may be associated with the up-regulation of eNOS and HIF-1α,as well as reducing the in-flammatory response.

Objective To discuss some expectation on reform of classroom teaching method for eight-year program medical education, in order to provide a basis for the evaluation and reform of classroom teaching method. Methods Investigation that mainly included expectation on reform of classroom teaching method, classroom teaching method of most expected application, and ex-pected value of classroom teaching method was investigated and analyzed with self-made question-naire, to total 78 medical students (22 of Grade 2008, 20 of Grade 2009, 20 of Grade 2010, 16 of Grade 2011) of eight-year program who had completed the stage before medical education in the uni-versity, and related 32 teachers. Software of SPSS 20.0 was used to make statistical analysis. Results In the survey, 55.8% students and 78.1% teachers hoped to reform the current classroom teaching methods (χ2=4.782,P=0.029). 61%students and 90.6% teachers expected comprehensive application of diverse method(χ2=15.464,P=0.017), including instruction combined with writing on blackboard, teaching by multimedia, PBL, inversion-type class, independent learning, a lot of questions for exami-nation, and so on. The value expectation (>60%) of classroom teaching method was multivariate, in-cluding to stimulate students' interest in learning, to cultivate ability of finding and solving problems, conducive to understanding of knowledge and memory, conducive to comprehension and memory of knowledge, conducive to cultivation of learning method, able to improve ability of creativity and criti-cal thinking, conducive to strengthening interaction and communication of teachers and students, to improve the subject consciousness of student in classroom, helpful to cultivate the spirit of teamwork, to improve the efficiency of teaching, and able to make full use of information technology. Conclusions For the diversified value demand and the highly expectation on reform of current classroom teaching method, more attention should be paid to evaluation and guidance on reform of classroom teaching method for eight-year program medical education.