Objective To investigate the effects of the dual-subject three-step method on periop-erative outcomes in patients with intradural tumors.Methods A total of 86 patients with intradural tumors were enrolled in a prospective study and were randomly divided into control group and observa-tion group,with 43 patients per group.The control group received routine perioperative care,while the observation group underwent intervention of the dual-subject three-step method.The recovery process,psychological state[Patient Health Questionnaire-9(PHQ-9)and Generalized Anxiety Dis-order-7(GAD-7)]at different perioperative time points,lumbar spine function scores of Japanese Orthopaedic Association(JOA),and occurrence of complication were observed.Results The obser-vation group exhibited shorter durations for first flatus,first ambulation,recovery of bowel move-ments,and hospital stay compared with the control group(P＜0.05).The PHQ-9 and GAD-7 scores in the observation group were lower than those in the control group at 1 day preoperatively,1 day post operatively,and 1 month after discharge(P＜0.05).At discharge,1 month after discharge,and 6 months during follow-up,the JOA scores in the observation group were higher than those in the con-trol group(P＜0.05).The complication rate in the observation group was lower than that in the con-trol group(6.98％versus 25.58％,P＜0.05).Conclusion Application of the dual-subject three-step method in patients with intradural tumors can effectively improve psychophysical stress,reduce complications,improve lumbar spine function,and promote early postoperative recovery.

Due to the complexity of traditional Chinese medicine （TCM） interventions and the diversity of herbal components， single-omics technologies such as genomics， transcriptomics， proteomics， and metabolomics often cannot comprehensively elucidate the scientific connotations of TCM. Multi-omics technologies driven by system biology can analyze the theoretical connotations and application mechanisms of TCM from different levels such as genes， gene expression， proteins， and metabolites， in line with the holistic view of TCM， which helps to promote the modernization of TCM. By reviewing the literature on the application of omics technologies in the field of TCM， it is found that multi-omics technologies have been widely used in TCM for syndrome differentiation， evaluation of herbal quality， elucidation of pharmacological mechanisms， and drug toxicity assessment， providing comprehensive explanations of the mechanisms of action of TCM and overcoming the limitations of single-omics technologies， and having obtained significant achievements. However， multi-omics technologies also face challenges such as high cost， difficulties in data analysis due to large data volumes， and insufficient translation of research results. In the future， it is expected that through strengthening interdisciplinary cooperation， conducting long-term and dynamic clinical research， standardizing and normalizing data analysis processes， adopting appropriate and reasonable multi-omics integration patterns， establishing multi-omics databases for TCM， revealing the individualized characteristics， therapeutic mechanisms， and disease regulatory networks of TCM， the modernization of TCM will be promoted.

Combining the knowledge of traditional Chinese medicine and modern medicine on glucolipid metabolism disorders， it is believed that the formation process of glycolipid metabolism disorders can be presented as five states "depression， phlegm-dampness， heat， blood stasis， and deficiency"， and the turbid pathogens run through the whole process. Accordingly， the method of "regulating states and removing turbidity" is proposed， which is specifically the method of resolving depression and turbidity， dispelling phlegm-dampness and turbidity， clearing heat and turbidity， dispelling blood stasis and turbidity， and replenishing deficiency and removing turbidity. Combined with the biological basis of glycolipid metabolism disorder， through the analysis of the clinical application of each method and the related mechanism of action， it is clarified that the method of regulating states and resolving turbidity can play a role in improving glycolipid metabolism disorder by regulating lipid metabolism disorder， insulin resistance， bile acid metabolism abnormality， intestinal bacterial flora， and its metabolite abnormality and other mechanisms of action.

Objective Differential genes related to prognosis of endometrial carcinoma(EC)were screened and prognostic models were constructed.Methods Gene Expression data of EC and normal control samples were downloaded from The Cancer Genome Atlas(TCGA)database and Gene Expression Omnibus(GEO)dataset GSE63678 to screen out common differential genes.LASSO regression analysis was used to screen out the genes with prognostic significance and construct prognostic characteristics.EC patients with complete information were obtained from the TCGA database and randomly divided into the training group and the validation group in a ratio of 1:1.In the training group,survival curves were constructed based on prognostic characteristics.Functional annotation and pathway enrichment analysis were conducted using gene ontology(GO)analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)analysis.Combined with prognostic features and clinical risk factors,a calibration curve and C-index were used to evaluate the performance of the histogram.Finally,use a verification group for validation.Results A total of 4800 and 257 differentially expressed genes were screened from TCGA and GEO databases respectively,of which 73 up-regulated genes and 52 down-regulated genes were co-expressed.6 prognostic genes(ORMDL2,BNC2,TTK,MAMLD1,KCTD7 and DCLK2)were screened out by LASSO regression analysis.The survival curve showed that the overall survival of patients in the high-risk group was significantly lower than that in the low-risk group(P<0.01).GO analysis and KEGG results exhibited that prognostic signature was associated with cell cycle.The nomogram showed powerful predictive ability in the training and validation groups.Conclusion We constructed a predictive model based on prognostic genes,which can accurately predict the prognosis of patients with EC and provide new theoretical support for clinical diagnosis and treatment.

ObjectiveTo investigate the association between ZJU index and the onset of nonalcoholic fatty liver disease （NAFLD） in the Uygur population and the value of ZJU index in predicting the risk of NAFLD. MethodsThe Uighur community of The 51st Regiment of The Third Division of Xinjiang Kashgar Corps was selected as the investigation site， and the Uygur residents who lived in this area and had an age of >18 years were selected as subjects. Follow-up studies were conducted in 2019， 2020， and 2021， and the investigation of outcomes was completed in June to August of 2021. Finally 10 597 subjects were enrolled for analysis. The Kruskal-Wallis H test was used for comparison of continuous variables between groups， and the chi-square test was used for comparison of categorical variables between groups. The subjects were divided into Q1-Q4 groups according to the level of ZJU index. The Kaplan-Meier curve was used to predict the incidence rate of NAFLD， and the Cox regression model was used to analyze the association between ZJU index and the risk of NAFLD； the area under the ROC curve （AUC） was used to evaluate the value of ZJU index in predicting the risk of NAFLD. ResultsDuring the median follow-up time of 4.92 years， the incidence rate of NAFLD was 9.4% （992/10 597） among the study population. After adjustment for multiple factors， there was a significant increase in the risk of NAFLD with the increase in ZJU index， with a hazard ratio of 2.55 （95% confidence interval ［CI］： 1.60‍ — ‍4.06）， 7.32 （95%CI： 4.78‍ — ‍11.20）， and 21.74 （95%CI： 14.32‍ — ‍33.00）， respectively （all P_trend<0.001）. The ROC curve showed that ZJU index had a higher value in predicting NAFLD （AUC=0.816）， and the male subgroup had a significantly higher predictive accuracy of ZJU index than the female subgroup （AUC： 0.829 vs 0.809）. ConclusionZJU index is a predictive factor for the onset of NAFLD in the Uygur population in rural areas of Xinjiang and has a good value in predicting the risk of NAFLD.

Objective:To explore the risk factors of pinhole infection in patients with external fixators, and build a risk prediction model.Methods:From January 2018 to June 2019, the data of patients ( n=300) with external fixators in the Department of Trauma and Orthopedics, South Hospital, South Medical University, were selected by retrospective survey, and were divided into infection group and non-infection group according to whether pinhole infection occurred in the postoperative case records. Single factor analysis and Logistic regression analysis were used to establish the risk factors of pinhole infection and its prediction model. The grade of risk prediction was constructed by the assignment method. Results:Among 300 patients with external fixators, 103 (34.33%) had pinhole infection and 197 (65.67%) had no infection. Logistic regression analysis showed that basic disease [ OR=4.726 (one of diabetes, pulmonary infection), 17.053 (two of diabetes, pulmonary infection, cardiovascular diseases) ], postoperative albumin [ OR=0.082 (<25 g/L) ], postoperative hemoglobin [ OR=3.715 (>90-120 g/L), 9.720 (>60-90 g/L), 7.338 (30~60 g/L) ], intraoperative bleeding volume [ OR=2.196 (200-400 ml), OR=3.256 (>400 ml) ] and the type of disinfectant [ OR=3.897 (chlorhexidine), 3.625 (iodophor + chlorhexidine) ] were risk factors for pinhole infection in patients with external fixators ( P<0.05). The constructed model was divided into high-risk group (≥ 7 points), higher-risk group (5-6 points), medium-risk group (4 points), low-risk group (3 points) and lower-risk group (0-2 points) . Conclusions:The model can well predict the risk of pinhole infection of orthopedic external fixator, provide reference for medical and nursing staff to identify the risk of external fixation infection in time, and prevent the occurrence of infection as soon as possible.

Objective:To analyzes the current status of radiation protection in non-medical sectors, together with the vulnerable spots in the prevention and control of occupational radiation sickness in China in order to provides both technical basis for occupational health management in non-medical radiation sectors and the better protection of occupational health benefits for radiation workers.Methods:The monitoring plan for this survey was worked out on the part of the National Institute for Radiological Protection, China CDC. Survey and monitoring of the current status of radiation protection and occupational health management were, under the monitoring the plan, completed by the relevant agencies of all provincial-level regions for the key industries of non-medical sectors countrywide, involving occupational health monitoring, personal dose monitoring, radiation protection monitoring instruments equipped, and radiation protection monitoring in workplace. Based on the survey result , the deficiencies in radiation protection and occupational health monitoring in non-medical sectors were analyzed.Results:The survey of non-medical sectors was divided into general investigation and detailed monitoring, with the general investigations covering 9 075 non-medical institutions in 31 provincial-level regions across the country. Of them, a total of 4 911 institutions within 329 district-level regions received detailed investigation and radiation protection monitoring. As survey result , the X, γ ambient dose equivalent rates for the institutions using ray-generator are greater than 2.5 μSv/h, about 2.35% of the total, with a maximum of 817 μSv/h. The values for those using radioactive sources were greater than 2.5 μSv/h, about 9.57%, with a maximum of 1 700 μSv/h. The frequencies of personal dose monitoring and occupational health examination were 72.9% and 82.1%, respectively.Conclusions:There is still a gap in radiation protection between the current status and the national regulations and standards in non-medical sectors, so both regulation and management of radiation protection should be further strengthened.

Objective:To understand the research hotspots of external fixation nursing in the past 5 years and analyze the research status and development trend of this field, so as to provide a reference for external fixation nursing practice and research development in China.Methods:PubMed, Web of Science, China National Knowledge Internet (CNKI), Wanfang Database and VIP database were used to retrieve external fixation nursing related literature published from August 2015 to July 2020. Bibliographic information data mining system software and graph clustering toolkit software were used to perform bibliometric and cluster analysis.Results:A total of 720 literatures were included, including 318 English literatures and 402 Chinese literatures. A total of 25 English high-frequency words were extracted with frequency greater than or equal to 23 times, and 17 Chinese high-frequency words were extracted with frequency greater than or equal to 25 times. After cluster analysis, two English research hotspots were obtained, namely, information acquisition and application in nursing research, functional recovery after external fixation. Five Chinese research hotspots were obtained, including the prevention of needle-path infection, the nursing effect of systematic nursing on patients with external fixation, application of negative pressure sealing drainage technology in open fractures, perioperative nursing of patients with bone defects and rehabilitation nursing of fractures at different locations.Conclusions:It is possible to use information management and big data to analyze the risk factors of external fixation care for prevention, and to standardize the external fixation care process through standardized procedures and the introduction of nursing guidelines for different parts of the external fixation. At the same time, attention should be paid to the functional recovery of patients with external fixation in order to improve the nursing quality of external fixation.

Objective To explore the clinical efficacy and indications of kyphoplasty with movement and secondary en?largement of balloon for the compression fracture of vertebral body with ruptured posterior wall. Methods A retrospective analy?sis was carried out on the data of 29 patients (10 males, 19 females;age range:55-86 years old;mean age:71 years old;29 verte?bral bodies in total) who suffered from compression fracture of the thoracolumbar spine and below, and underwent kyphoplasty through the movement and secondary enlargement of balloon within the vertebral body and were followed up from January 2011 to November 2014. These patients had backache, accompanied by lowered support, limitation of movement, no symptom of nervous lesion on both lower extremities and no past history of balloon kyphoplasty. All fractured vertebral bodies were at T 11 or below, in?cluding 1 case at T11, 4 cases T12, 11 cases L1, 9 cases L2 and 4 cases L3. The causes of injury included fall (19 cases), car accident (8 cases) and unknown reasons (2 cases). All patients underwent kyphoplasty with the movement and secondary enlargement of bal?loon within the vertebral body. Photos were taken immediately after the surgery, at 1 month, 3 months, 6 months and 12 months, and these patients were assessed and analyzed in terms of vertebral height, Cobb angle, visual analogue score (VAS) and Oswestry disability index (ODI). Results The operation time (including the formation and solidification of bone cement) of 29 patients was 40 to 65 min and the mean time was 55 ± 7 min;the blood loss during operation was 2 to 15 ml and the mean blood loss was 5 ± 2 ml;the injected volume of bone cement was 2.5-7.5 ml and the mean volume was 5.5±0.5 ml. Post?operative pain was relieved and ambulation was performed under the protection of lumbar orthosis brace. Statstical analysis was conducted on VAS, ODI, vertebral height and Cobb angle before operation and at 1 month, 3 months, 6 months and 12 months after operation, showing statistically significant differences. X ray examination found that there was no alternation or displacement of bone cement location, and no change in vertebral morphology, the vertebral height and cobb angle remained the post?operative status, and posterior wall rupture of the vertebral body was recovered well. CT revealed that the morphology of bone cement was irregular and closely integrated with bone substance, and no cavity or fissure was seen. Conclusion Kyphoplasty with movement and secondary enlargement of bal?loon within the vertebral body has a good, definite clinical efficacy in treating compression vertebral fracture with incomplete pos?terior wall of the vertebral body without obvious displacement of fractured bone and symptom of nervous lesion on both lower ex?tremities. This surgery is easy to operate, and has an immediate analgesic effect, which could recover vertebral height as well as re?duce kyphosis deformity and improve patient’s prognosis.

We analyzed the cost effectiveness of four different surgical methods (A,B,C and D) in treatment of hepatic echinococcosis.Totally 757 cases of hepatic echinococcosis surgery clinical data and cost information of hospitalized cases were collected from nine hospitals in Xinjiang during 2005-2013.The clinical effects,cost effectiveness ratio and incremental costeffectiveness ratio were analyzed and compared.The total complication rates were 15.8％,9.2％,0％ and 2.9％;the recurrence rates were 7.3％,6.2％,0％ and 0％;the cure rates were 77.8％,84.6％,100.0％ and 97.1％;the cost (RMB) were 11 947.3,18 543.6,25 510.7 and 18 877.4,cost-effectiveness ratio were 153.6,219.1,255.1 and 194.3,incremental cost-effectiveness ratio /C//E were 964.4,610.4 and 358.0 respectively for group A,B,C and D.The results after adjusting of price factor were consistent with original cost effectiveness analysis.The complete resection of inner and outer capsule (D) is the most effective and economical way of clinical operation and may worthy be promoted in treatment of hepatic echinococcosis.