OBJECTIVE To explore the early detection of large vestibular aqueduct syndrome(LVAS)in children by applying several audiological indicators.METHODS Ninety-two children with hearing loss(aged 1-70 months)were enrolled and divided into an LVAS group(45 cases)and a control group(47 cases).Eleven audiological indicators were statistically analyzed:lateral of hearing loss,the degree of hearing loss,configuration of hearing loss;ABR air-conduction threshold;ABR air-bone gap;ASSR average threshold;ASSR thresholds at 0.5,1,2,and 4 kHz;and tympanogram type.Indicators showing significant two-group differences were used to construct a visualized multifactorial linear prediction model using the R language.RESULTS Nine indicators demonstrated statistically significant differences between groups(P<0.05):laterality,configuration of hearing loss,ABR air-conduction threshold,ASSR average threshold,ASSR thresholds at all frequencies(0.5,1,2,4 kHz),and tympanogram type.A prediction model was established.When the total model score ranged between 200 and 240 points,the predicted LVAS risk probability was 0.1 to 0.99.The consistency index(C-index)was 0.85,indicating good predictive ability of the model.CONCLUSION The identified nine audiological indicators are valuable for the early detection of LVAS in children.The developed model can estimate LVAS risk.After refinement,this model holds potential to support early clinical diagnosis and intervention.

With the rapid development of population aging in various countries around the world,the health and elderly care industry has been paid high attention.The standardization of smart health and elderly care technology and services is particularly important.This paper firstly reviewed the policies related to healthy elderly care in China.By analyzing the industrial standards and provincial standards issued,this paper focused on the policies proposed by the Shanghai Municipal Government for the standardization of smart health and elderly care,as well as the researches on the standard system and the construction of standard families.Shanghai group standards in the field of smart health and elderly care were summarized,including the guidelines for the construction of standard systems,elderly care service platforms,community elderly cafeterias,portable health monitoring terminals,indoor sports services,and home-based elderly care safety monitoring.A series of case analyses of the standardized implementation of the above aspects were also provided.Through standardization research and practice in recent years,it has been fully demonstrated that the standard research plays an important leading role in the field of smart health and elderly care.

ObjectiveTo develop a reliable and valid health self-management competence assessment questionnaire for primary and secondary school students in Shanghai, so as to provide an effective tool to evaluate and improve their health management competencies. MethodsBased on the theory and process of scale development, an initial item pool was formed. After two rounds of Delphi consultation with 22 experts in related fields, assessment indicators suitable for evaluating the health self-management ability of Shanghai primary and secondary school students were determined. A total of 666 students were selected using stratified cluster sampling method to carry out the survey. The questionnaire content was refined and items were screened for reliability and validity analyses. ResultsAfter the two rounds of Delphi expert consultation, the original three-dimensional structure (individual management behaviors, personal health cognition and self-management environment) was revised into four dimensions: self-health cognition, self-health skills, self-will quality and self-action level. The initial 50 items were reduced, merged, or newly created, yielding a final 30-item questionnaire. Expert response rates for the two rounds of Delphi consultation were 86.36% and 90.91%, respectively, with an expert authority coefficient of 0.91. The KMO value was 0.936 and Bartlett’s sphericity test yielded a P value of <0.001, indicating that the questionnaire demonstrated good construct validity. The results of internal consistency testing showed that the overall Cronbach’s α coefficient was 0.932, and the split-half reliability coefficient was 0.920. The Cronbach’s α coefficient of each dimension ranged from 0.716 to 0.884, and the split-half reliability coefficient ranged from 0.733 to 0.900. Finally, an evaluation scale with 30 items across 4 dimensions was constructed. ConclusionThe health self-management competence evaluation scale for primary and secondary school students in Shanghai demonstrates good homogeneity and high reliability. It can be used as a tool for evaluating the health self-management competency of primary and secondary school students in Shanghai and provide theoretical support for targeted health interventions.

BACKGROUND:Vibration environment can cause spinal injury,especially in patients with scoliosis.At present,there is no information about the inherent mode of the whole spine from T1 to the pelvis in scoliosis patients in the free state. OBJECTIVE:To analyze the dynamic characteristics of the whole spine in patients with scoliosis by the finite element method. METHODS:Based on CT scan images,a three-dimensional finite element model of the T1-pelvic total spine of an 11-year-old patient with thoracolumbar biflexion scoliosis was established,and the Cobb angles of thoracolumbar scoliosis were 36° and 24°,respectively.The mode analysis in the free state of the whole spine was carried out by the finite element method. RESULTS AND CONCLUSION:The fifteen-order free modes of the spine were extracted,and the dynamic characteristics of the scolio-curved spine were obtained.The resonance frequency distribution of the spine was concentrated.The thoracic vertebra was the most deformed in the whole spine model,and the amplitude of the thoracic vertebra was larger than that of the lumbar vertebra.Modal analysis was used to analyze the vibration characteristics of scoliosis patients in the vibration environment.It is of great significance to determine the natural frequency,vibration mode,and amplitude of scoliosis patients for analyzing the vibration characteristics of scoliosis.

Objective To investigate the effectiveness of intravenous thrombolytic therapy mode led by fast-track specialist nurses on patients with acute ischemic stroke(AIS).Methods This study involved 124 AIS patients who underwent intravenous thrombolytic therapy in the Department of Emergency of our hospital from March 2021 to February 2023.Among the patients,61 admitted between March 2021 and February 2022 received conventional AIS thrombolytic therapy were assigned to a control group.While the 63 patients who received AIS thrombolytic therapy under the specialist nurse-led intravenous thrombolytic therapy mode between March 2022 and February 2023 were assigned to an observation group.The two groups were compared in terms of the time from admission to completion of CT examination,time for signing the informed consent for thrombolytic therapy,door to needle time and percentage of DTN<60 minutes,as well as the post-thrombolysis scores according to the National Institute of Health Stroke Scale(NIHSS)and satisfaction to medical consultation.Results The observation group exhibited a significantly shorter time from admission to completion of CT examination,a shorter time for signing an informed consent for thrombolytic therapy,a shorter door to needle time and a higher percentage of DTN<60 minutes,all with significant difference in comparison with those in the control group.After thrombolysis,the NIHSS score of the observation group decreased more than that of the control group(P<0.05).The patients and their families in the observation group reported significantly higher satisfaction compared to those in the control group(both P<0.05).Conclusion The fast-track specialist nurse-led intravenous thrombolytic therapy mode demonstrates the superiority in reduction of the time from admission to completion of CT examination,time for signing an informed consent for thrombolytic therapy,door to needle time and the NIHSS scores,higher percentage of DTN<60 minutes as well as improvement of patient satisfaction.

Adenosine monophosphate-activated protein kinase(AMPK) is a highly conserved serine/ threonine protein kinase which plays an important role in regulating energy metabolism of the systemic cells. Under stress conditions, such as ischemia and hypoxia, AMPK can be activated.Then it plays a neuroprotective role in regulating mechanisms such as oxidative stress, autophagy, apoptosis and neuroinflammation and so on. Researches have found that chronic cerebral hypoperfusion may be a major cause of vascular cognitive impairment(VCI).AMPK can exert neuroprotective effects on VCI by regulating the aforementioned pathological processes.Therefore, this article reviews the molecular biological characteristics of AMPK and its role and mechanism in VCI, with the aim of promoting further research on AMPK and making it a new target for VCI treatment.

China prospective multicenter birth cohort (Prospective Omics Health Atlas birth cohort, POHA birth cohort) study was officially launched in 2022. This study, in collaboration with 12 participating units, aims to establish a high-quality, multidimensional cohort comprising 20 000 naturally conceived families and assisted reproductive families. The study involves long-term follow-up of parents and offspring, with corresponding biological samples collected at key time points. Through multi-omics testing and analysis, the study aims to conduct multi-omics big data research across the entire maternal and infant life cycle. The goal is to identify new biomarkers for maternal and infant diseases and provide scientific evidence for risk prediction related to maternal diseases and neonatal health.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

【Objective】 To compare the clinical safety and effectiveness of super-mini-percutaneous nephroscope (SMP) combined with flexible ureteroscopic lithotripsy (FURL) in oblique supine lithotomy position and FURL alone in the treatment of 2.0-3.0 cm renal calculi. 【Methods】 Clinical data of 55 patients treated during Jan.2018 and May 2021 were retrospectively analyzed, including 47 cases complicated renal calculi, and 14 cases of lower calyceal calculi with infundibulopelvic angle ≤30°. SMP combined with FURL was performed in 23 cases (combined group), and FURL alone was performed in 32 cases (FURL group). The operation time, hemoglobin reduction, postoperative hospital stay, hospitalization expenses, stone-clearance rate and complications were compared. 【Results】 All operations were successful. Compared with the FRUL group, the combined group had significantly more hemoglobin reduction [(16.30±10.17) g/L vs. (6.94±6.61) g/L], longer postoperative hospital stay [(5.35±1.61) d vs. (3.19±1.26) d], and higher hospitalization expenses [(22 481±2 234) yuan vs. (18 209±2 584) yuan] (P<0.05). However, there was no significant difference in operation time [(79.57±8.52) min vs. (79.22±3.83 min),P>0.05]. One month after surgery, CT results showed that the combined group had higher stone-clearance rate (91.30% vs. 65.63%, P=0.027). There was no difference in the complication rate (21.74% vs. 21.88%, P>0.05). One case (4.35%) in the combined group and 5 cases (15.63%) in the FURL group received retreatment (P>0.05). 【Conclusion】 SMP combined with FURL in oblique supine lithotomy position is safe and effective in the treatment of 2.0-3.0 cm renal calculi, with high stone-clearance rate and low complication rate.

Hip fracture is considered as the most severe osteoporotic fracture characterized by high disability and mortality in the elderly. Improved surgical techniques and multidisciplinary team play an active role in alleviating prognosis, which places higher demands on perioperative nursing. Dysfunction, complications, and secondary impact of anaesthesia and surgery add more difficulties to clinical nursing. Besides, there still lack clinical practices in perioperative nursing for elderly patients with hip fracture in China. In this context, led by the Orthopedic Nursing Committee of Chinese Nursing Association, the Expert consensus on clinical practice in perioperative nursing for elderly patients with hip fracture ( version 2023) is developed based on the evidence-based medicine. This consensus provides 11 recommendations on elderly patients with hip fracture from aspects of perioperative health education, condition monitoring and inspection, complication risk assessment and prevention, and rehabilitation, in order to provide guiding advices for clinical practice, improve the quality of nursing and ameliorate the prognosis of elderly patients with hip fracture.