The traditional Chinese medicine （TCM） in pediatric care has a long history，proven efficacy，and distinctive characteristics.The China Association of Chinese Medicine has organized a series of youth salons to discuss the clinical advantages of treating diseases.Experts at this seminar proposed that the superior disease categories in pediatric TCM are significant for showcasing the unique strengths and advantages of TCM in the treatment of pediatric diseases，enhancing diagnostic and treatment levels，inheriting TCM knowledge，promoting the integration of TCM and Western medicine，and meeting patients' needs.The strengths of pediatric TCM are summed up as "having what others do not，excelling at what others have，being special in what others excel at，and ensuring safety in what others specialize in." The scope of superiority in pediatric TCM covers multiple systems，including respiratory，digestive，endocrine，psychological，and dermatological systems.This article summarized the advantages of TCM in treating 13 diseases discussed in the salon，such as upper respiratory tract infections，coughs，pneumonia，allergic rhinitis，bronchial asthma，atopic dermatitis，functional dyspepsia，functional constipation，enuresis，marginal short stature，simple obesity，attention deficit hyperactivity disorder，and tic disorders.The overall advantages were reflected in three aspects：First，the holistic concept and treatment based on syndrome differentiation in TCM highlight the advantage of treating the root causes of diseases，making the treatment methodical and precise.Second，most traditional Chinese herbs are natural and have strong safety profiles.Third，TCM treatment methods are abundant，especially the external treatment methods，which are widely used in pediatrics，highly accepted by parents，and have definite efficacy，as well as good safety and compliance.

Objective: To explore the relationship between the ratio of dietary vitamin A (VitA) to body weight and hypertension among children, so as to provide a reference for blood pressure control through dietary nutritional interventions and childhood hypertension prevention. Methods: Utilizing the baseline survey and followup sample data from the Healthy Children Cohort established in urban and rural areas of Chongqing from 2014 to 2019, structured quantitative dietary questionnaire and selfdesigned questionnaire were used to investigate the information of dietary intake and socioeconomic characteristics of 15 279 children, as well as blood pressure, height, weight measurement. The ratio of dietary VitA to body weight was divided into four groups based on quartiles [≤P25(Q1), >P25~P50(Q2), >P50~P75(Q3), >P75(Q4)]. Generalized linear regression models and Logistic regression models were used to analyze the correlation between ratio of dietary VitA to body weight with blood pressure levels and prevalence of hypertension. Results: The results of the 2014 baseline survey indicated that, after adjusting for confounding factors such as demographic indicators and nutritional intake, significant differences were observed in systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) among different groups categorized by the ratio of dietary VitA to body weight (F=157.57, 44.71, 95.92, P<0.01). The baseline ratio of dietary VitA to body weight in children exhibited a negative correlation with DBP, SBP and MAP at baseline and in 2019[baseline: β(95%CI)=-0.65(-0.89--0.42), -0.22(-0.42--0.01), -0.36(-0.56--0.16); 2019: β(95%CI)=-0.77(-1.34--0.19), -0.62(-1.21--0.02), -0.77(-1.34--0.19), P＜0.05]. Compared to Q1 group, the risk of hypertension decreased among children in Q4 at baseline and followup in 2019 [OR(95%CI)=0.63(0.49-0.81), 0.18(0.08-0.42), P<0.01]. Conclusions The ratio of dietary VitA to body weight is significantly negatively correlated with blood pressure levels among children, and dietary VitA deficiency is an independent risk factor for hypertension among children. Measures should be taken to actively adjust childrens dietary nutrition and reduce the risk of childhood hypertension.

Objective To explore the clinical value of models based on clinical features and enhanced MRI radiomics for predicting the occurrence of post-acute pancreatitis diabetes mellitus(PPDM-A).Methods A retrospective selection of 161 acute pancreatitis(AP)patients was conducted,comprising 99 in the non-PPDM-A group and 62 in the PPDM-A group.They were randomly divided into training set and test set in a ratio of 7∶3.Region of interest(ROI)were delineated and radiomics features were extracted on the late arterial phase MRI images.Optimal radiomics features were selected by maximum relevance and minimum redundancy(mRMR)and least absolute shrinkage and selection operator(LASSO).Support vector machine(SVM)was used to develop three predictive models.The efficacy of the models in predicting PPDM-A was evaluated,the receiver operating characteristic(ROC)curve was drawn,and the DeLong test was employed to assess the difference in predictive capability among the models.Results In the training set,the area under the curve(AUC)of the clinical model,radiomics model,and combined model were 0.702,0.810 and 0.901,respectively,and in the test set were 0.678,0.797 and 0.830,respectively.The DeLong test revealed a statistically significant difference in the predictive capability of the combined model compared to the clinical model both in the training and test sets(training set:P＜0.001;test set:P=0.019).Conclusion The combined model based on clinical features and enhanced MRI radiomics features demonstrates good predictive effi-cacy and can provide valuable insights for clinical interventions aimed at preventing PPDM-A.

Targeted to the junior nursing students in our university, we applied experiential teaching in the course of Obstetrics and Gynecology Nursing to carry out humanistic care infiltration education, which mainly included three parts: aesthetic activities in theoretical class, experiential activities in experimental class and enlightenment after class. After class, compared with the nursing students who were educated by traditional teaching methods, the quality of humanistic care of nursing students who accepted experiential teaching was improved more obviously. It is suggested that the application of experiential teaching is effective in infiltrating humanistic care education in nursing professional courses, which is also in line with the development of nursing discipline.

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.

Objective:To explore the use of intracardiac electrocardiogram method for positioning the tip of neonatal peripherally inserted central venous catheter (PICC) in 33 hospitals with neonatal beds in Zhejiang Province.Methods:This study was a cross-sectional study. From May to June 2021, a questionnaire survey was conducted among 52 head nurses or intravenous therapy specialist nurses from 33 hospitals in Zhejiang Province. The self-made "Neonatal Electrocardiogram Positioning Technology Use and Development Questionnaire" was used to investigate. A total of 52 valid questionnaires were recovered, with a valid recovery rate of 100%.Results:Among the 52 respondents, 34.62% (18/52) used intracardiac electrocardiogram method for positioning the tip of neonatal PICC. A total of 49 nurses (94.23%, 49/52) preferred the vertebral body as the judgment basis of PICC tip. The factors that affected the accuracy of intracardiac electrocardiogram method for positioning the tip of neonatal PICC included poor pipeline signal transmission (83.33%, 15/18) , crying and noisy children (66.67%, 12/18) , insufficient mastery of electrocardiogram knowledge by medical and nursing staff (66.67%, 12/18) . A total of 28 nurses (53.85%, 28/52) said that their hospitals had no training on neonatal intracardiac electrocardiogram positioning technology, while 13 nurses (54.17%, 13/24) chose face-to-face teaching.Conclusions:The practice in the use, development and training of intracardiac electrocardiogram positioning technology for neonates in Zhejiang Province needs to be further improved. It is suggested that unified standards and norms should be formulated, and training on the use of intracardiac electrocardiographic positioning technology in neonates should be strengthened to improve the quality of nursing.

Objective:To deeply understand the work experience and the needs of nurses in family accompanying ward of neonatology department, provide necessary support for nurses, promote the improvement of their nursing ability, and provide reference for peers who are going to carry out family accompanying ward.Methods:Phenomenological research method was used to conduct semi-structured in-depth interviews with 15 neonatology nurses who cared for children in the family accompanying ward in Children′s Hospital Affiliated to Zhejiang University School of Medicine from June 2022 to September 2022. Colaizzi 7-step analysis method was used to collect and collate data, and analyze and extract themes.Results:Four themes were analyzed, which were as follows: more emotional experience, nursing concept need to be changed, professional ability needs to be improved, and teamwork needs to be strengthened.Conclusions:Managers should pay attention to the pressure and needs of nurses in family accompanying wards, help release negative emotions to promote the physical and mental health of nurses, strive to change traditional nursing concepts, promote patient-and family-centered nursing work, strengthen the training of various related professional knowledge and communication skills, strengthen multidisciplinary teamwork, and improve the comprehensive caring ability of neonatology nurses in family accompanying wards.

Objective:To analyze and compare the practical value of serum cystatin C(Scys C)and serum creatinine(SCr)in the assessment of kidney function in older adults.Methods:A retrospective, cross-sectional study was performed in 2 450 participants who were divided into a non-elderly group(<65 years)and an elderly group(≥65 years).Glomerular filtration rate(GFR), Scys C and SCr were measured by 99mTc-DTPA clearance, particle-enhanced immunoturbidimetry and an oxidase method, respectively.The χ2 test was used to compare increases in percentage of Scys C and SCr at the same GFR level.The screening value of Scys C and SCr for GFR<60 ml·min -1·1.73m -2was evaluated by the area under curve(AUC)of the receiver operating characteristic(ROC)curve.Values of 95% reference ranges were established for Scys C and SCr at different GFR levels. Results:The proportions of the general population with increased Scys C were 82.74%(556/672)and 94.74%(90/95), respectively, for GFR levels between 30~59 ml·min -1·1.73m -2and <30 ml·min -1·1.73m -2, while only 38.24%(257/672)and 75.79%(72/95)had elevated SCr levels( χ2=278.328, 13.571, both P<0.001).For the above GFR intervals, the proportions of older adults with increased Scys C were 84.81%(240/283)and 100.00%(43/43)respectively, and the proportions for non-elderly adults with increased Scys C were 81.23%(316/389)and 90.38%(47/52)( χ2=1.463, 4.364, P=0.226, 0.037), respectively.The screening value of Scys C for GFR<60 ml·min -1·1.73m -2was slightly better than SCr in terms of sensitivity, specificity and the Youden index.However, the sensitivity and specificity of Scys C in older adults were 76.4% and 75.7%, respectively, both lower than 78.7% and 84.0% in non-older adults.The variability of Scys C increased progressively with age.The reference range for Scys C was higher in older adults than in non-older adults at the same GFR level. Conclusions:When screening for GFR<60 ml·min -1·1.73m -2, the sensitivity and specificity of Scys C are slightly better than those of SCr, but are lower in older adults than in non-older adults.Scys C levels are higher and more variable in older adults.Using Scys C to assess GFR may lead to over-diagnosis of chronic kidney disease in older adults.

Objective To analyze the effect of hand hygiene compliance on the incidence of ventilator-associated pneumo-nia(VAP )in children,and explore the role of hand hygiene in the prevention and control of VAP .Methods Hand hygiene compliance among HCWs in a pediatric intensive care unit (PICU)was intervened,hand hygiene compliance rate of HCWs and incidence of VAP in children with mechanical ventilation from March 1,to October 31,2012 (before intervention)and from January 1,to August 31,2013 (after intervention)were compared.Results Hand hygiene compliance rate after in-tervention was higher than before intervention(37.31%[97/260]vs 24.17% [58/240])(χ2 =10.08,P <0.01);the con-sumption of hand washing liquid and alcohol-based handrub enhanced from 3.48mL /bed day before intervention to 4.49 mL/bed day after intervention,which increasing by 29.02%.The incidence of VAP after intervention was lower than be-fore intervention (2.21‰[5/2 261]vs 6.50‰[13/2 001])(χ2 =4.67,P <0.05).Conclusion Implementation of com-prehensive measures and improvement of HCWs’hand hygiene compliance can reduce the incidence of VAP in chil-dren.

Objective To observe the protective effects of genistein sodium sulfonate(GSS)on mice chronic hepatic injury in-duced by carbon tetrachloride(CCl4 )and its influence on the protein expression of α7 nicotinic acetylcholine receptor(α7nAChR) and interleukin-1 beta (IL-1β)in liver tissue.Methods 60 SPF grade male Kunming mice were randomly divided into 5 groups,in-cluding the control group,model group,low and high doses GSS groups,and positive control group,12 cases in each group.Except for the control group,the other 4 groups were intra peritoneally injected by 10 % CCl4 with a volume of 0.1 mL/10 g for 6 weeks. The mice chronic liver injury was prepared.At the same time,the high and low doses DSS groups were given the different doses of GSS(0.30,0.10 mg/kg),the positive control group was given bifendate(DDB,2.5mg/kg),the control group and the model group were given the equal volume of normal saline for 6 consecutive weeks.The AST and ALT activity was detect and the ratio of ALT/AST was calculated;the Western blot method was used to detect the expression levels ofα7nAChR and IL-1βprotein in liver.Re-sults The serum levels of ALT and AST in the model group were increased obviously,and the expression level ofα7nAChR in the liver tissue was decreased,while the expression level of IL-1βwas increased;after the GSS treatment,the serum AST and ALT lev-els were significantly lower than those in the model group(P <0.05),while the expression level ofα7nAChR was increased (P <0.01)and the expression level of IL-1βwas decreased(P <0.05).Conclusion GSS might increase the expression ofα7nAChR in injured liver tissue,activates the cholinergic anti-inflammatory pathway,thus decreases the expression of inflammatory cytokines and antagonizes the mice chronic liver injury by inhibiting the inflammatory reaction.