ObjectiveTo analyze the characteristics of 150 patients with spinal cord injury complicated with spasticity. MethodsA cross-sectional survey was conducted on 150 patients with spinal cord injury accompanied by spasticity from September, 2019 to December, 2024. Their age, gender, cause of injury, injury site, severity of injury, spasticity severity and other indicators were recorded. The relationships between different characteristics were analyzed, and a correlation analysis of disease duration, spasticity grade, injury level, injury severity and age were conducted. ResultsThere was no significant difference in age distribution between patients with tetraplegia and paraplegia (Z = 0.806, P = 0.420). The proportions of trauma (χ² = 3.982, P = 0.046) and tetraplegia (χ² = 10.559, P = 0.010) were higher in males than in females. Trauma was the main cause of injury in both tetraplegia and paraplegia patients; the proportion of tetraplegia was higher than paraplegia in trauma patients, while paraplegia was higher than tetraplegia in non-trauma patients (χ² = 11.885, P < 0.001). Patients with tetraplegia was dominated by incomplete injury, whereas patients with paraplegia was dominated by complete injury (χ² = 10.885, P = 0.012). Grade A injury was predominant in trauma patients (P = 0.003). Spasticity grade showed a very weak positive correlation with disease duration (r = 0.175, P = 0.032) and age (r = 0.168, P = 0.040). Injury severity showed a very weak positive correlation with age (r = 0.183, P = 0.025). ConclusionCharacteristics of patients with spinal cord injury complicated with spasticity is different with gender, cause of injury, injury level, injury severity.

OBJECTIVE To investigate the actual construction and operation status of established and under-construction centralized （cloud） prescription review centers （shortened for “prescription review center”） of close-knit county-level medical consortium in a certain city， so as to provide reference for improving the construction quality of the prescription review center. METHODS An online questionnaire survey was conducted to collect the data from 51 established and under-construction prescription review center in the city， covering basic information， funding sources， talent management， system construction， review rule maintenance， prescription review practices， prescription evaluation， data utilization， and current challenges. The collected data were summarized and analyzed. RESULTS A total of 51 valid questionnaires were retrieved， covering 32 established and 19 under-construction prescription review center. Among the 32 established prescription review centers， the main funding sources for their construction came from government financial allocations， accounting for 56.25%. Only 25.00% of prescription review center had review pharmacists who fully met national qualification requirements， and just 55.00% updated more than 10 review rule entries per month on average. Outpatient prescription verification realized full coverage， but 37.50% of prescription review centers only supported rationality verification of single prescriptions， and 50.00% could not retrieve laboratory and examination results to assist in prescription review. Additionally， 40.62% of prescription review center had not regularly conducted prescription evaluations for primary care institutions. The data from prescription review center was mainly used to support medication monitoring. Among the 19 prescription review centers currently in the planning stage， 63.16% had no identified funding sources. CONCLUSIONS The operation and construction of prescription review center in the city face challenges， such as funding shortages， absence of collaborative incentive mechanisms， and insufficient manpower.It is suggested that the state should issue a unified standard for the construction of the prescription review center as soon as possible， and local health administrative departments should formulate supporting policies and clarify assessment indicators in combination with the actual situation of the region.

Objective To establish the therapeutic effect prediction model of platelet transfusion in hematological patients,and receiver operating characteristic(ROC)curve and clinical cases are used to evaluate the clinical application value of the predic-tion model.Methods A total of 485 patients with hematological diseases who received platelet transfusion therapy in Kailuan General Hospital from January 2020 to December 2023 were selected,corrected count increment(CCI)was used to divide the patients into platelet transfusion effective group(n=340)and transfusion ineffective group(n=145).Multivariate Logistic regres-sion analysis was used to establish the prediction model of platelet infusion efficacy,and ROC curve was used to evaluate the application effect of the forcasting model.109 clinical cases were used to verify the practical application effect of the model,and the sensitivity,specificity and accuracy were calculated.Results Among 485 patients with hematological diseases,the incidence of ineffective platelet transfusion was 29.90%(145/485).Compated with the effective group,the ineffective group had more previous platelet transfusions was higher,and the difference was statistically significant(t=-4.435,P<0.05).In the ineffective group,there were more cases of hyperplenism,aplastic anemia and lymphoma,higher infection rate and higher positive rate of platelet antibody,and the differences were statistically significant(χ2=6.301～37.522,all P<0.05).Multivariate Logistic regres-sion analysis found that previous platelet infusion times,infection,leukemia,aplastic anemia and platelet antibodies were risk factors for ineffective platelet transfusion in patients with hematological diseases(Wald χ2=5.224～21.548,all P<0.05).Based on these risk factors,platelet infusion effect prediction models 1 and 2 were constructed.ROC curve was used to evaluate the application effect of the prediction model.The area under the curve(AUC),cut-offpoint,sensitivity and specificity of model 1 were 0.884,0.042,82.35%,88.89%.The AUC,cut-offpoint,corresponding sensitivity and specificity of prediction model 2 were 0.910,59.784,81.18%,94.44%,respectively.The Z values of model 1 and model 2 were 12.159 and 13.151,respectively.The prediction effect of model 2 was better than that of model 1.The actual application results showed that the sensitivity,specificity and accuracy of prediction model 1,2 were 85.71%,92.05%,90.89%and 90.48%,93.18%,92.66%,respectively.Conclusion The ineffective rate of platelet transfusion in hematological patients is relatively high.The prediction models 1 and 2 for platelet transfusion effectiveness have good results in predicting ineffective platelet transfusion,and prediction model 2 is better than pre-diction model 1,which can provide reliable basis for hematological patients on accurate platelet transfusion.

Objective:To analyze the early family diet nursing guidance needs of patients with gastrointestinal polyps resection based on Kano model, further screen the needs and optimize nursing strategies.Methods:This was a cross-sectional study. A total of 215 patients who underwent gastrointestinal polypectomy in Yingtan 184 Hospital of China Rongtong Group Healthcare Co. Ltd from January 2022 to June 2024 were prospectively selected using the purposive sampling method. The Kano model combined with Delphi expert consultation method was used to design a questionnaire on the family dietary nursing guidance needs of patients with gastrointestinal polypectomy. The Kano model needs attribute classification, Better-Worse coefficient analysis and two-dimensional matrix analysis were used to determine the information needs attributes, and the most sensitive and most needed factors were screened out for strategy optimization.Results:In this study, 232 questionnaires were distributed, and 215 valid questionnaires were returned, with an effective return rate of 92.67%. The 215 patients ranged in age from 20 to 72 years, with a mean age of 40.92 ± 10.06 years, including 163 males and 52 females. Among the 16 items in the survey questionnaire, 15 items need to be improved first. These include 1 attractive demand, 7 basic demands and 7 expected demands. The top 3 most sensitive needs were the formulation of an early home diet plan, the evaluation of the current diet structure, and the avoidance of exacerbating negative emotions, with sensitivities of 0.380, 0.370 and 0.328, respectively.Conclusions:The follow-up recommendations focus on providing support for family diet nursing, strengthening education on healthy diet, helping patients build a reasonable diet structure and habits, preventing malnutrition in the process, so as to meet the needs of early family diet nursing guidance for such patients.

Objective To explore the factors for chemotherapy-induced nausea and vomiting(CINV)in patients with advanced colorectal cancer receiving moderately emetic chemotherapy regimens.Methods 296 patients with colorectal cancer treated with oxaliplatin/irinotecan combination therapy and standard antiemetic prophylaxis regimen at the First Hospital of Jiaxing from July 1,2022 to June 30,2024 were selected,including 164 patients in oxaliplatin combination therapy group and 132 patients in irinotecan combination therapy group.Evaluated the nausea and vomiting status of patients within 5 days after the start of chemotherapy.Analyzed demographic data,medical history data,follow-up data.Results The incidence of CINV in oxaliplatin combination therapy group was 61.59％,and that in irinotecan combination therapy group was 53.79％.The incidence of delayed CINV and severe acute CINV in oxaliplatin combination therapy group were significantly higher than those in irinotecan combination therapy group(P＜0.05).Multivariate analysis showed that the risk factors for acute CINV in the oxaliplatin-based combination regimen were smoking history and CINV history.The risk factors for delayed CINV were age,no history of drinking,history of pregnancy-induced vomiting,motion sickness history,CINV history,and first use of the regimen.For the irinotecan-based combination regimen,the risk factors for acute CINV were motion sickness history and CINV history.The risk factors for delayed CINV were CINV history and anxious emotions.Conclusion When useing standard anti-emetic prophylaxis that still have a high incidence of CINV by moderate emetic chemotherapy drugs in advanced colorectal cancer patients.Patients with high risk factors should actively take preventive measures to control CINV.

Objective To establish the therapeutic effect prediction model of platelet transfusion in hematological patients,and receiver operating characteristic(ROC)curve and clinical cases are used to evaluate the clinical application value of the predic-tion model.Methods A total of 485 patients with hematological diseases who received platelet transfusion therapy in Kailuan General Hospital from January 2020 to December 2023 were selected,corrected count increment(CCI)was used to divide the patients into platelet transfusion effective group(n=340)and transfusion ineffective group(n=145).Multivariate Logistic regres-sion analysis was used to establish the prediction model of platelet infusion efficacy,and ROC curve was used to evaluate the application effect of the forcasting model.109 clinical cases were used to verify the practical application effect of the model,and the sensitivity,specificity and accuracy were calculated.Results Among 485 patients with hematological diseases,the incidence of ineffective platelet transfusion was 29.90%(145/485).Compated with the effective group,the ineffective group had more previous platelet transfusions was higher,and the difference was statistically significant(t=-4.435,P<0.05).In the ineffective group,there were more cases of hyperplenism,aplastic anemia and lymphoma,higher infection rate and higher positive rate of platelet antibody,and the differences were statistically significant(χ2=6.301～37.522,all P<0.05).Multivariate Logistic regres-sion analysis found that previous platelet infusion times,infection,leukemia,aplastic anemia and platelet antibodies were risk factors for ineffective platelet transfusion in patients with hematological diseases(Wald χ2=5.224～21.548,all P<0.05).Based on these risk factors,platelet infusion effect prediction models 1 and 2 were constructed.ROC curve was used to evaluate the application effect of the prediction model.The area under the curve(AUC),cut-offpoint,sensitivity and specificity of model 1 were 0.884,0.042,82.35%,88.89%.The AUC,cut-offpoint,corresponding sensitivity and specificity of prediction model 2 were 0.910,59.784,81.18%,94.44%,respectively.The Z values of model 1 and model 2 were 12.159 and 13.151,respectively.The prediction effect of model 2 was better than that of model 1.The actual application results showed that the sensitivity,specificity and accuracy of prediction model 1,2 were 85.71%,92.05%,90.89%and 90.48%,93.18%,92.66%,respectively.Conclusion The ineffective rate of platelet transfusion in hematological patients is relatively high.The prediction models 1 and 2 for platelet transfusion effectiveness have good results in predicting ineffective platelet transfusion,and prediction model 2 is better than pre-diction model 1,which can provide reliable basis for hematological patients on accurate platelet transfusion.

Objective:To analyze the early family diet nursing guidance needs of patients with gastrointestinal polyps resection based on Kano model, further screen the needs and optimize nursing strategies.Methods:This was a cross-sectional study. A total of 215 patients who underwent gastrointestinal polypectomy in Yingtan 184 Hospital of China Rongtong Group Healthcare Co. Ltd from January 2022 to June 2024 were prospectively selected using the purposive sampling method. The Kano model combined with Delphi expert consultation method was used to design a questionnaire on the family dietary nursing guidance needs of patients with gastrointestinal polypectomy. The Kano model needs attribute classification, Better-Worse coefficient analysis and two-dimensional matrix analysis were used to determine the information needs attributes, and the most sensitive and most needed factors were screened out for strategy optimization.Results:In this study, 232 questionnaires were distributed, and 215 valid questionnaires were returned, with an effective return rate of 92.67%. The 215 patients ranged in age from 20 to 72 years, with a mean age of 40.92 ± 10.06 years, including 163 males and 52 females. Among the 16 items in the survey questionnaire, 15 items need to be improved first. These include 1 attractive demand, 7 basic demands and 7 expected demands. The top 3 most sensitive needs were the formulation of an early home diet plan, the evaluation of the current diet structure, and the avoidance of exacerbating negative emotions, with sensitivities of 0.380, 0.370 and 0.328, respectively.Conclusions:The follow-up recommendations focus on providing support for family diet nursing, strengthening education on healthy diet, helping patients build a reasonable diet structure and habits, preventing malnutrition in the process, so as to meet the needs of early family diet nursing guidance for such patients.

Autoimmune disease is a kind of disease characterized by immune imbalance,abnormal activation of immune cells,massive production of inflammatory factors and immune complexes,which leads to the damage of multiple organs and systems.Autoimmune disease is easy to recur in clinical practice.The previous studies showed that there is a correlation between dampness syndrome in traditional Chinese medicine(TCM)and immune dysfunction.This paper explains the theoretical basis for the correlation between dampness syndrome of TCM and the recurrence of autoimmune diseases,and the similarities between the two in macro appearance,pathogenesis characteristics,etc.,analyzes the possible correlation about biological mechanism between dampness syndrome and autoimmune diseases,and discussed the correlation between pathogenic dampness of TCM and the recurrence of autoimmune diseases such as psoriasis,rheumatoid arthritis,ulcerative colitis,and nephrotic syndrome.It is pointed out that pathogenic dampness of TCM is an important pathogenic factor for the recurrence of autoimmune diseases,and is closely related to the recurrence of autoimmune diseases.Autoimmune diseases can be treated from the perspective of pathogenic dampness in TCM,and therapy of invigorating spleen,replenishing qi and removing dampness is frequently adopted,which is beneficial to alleviating the clinical symptoms of patients and reducing the recurrence of autoimmune disease.

Objective: To analyze the temporal changes in lipid levels in patients following acute pancreatitis(AP) and explore the factors associated with post-AP serum triglyceride( TG) level changes. Methods: Patients diag- nosed with AP were included in this study. Clinical data were collected retrospectively , and lipid profile data from follow-up visits after discharge were tracked. Kaplan-Meier(K-M) curves were used to stratify follow-up duration ,iodine content detection. Thyroid volume was measured using a fully digital ultrasound imaging system , and goiter prevalence was calculated. Results: A total of 141 patients with 306 follow⁃up visits were included. Spearman correlation analysis showed a mild increase in lipid levels over time post⁃discharge : TG( r = 0. 159 , P = 0. 005) , total cholesterol(TC)( r = 0. 231 , P < 0. 000 1) , high⁃density lipoprotein cholesterol( HDL⁃C) ( r = 0. 181 , P = 0. 002) , and apolipoproteinA1 ( ApoA1) ( r = 0. 371 , P <0. 000 1) . In the univariate linear mixed model , male gender(β = 0. 160 ,P = 0. 007) , body mass index(BMI) (β= 0. 017 , P = 0. 007) , diabetes history(β = 0. 138 , P = 0. 030) , smoking history(β = 0. 166 ,P = 0. 004) , and recurrent AP(β = 0. 119 , P = 0. 029) were significantly associated with Lg(TG) levels (P < 0. 05) . In the multivariate model , BMI( β = 0. 019 , P = 0. 042) , smoking history ( β = 0. 155 , P = 0. 049 ) , and recurrent AP( β =0. 148 , P = 0. 032) remained significantly positively correlated with changes in Lg(TG) levels after AP , albeit with a low correlation strength (r < 0. 200) . Conclusion Lipid levels , including TG , TC , HDL⁃C and ApoA1 , tend to increase over time in AP patients after discharge , with this trend being more pronounced in those with hypertriglyceridemic acute pancreatitis. Post⁃AP TG levels are significantly influenced by BMI at the time of onset , smoking history and recurrent AP.

Objectives:QT interval prolongation during treadmill test exercise is one of the clinical feature of patients with long QT syndrome(LQTS).This study aimed to explore the feasibility and efficacy of treadmill exercise testing as an auxiliary diagnosis tool for LQTS in clinical practice.Methods:We enrolled normal healthy individuals,common cardiovascular disease patients,and clinically diagnosed or suspected LQTS patients,who underwent treadmill exercise test from July 2023 to July 2024 at Fuwai Hospital.A special treadmill exercise testing procedure was designed to record the QT interval correction(QTc)intervals of the twelve lead electrocardiogram at 6 time points when performing the exercise tablet,including supine,sitting,standing,peak exercise,and recovery at 1-minute and 4-minute.The differences in QTc intervals among healthy group,cardiovascular diseases group,and suspected LQTS group were compared.Results:A total of 80 cases were consecutively enrolled,including 37 normal healthy controls,25 patients with common cardiovascular disease,and 18 patients with suspected LQTS.The QTc intervals at 6 points did not differ significantly between normal healthy controls and patients with cardiovascular disease,with QTc intervals less than 480 ms at all measurement.For patients with suspected LQTS,67.7%(12/18)of these patients presented a QTc interval≥480 ms at the 4-minute during recovery period.Among them,5 cases were confirmed to have pathogenic gene mutations of LQTS by genetic testing(including 1 case with a lying electrocardiogram QTc interval of 489 ms diagnosed with LQTS 1 type and a QTc interval of 636 ms during the 4-minute recovery period after exercise);5 clinically diagnosed patients(negative or undetectable in genetic testing)with a Schwartz score≥4,and the remaining 2 patients had a Schwartz score of 3.The remaining 5/18 patients,include 2 patients with clinical Schwartz scores≥4 and 3 patients with clinical suspicion(Schwartz scores 2-3)had a 4 min QTc interval of 445-480 ms during exercise recovery.Another patient with clinical suspicion(Schwartz score 3)had a 4 min QTc interval of<445 ms during exercise recovery and a negative genetic test at a later stage.Receiver operating characteristic curve analysis showed a sensitivity of 83.3%and specificity of 98.4%for QTc interval≥482 ms during the 4-minute recovery period of exercise as the LQTS diagnostic cutoff.Conclusions:This study results suggest that this special treadmill exercise testing protocol is effective in identifying LQTS and has strong feasibility and generalizability for clinical practice.