Drainage technology is widely used in clinical practice.At present,the observation of drainage fluid mainly relies on long-term,intermittent manual monitoring and estimation by medical personnel.This method is not only time-consuming and labor-intensive,but also has low accuracy,improper implementation,however,may result in excessive drainage,potentially leading to a spectrum of complications.Therefore,there is an urgent need to develop an intelligent drainage bag capable of quantitative automatic alarm to achieve accurate quantitative control of drainage fluid.For this reason,School of Nursing,Nanjing University of Chinese Medicine and Dongguan Mengtai Nursing Products Co.,Ltd.designed an intelligent drainage bag based on magnetic control adjustment that can alarm,and obtained a National Utility Model Patent of China(Patent Number:ZL 2021 2 0238620.4),this device is mainly composed of drainage bag,alarm,electrode wire,magnet,metal positioning ball,using the principle that water can conduct electricity design circuit diagram,there is a magnet on the outside side of the drainage bag,through the magnet to the magnetic principle of the metal positioning ball to control the location of the positioning ball,when the drainage fluid triggers the positioning ball,that is,the drainage fluid reaches the predetermined value.The alarm alarms automatically.The device enables accurate and personalized control of drainage fluid,reduces the incidence of excessive drainage,and features low production cost and simple operation,and can be widely used in clinical departments,worthy of clinical practice and application.

Drainage technology is widely used in clinical practice.At present,the observation of drainage fluid mainly relies on long-term,intermittent manual monitoring and estimation by medical personnel.This method is not only time-consuming and labor-intensive,but also has low accuracy,improper implementation,however,may result in excessive drainage,potentially leading to a spectrum of complications.Therefore,there is an urgent need to develop an intelligent drainage bag capable of quantitative automatic alarm to achieve accurate quantitative control of drainage fluid.For this reason,School of Nursing,Nanjing University of Chinese Medicine and Dongguan Mengtai Nursing Products Co.,Ltd.designed an intelligent drainage bag based on magnetic control adjustment that can alarm,and obtained a National Utility Model Patent of China(Patent Number:ZL 2021 2 0238620.4),this device is mainly composed of drainage bag,alarm,electrode wire,magnet,metal positioning ball,using the principle that water can conduct electricity design circuit diagram,there is a magnet on the outside side of the drainage bag,through the magnet to the magnetic principle of the metal positioning ball to control the location of the positioning ball,when the drainage fluid triggers the positioning ball,that is,the drainage fluid reaches the predetermined value.The alarm alarms automatically.The device enables accurate and personalized control of drainage fluid,reduces the incidence of excessive drainage,and features low production cost and simple operation,and can be widely used in clinical departments,worthy of clinical practice and application.

Objective To investigate the relationship between Kirsten rat sarcoma viral oncogene homolog(KRAS),neuroblastoma viral oncogene RAS homolog(NRAS),V-raf murine sarcoma viral oncogene homo-log B(BRAF),human epidermal growth factor receptor 2(HER2)gene mutations and microsatellite instabili-ty(MSI)status and clinicopathological features in patients with colorectal cancer.Methods The clinical data of 226 patients with colorectal cancer treated in the hospital from October 2019 to March 2022 were collected.Next-generation sequencing technology was used to detect KRAS,NRAS,BRAF,HER2 gene mutations and MSI status.Immunohistochemistry was used to evaluate the mismatch repair system(MMR)status.Multiva-riate Logistic regression analysis was used to analyze the relationship between KRAS,NRAS,BRAF,HER2 gene mutations and clinicopathological features.Results Among 226 colorectal cancer patients,the mutation frequencies of KRAS,NRAS,BRAF and HER2 were 54.89％,5.3％,8.4％and 1.8％,respectively.The fre-quency of KRAS mutation in mucinous adenocarcinoma was higher than that in common adenocarcinoma(P＜0.05).The risk of KRAS mutation in right colon cancer was increased(OR=2.145,P=0.012).NR AS gene mutation was more frequent in left colon and rectal cancer(P＜0.05).The frequency of BRAF gene mu-tation was higher in poorly differentiated and microsatellite instability-high(MSI-H)colorectal cancer(P＜0.05),and the risk of BRAF gene mutation in the right colon was increased(OR=2.844,P=0.042).HER2 gene amplification mutation showed distant metastasis(P＜0.05).KRAS mutations were mutually exclusive with NRAS,BRAF and HER2 amplification mutations(P＜0.05).MSI-H was more frequent in the right co-lon(P＜0.05).Of the 226 cases,10 cases were defective mismatch repair(dMMR)/MSI-H,8 cases were dM-MR/microsatellite stable,and 5 cases were proficient mismatch repair/MSI-H.There was a moderate agree-ment between dMMR and MSI-H(Kappa=0.575).Conclusion KRAS,NRAS,BRAF,HER2 and MSI sta-tus are associated with clinicopathological features in patients with colorectal cancer.Combined detection of KRAS,NRAS,BRAF,HER2 and MSI can provide more accurate and effective data to guide the treatment and prognosis of patients.

Objective To construct a model of heart failure risk prediction based on four machine learning algo-rithms in order to support early diagnosis and intervention.Methods After reviewing the heart failure dataset pub-lished on the Kaggle community,feature selection was used to select relevant factors related to heart failure as pre-dictive indicators.Four machine learning algorithms,namely logistic regression,support vector machine,random forest,and XGBoost were selected to establish predictive models.Compared and analyzed its accuracy,precision,recall,F1 score and area under the ROC curve(AUC)to verify the performance of the model.Results The study analyzed 11 features of 918 patients with heart failure and selected 10 feature factors for modeling.After optimizing the hyper-parameters through grid search,the XGBoost model performed the best,with accuracy,precision,recall,and f1_score and AUC values were 87.5%,90.38%,89.71%,90.04%and 0.93,respectively.In addition,data analysis showed that exercise ST slope,chest pain type,and exercise induced angina were main influencing factors for heart failure.Conclusions The XG Boost model has the best predictive tool for heart failure,and machine learning algorithms may support early prevention,early diagnosis as well as control of heart failure.

Objective To investigate the distribution of serum allergens in children with respiratory allergic or infectious diseases,and then provide evidence for the prevention and treatment of children's respiratory allergic and infectious diseases.Methods The clinical data of 2 334 children aged 1 to 14 years old(median 5 years)visited Shengjing Hospital Affiliated to China Medical University from April 2019 to June 2022 were retrospectively analyzed.All the children were diagnosed with respiratory allergic or infectious diseases.The Phadia 250 automatic fluorescence enzyme immunoassay system and its supporting detection reagents were used to detect serum sIgE to allergens and statistical analysis was conducted using the GraphPad Prism 8.0 software.Results The positive rates of sIgE to allergens in children with respiratory allergic diseases(n=1 151)and respiratory infectious diseases(n=1 183)were 75.85%and 47.68%,respectively.The main allergen in the children with asthma was a mixture of dust mites(44.18%),followed by a mixture of fungi(40.64%).The main allergens in the children with allergic rhinitis were a mixture of dust mites and weed pollen,both accounting for 52.51%.The common allergen of respiratory infectious diseases was mold mixture(27.81%),followed by a mixture of dust mites(24.77%).The main allergen in children under 7 years old was a mixture of fungi(33.31%).As age increased,the positive rates of allergens in different combinations increased.The positive rates of serum sIgE to dust mite mixture,dander mixture,and weed pollen mixture in children aged≥7 years old were significantly higher than those in children aged≤3 years old and 4-6 years old(P＜0.000 1).The positive rate of serum sIgE to allergens in male patients(64.33%)was significantly higher than that in female patients(56.33%,χ2=14.29,P=0.000 2).Among various disease groups,the levels of sIgE to dust mite mixture and weed pollen mixture were distributed at levels 1-6,with the highest distribution rate at level 6 in allergic rhinitis.Each disease group was associated with one allergen or a combination of two allergens.As the number of allergen combinations increased,the positive rate of sIgE gradually de-creased.The tIgE levels in children with allergic rhinitis were significantly higher than those in children with asthma,upper respiratory tract infection,and lower respiratory tract infection(all P＜0.005).Conclusion Dust mite mixture and mold mixture are common al-lergens in children with asthma,while weed pollen mixture and dust mite mixture are common allergens in children with allergic rhini-tis.As age increases,children become more and more allergic to dust mite,mold,dander,weeds,and pollen.

Objective: To understand the oral health status and associated factors of preschool children with disabilities in Bengbu City, so as to provide evidence for preventing dental caries in children with disabilities. Methods: From September 2021 to March 2022, a total of 405 preschool children with disabilities from two rehabilitation institutions in Bengbu were randomly selected for oral health examination, questionnaire survey and physical examination. The caries prevalence rate among disabled children was analyzed. After grouping based on childrens BMI, the correlation between body mass index (BMI) and dental caries among children was explored. Multivariate binary Logistic regression analysis was employed to investigate the factors associated with dental caries occurrence in children. Results: The prevalence of dental caries in preschool children with disabilities was 74.07%, with rates of 71.01% for boys and 77.27% for girls. There was a significant difference in caries prevalence between boys and girls aged 5（66.67%，88.24%） (χ2=7.53, P<0.05). There were significant differences in the dmft index among different BMI groups (underweight: 240, normal weight: 606, overweight:30,obese:60,H=35.66,P<0.05). BMI was negatively correlated with dmft（r=-0.50，P＜0.01）. Frequent tooth brushing (2-3 times daily), the use of fluoride toothpaste, limited intake of sugary foods (< 2 times/d) in the past six months, and exclusively breastfeeding within first six months were negatively correlated with the occurrence of dental caries in disabled children (OR=0.09，0.41，0.24, P＜0.05). Sleep forward to eat，parental education level of junior high school or lower, and parental education of vocational school or high school were positively correlated with dental caries (OR=3.18，5.95，3.99，66.95，7.75，P＜0.05). Conclusions The caries prevalence rate of disabled children in Bengbu City is high and is influenced by multiple factors. It is time to strengthen the oral health training for parents and teachers in educational institutions, pay attention to childrens oral health care, and help disabled children improve their quality of life.

In 2016, a national one million general population cohort project was set up in China for the first time in "Precision Medicine Research" Key Project, National Key Research and Development Program of China, which consists of general population cohorts in seven areas in China. As one of the seven major areas in China, northeastern China has unique climate and specific dietary patterns, and population aging is serious in this area. And the burden of chronic and non-communicable diseases ranks tops in China. Therefore, it is of great significance to establish a large general population cohort in northeastern China to explore the area specific exposure factors related to pathogenesis and prognosis of chronic and non-communicable diseases, develop new prevention strategies to reduce the burden of the diseases and improve the population health in northeastern China. In July 2018, the general population cohort study in northeastern China was launched, the study includes questionnaire survey, health examination and blood, urine and stool sample collection and detection in recruited participants. By now, the cohort has covered all age groups, and the baseline data of 115 414 persons have been collected. This paper summarizes the design and practice of the general population cohort study in northeastern China to provide reference for related research in China.

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

Objective:To investigate the correlation between the SUV index (SUV max of the lesion/SUV mean of the liver) in 18F-FDG PET/CT imaging and the invasiveness of early lung adenocarcinoma presenting as ground-glass nodule (GGN). Methods:From January 2012 to March 2020, 167 GGN patients (49 males, 118 females; age: (61.5±9.0) years) with early lung adenocarcinoma who underwent PET/CT imaging in Changzhou First People′s Hospital were retrospectively enrolled. The image parameters including the GGN number, location, type, edge, shape, abnormal bronchus sign, vacuole sign, pleural depression, vessel convergence sign, GGN diameter ( DGGN), solid component diameter ( Dsolid), consolidation to tumor ratio (CTR, Dsolid/ DGGN), CT values (CT value of ground-glass opacity (CT GGO), CT value of lung parenchyma (CT LP), ΔCT GGO-LP (CT GGO-CT LP)) and SUV index were analyzed. Single and multivariate logistic regressions were used to analyze the correlation between SUV index and infiltration. The generalized additive model was used for curve fitting, and the piece-wise regression model was used to further explain the nonlinearity. Results:In 189 GGNs, invasive adenocarcinoma accounted for 85.2% (161/189). Single logistic regression showed that the GGN number, type, shape, edge, abnormal bronchus sign, pleural depression, vessel convergence sign, DGGN, Dsolid, CTR, CT GGO, ΔCT GGO-LP and SUV index were related factors of infiltration (odds ratio ( OR) values: 0.396-224.083, P<0.001 or P<0.05). After fully adjusting for confounding factors, SUV index was significantly correlated with increased risk of invasion ( OR=2.162 (95% CI: 1.191-3.923), P=0.011). Curve fitting showed that the SUV index was non-linearly related to the risk of infiltration, and the risk of infiltration increased significantly only when the SUV index was greater than 0.43 ( OR=3.509 (95% CI: 1.429-8.620), P=0.006). The correlation between SUV index and infiltration had no interaction between age, vacuoles, pleural depression and CTR subgroups (all P>0.05). Conclusions:SUV index is an independent factor related to the invasiveness of early lung adenocarcinoma. The higher the SUV index, the greater the risk of invasion; but the two are not simply linearly correlated.

Objective:To investigate the clinical effect of the first dorsal metatarsal-dorsal phalangeal artery flap in repairing large area of soft tissue defect on the palmar side of finger.Methods:From February, 2016 to June, 2018, 11 fingers of 11 patients (7 males and 4 females, aged 19-46 years old with an average of 32.5 years old) with large area of soft tissue defect on the palmar side of the finger were repaired with the first dorsal metatarsal-dorsal phalangeal artery flap. These included 3 with the first dorsal metatarsal-first dorsal phalangeal artery blood supply, and 8 with the first dorsal metatarsal-second dorsal phalangeal artery blood supply. In which 3 with retained finger pulp was for repairing the defects and bridging arteries, including 1 flexor tendon defect repaired by the extensor digitorum brevis tendon of the second toe with the flap. The type of blood vessel was Gilbert I detected by CDU before surgery. The area of the flaps was from 1.5 cm×5.0 cm to 3.0 cm×8.0 cm. The donor area of the flaps was compressed with full thickness skin grafts of the shank. The follow-up data was collected by outpatient clinic visits and telephone interviews.Results:All the 11 flaps survived and were followed-up for an average of 14 months, ranged from 6 months to 24 months. The colour and texture of the flaps were good. Sensing of temperature, pain and touch restored, without swelling. Function of the fingers was well restored. The range of motion of distal and proximal interphalangeal joints was closed to normal. The TPD of the flaps was 5-11 mm, with an average of 8 mm. Ten had primary wound healing in the donor sites of foot. One case had necrosis of the proximal toe of the skin graft and healed after dressing change. Long-term follow-up of the skin grafting area was wear-resistant, and does not hinder walking without rupture.Conclusion:Application of the first dorsal metatarsal-dorsal toe artery flap to repair large area of soft tissue defect on the palmar side of finger has number of advantages such as it, covers the wound and carry the tendons, bridges the arteries at the same time, plus delivers satisfactory outcome.