Objective To evaluate the accuracy and reproducibility of AlignRT-guided positioning by comparing two positioning workflows for pelvic tumor radiotherapy,and to further explore the feasibility of using it to replace skin marker alignment.Methods Forty cases of pelvic tumor treated with radiotherapy using Infinity accelerator in Sun Yat-sen University Cancer Center between March 2022 and March 2023 were included in the study,with 20 cases using the skin marker alignment workflow and the other 20 adopting AlignRT-guided positioning workflow.The translational errors(LAT,LNG,VRT)and rotational errors(Yaw,Pitch,Roll)were determined by the registration of pre-treatment cone-beam CT(CBCT)with planned CT.Both CBCT shifts and error offset distributions were analyzed;planning target volume(PTV)margins were calculated;and correlation analyses were conducted among six-dimensional errors,and between body mass index and setup errors.Results The median translational and rotational setup errors of skin marker alignment workflow vs AlignRT-guided positioning workflow were 0.19-0.34 cm vs 0.10-0.15 cm and 0.50°-1.30°vs 0.50°-0.70°,with the maximum offset ranges of 1.20-1.70 cm vs 0.42-0.47 cm and 2.00°-5.50° vs 1.80°-2.00°,respectively.Additionally,for skin marker alignment workflow,inter-fractional errors>0.5 cm and>3° were observed in 23.3%and 9.8%of fractions.The PTV margins of AlignRT-guided positioning workflow were 0.37,0.38 and 0.34 cm in the left-right,superior-inferior and anterior-posterior directions,respectively,which were much smaller than those of skin marker alignment workflow(0.67,1.22 and 0.95 cm).No correlation was found between six-dimensional errors in two positioning workflows.When using AlignRT-guided positioning workflow,the setup errors in LAT,LNG and Pitch directions had low correlations with body mass index.Conclusion In pelvic tumor radiotherapy,AlignRT-guided positioning can reduce translational and rotational errors,achieve precise setup and excellent inter-fractional reproducibility and stability,and replace traditional skin marker alignment while being used in conjunction with CBCT.

Objective:To construct a clinical practice training system for master′s degree students specializing in oral nursing based on the competency iceberg model for job performance, and to provide a valuable reference for the clinical training of master′s students in oral nursing.Methods:The research team initially formulated the components of the clinical practice training system through an extensive literature review and semi-structured interviews. From October 17, 2023, to November 13, 2023, the Delphi expert consultation methodology was utilized to facilitate two rounds of inquiries involving 20 specialists in the domain of oral care.Results:The positive coefficients of the two rounds of expert inquiries were 95.24% (20/21) and 100.00% (21/21). The authority coefficients were 0.925 and 0.929, while the variation coefficients ranged from 0.00 to 0.22 and from 0.05 to 0.11. Additionally, Kendall′s harmony coefficients were 0.229 and 0.319 (both P<0.01). The finalized training system included training objectives, training content, training requirements and examinations, totaling 3 first-level items, 18 second-level items and 67 third-level items. Conclusions:The training system of clinical practice for oral nursing graduate students constructed in this study is informative and reliable, and can provide reference for clinical practice of professional postgraduates in oral nursing.

Objective Taking into account the physical and mental characteristics of patients with COPD,we develop and implement a lung rehabilitation education game software,aiming to explore more effective health education practices for COPD.Methods Drawing on the Health Belief Model theory,the game content was developed by semi-structured interviews,brainstorming sessions,and expert consultations,and it was implemented via a WeChat mini program.Patients with COPD from the respiratory department of a tertiary general hospital of Luzhou city between March and October 2023 were conveniently selected as the study subjects.Among them,40 patients from July to October 2023 were designated as an experimental group,and another 40 from March to June 2023 constituted a control group.The experimental group was provided with routine health education combined with pulmonary rehabilitation games,whereas the control group received standard health education.After the intervention,the researchers compared the COPD knowledge questionnaire scores and pulmonary rehabilitation adherence between the 2 groups,and assessed the satisfaction of both patients and nurses with the software.Results No sample detachment.The score of the COPD knowledge questionnaire in the experimental group was higher than that in the control group,and the difference was statistically significant(Z=5.361,P＜0.001).The proportion of patients in the experimental group with good adherence to pulmonary rehabilitation(85％)was significantly higher than it in the control group(25％),(x2=29.091,P＜0.001).The patients'overall satisfaction rate with the game was 95％,with operational effectiveness receiving the highest satisfaction rating at 97％.Conclusion The pulmonary rehabilitation education game for patients with COPD can improve their knowledge of COPD,enhance their compliance with pulmonary rehabilitation.Patients have high satisfaction with the software.The software enriches the clinical health education methods,which can be used in clinical practice.

Objective:To construct a clinical practice training system for master′s degree students specializing in oral nursing based on the competency iceberg model for job performance, and to provide a valuable reference for the clinical training of master′s students in oral nursing.Methods:The research team initially formulated the components of the clinical practice training system through an extensive literature review and semi-structured interviews. From October 17, 2023, to November 13, 2023, the Delphi expert consultation methodology was utilized to facilitate two rounds of inquiries involving 20 specialists in the domain of oral care.Results:The positive coefficients of the two rounds of expert inquiries were 95.24% (20/21) and 100.00% (21/21). The authority coefficients were 0.925 and 0.929, while the variation coefficients ranged from 0.00 to 0.22 and from 0.05 to 0.11. Additionally, Kendall′s harmony coefficients were 0.229 and 0.319 (both P<0.01). The finalized training system included training objectives, training content, training requirements and examinations, totaling 3 first-level items, 18 second-level items and 67 third-level items. Conclusions:The training system of clinical practice for oral nursing graduate students constructed in this study is informative and reliable, and can provide reference for clinical practice of professional postgraduates in oral nursing.

Objective To prepare a dissolvable microneedle(MN)patch loaded with sodium houttuyfonate(SH)combined with erythromycin(ERY)(SH+ERY-MN patch),to characterize its properties,and to investigate its synergistic anti-acne effects and the mechanisms involved.Methods The SH+ERY-MN patch was prepared by two-step centrifugation.The morphology and skin puncture performance of the microneedles were evaluated using scanning electron microscopy,puncture tests,and other methods.The combined antibacterial effect was assessed using the checkerboard assay.The in vitro anti-inflammatory effect of the SH+ERY-MN patch was evaluated by quantitative PCR(qPCR)and enzyme-linked immunosorbent assay(ELISA).The therapeutic effect of the SH+ERY-MN patch on acnes in mice was investigated using an animal model.Results The microneedle patch prepared in the study had well-aligned microneedles,excellent needle shape,and good mechanical properties,which could effectively penetrate the skin to reach the superficial dermis.The minimum inhibitory concentration(MIC)of ERY against acne was 1.28 mg/mL.When ERY was combined with SH,the results showed that the fractional inhibitory concentration(FIC)was 0.375,indicating that the medication combination had a synergistic antibacterial effect.In particular,the MIC value of ERY in combination was 1/4 of that of ERY used alone.The results of in vitro qPCR showed that SH+ERY-MN could downregulate the production of interleukin(IL)-1β,IL-18,tumor necrosis factor α(TNF-α),inhibitor of κB(I-κB),Toll-like receptor 4(TLR4),NLR family pyrin domain containing 3(NLRP3),and cysteine-aspartic proteases(Caspase-1)induced by Propionibacterium acnes(PA)in cell culture supernatant(P＜0.05).According to the in vivo findings,SH+ERY-MN had a significant anti-acne effect and effectively alleviated cytokine-mediated inflammatory responses.The results of qPCR and ELISA showed that SH+ERY-MN could effectively reduce the levels of IL-1β,IL-18,NLRP3,and Caspase-1 in the serum of the mouse acne inflammation model(P＜0.01),and had good antibacterial and anti-inflammatory effects.Conclusion SH+ERY-MN patch was successfully prepared and demonstrated obvious anti-acne effects.The SH+ERY-MN patch enhances the transdermal delivery of SH combined with ERY.It provides an innovative method for acne treatment and creates new possibilities for achieving effective drug delivery and improving therapeutic efficacy.

Objective:To compare the efficacy and safety of crisaborole ointment 2% versus pimecrolimus cream 1% in the treatment of mild to moderate atopic dermatitis in children aged 2 years or older.Methods:A multicenter, randomized, open-label, controlled clinical trial was conducted. A total of 120 pediatric patients aged 2 - 17 years with mild to moderate atopic dermatitis were enrolled from departments of dermatology of 8 hospitals in China between March 2022 and February 2023. The participants were randomly assigned in a 1∶1 ratio to the crisaborole group and the pimecrolimus group, and received the treatment with crisaborole ointment 2% and pimecrolimus cream 1% respectively, twice a day for 4 weeks. Visits were scheduled at baseline/on day 1, as well as on days 8, 15, and 29. The primary efficacy outcome was the percentage of patients achieving the Investigator's Static Global Assessment (ISGA) success (defined as clear [0] or almost clear [1] on the ISGA scale, combined with ≥ 2‐grade improvement from baseline) on day 29. The secondary efficacy outcomes included changes in the Eczema Area and Severity Index (EASI) total scores from baseline to day 29, percentages of patients achieving ISGA improvement (defined as clear [0] or almost clear [1] on the ISGA scale), as well as changes in the Peak Pruritus Numerical Rating Scale (NRS) scores, Dermatology Life Quality Index (DLQI) /Infants' Dermatology Life Quality Index (IDLQI) /Children's Dermatology Life Quality Index (CDLQI) scores, and in the Dermatitis Family Impact (DFI) scores. Drug safety was evaluated according to the incidence of adverse events. Categorical data were compared using the chi-square test. Since measurement data did not follow a normal distribution, the rank sum test was used for comparisons of measurement data between groups.Results:A total of 106 children with mild to moderate atopic dermatitis were included in the per-protocol analysis set, with 52 in the crisaborole group (26 males and 26 females) and 54 in the pimecrolimus group (27 males and 27 females). There were no significant differences in age, disease duration, ISGA and EASI scores at baseline between the two groups (all P > 0.05). On day 29, 22 patients (42.31%) in the crisaborole group and 25 (46.30%) in the pimecrolimus group achieved ISGA success, with no significant difference between the two groups ( χ2 = 0.17, P = 0.68) ; 35 patients (67.31%) in the crisaborole group and 45 (83.33%) in the pimecrolimus group achieved ISGA improvement, also with no significant difference between the two groups ( χ2 = 3.68, P = 0.06) ; additionally, there were no significant differences in the EASI, pruritus NRS, DLQI/IDLQI/CDLQI, or DFI scores between the two groups (all P > 0.05). Adverse reactions to the two topical agents were mainly local reactions such as mild to moderate pain, itching, or worsening of itching, and no obvious systemic adverse reactions occurred. The incidence of drug-related adverse reactions was 46.15% (24 cases) in the crisaborole group and 37.04% (20 cases) in the pimecrolimus group, with no significant difference between the two groups ( χ2 = 0.91, P = 0.34) . Conclusion:The efficacy of crisaborole ointment 2% was comparable to that of pimecrolimus cream 1% in the treatment of mild to moderate atopic dermatitis in children aged ≥ 2 years, and it yielded early and rapid improvement in the quality of life of patients and their families, with good safety and tolerability profiles.

Objective:To explore the current status of orthopedic nurses' health science popularization information generation capacity and training needs in Beijing.Methods:This study was a cross-sectional survey. Convenience sampling was used to select 818 orthopedic nurses from 54 hospitals (48 Class Ⅲ hospitals and 6 ClassⅡ hospitals) in Beijing in April 2024 for the study. General Information Questionnaire, Self-assessment Scale for Orthopedic Nurses' Health Science Popularization Information Generation Capacity, and Training Needs Scale for Orthopedic Nurses' Health Science Popularization Information Generation Capacity were used to survey the study participants. Multiple linear regression was used to analyze the factors influencing orthopedic nurses' health science popularization information generation capacity. A total of 818 questionnaires were distributed and 781 valid questionnaires were recovered, with a valid recovery rate of 95.48% (781/818) .Results:The 781 orthopedic nurses had a total score of [49.00 (42.00, 57.00) ] on the Self-assessment Scale for Orthopedic Nurses' Health Science Popularization Information Generation Capacity. Multiple linear regression analysis showed that years of working experience, health status, intention to participate in health science popularization, stage of health science popularization behavior, and frequency of participation in health science popularization training were the factors influencing orthopedic nurses' health science popularization information generation capacity ( P<0.05), which explained 17.30% of the total variation. Beijing orthopedic nurses had training needs in five areas of assessing audience needs, assessing message risk, revising and improving messages, generating messages, and pretesting messages. Conclusions:The Beijing orthopedic nurses' health science popularization information generation capacity is at a medium and high level, but there is still much room for improvement. It is recommended to pay attention to the physical and mental health of orthopedic nurses, improve the work commitment, and build a long-term incentive mechanism to stimulate the enthusiasm of orthopedic nurses in health science popularization. Medical institutions or specialty societies should actively formulate training programs, build training platforms, and gradually perfect the orthopedic nurses' health science popularization training system in order to comprehensively enhance the health science popularization information generation capacity and help China's great health.

Infectious diseases continue to pose a threat to global public health. Successive global shocks caused by emerging and re-emerging pathogens have continuously challenged existing surveillance systems, highlighting the urgent need to build efficient and precise pathogen surveillance networks. Pathogen genomic databases have been developed rapidly in recent two decades, significantly improving the molecular identification, evolutionary analysis, and transmission tracking of pathogens, and changing disease surveillance strategies and patterns. This paper summarizes the developmental history and current state of pathogen genomic databases, and discusses their applications in public health, including pathogen variation surveillance, emerging or suspected pathogen identification, and epidemiological tracing. Furthermore, this paper systematically analyzes the limitations and key challenges faced by current global health prevention and control system, and suggests the focus of the development of online pathogen databases to address existing shortcomings, ultimately improve global infectious disease surveillance and early warning

Objective:To develop an evaluation index system for discharge preparation management in elderly patients with hip fractures, providing a reference for clinical discharge planning.Methods:Guided by the operational definition of discharge readiness, a preliminary index system was constructed through literature review, semi-structured interviews, and expert group discussions. Using purposeful sampling, 22 experts were recruited for two rounds of expert consultation conducted between July and August 2024. The final index system was established based on expert consensus.Results:The effective response rates for the two Delphi rounds were 95.65% (22/23) and 100.00% (22/22) , respectively. The rates of feedback comments were 77.27% (17/22) and 40.91% (9/22) . The expert authority coefficients were 0.955 and 0.934, and the Kendall's coordination coefficients were 0.129 and 0.104, respectively (both P<0.01) . The final index system consisted of four first-level indicators, 16 second-level indicators, and 39 third-level indicators. Conclusions:The constructed evaluation index system demonstrates good scientific rigor and practical applicability. It can serve as a reference for the discharge preparation management of elderly patients with hip fractures.

Teicoplanin,currently one of the preferred drugs for treating infections caused by multidrug-resistant Staphylococcus aureus and Enterococcus in clinical practice,has a high plasma protein binding rate.Most of the drug binds to protein after entering the body,only a portion of the drug exists in a free form.Since the free drug can pass through biological membranes and enter the target tissue to exert its therapeutic effect,monitoring the free teicoplanin blood concentration is clinically important and plays a role in guiding individualized drug therapy.This article summarizes and compares the current methods for determining the concentration of free teicoplanin in the blood,and analyzes their advantages and disadvantages.Based on this,it analyzes the possible factors affecting the concentration of free teicoplanin in the blood,providing a reference for the development of new methods for detecting free teicoplanin concentration and providing more accurate individualized medication plans based on free concentration.