AIM: To observe the variation characteristics of postoperative optical coherence tomography(OCT), optical coherence tomography angiography(OCTA)examination indicators in patients with high myopia and macular hole retinal detachment(MHRD), and analyze their correlation with visual function.METHODS: A total of 78 MHRD patients with high myopia who were treated in the Baoding No.1 Central Hospital from January 2019 to October 2023 were selected as the study objects, all of which underwent vitrectomy combined with internal limiting membrane tamponade. The changes in the best corrected visual acuity(BCVA), OCT and OCTA parameters, including choriocapillary blood flow area(CBFA), diameter of ellipsoid zone absence(DEZA)and blood flow density were observed at 1, 3 and 6 mo after surgery. Pearson correlation analysis and multiple linear regression analysis were conducted to analyze the correlation between BCVA and CBFA, DEZA, and blood flow density at different time points after surgery.RESULTS: BCVA of enrolled patients at 1, 3, and 6 mo after surgery were 1.75±0.79, 1.49±0.53, and 1.08±0.44, respectively, and the differences at different points were statistically significant(all P<0.05). At 1, 3, and 6 mo after surgery, the patient's CBFA was 1.67±0.24, 1.82±0.13, and 1.94±0.15 mm2, respectively, the DEZA was 813.27±453.16, 590.89±421.38, and 427.58±385.34 μm, respectively, and the blood flow density was 24.36±7.81, 27.74±8.12, and 31.54±8.59, respectively. The differences in above indicators at different time points were statistically significant(all P<0.05). Pearson correlation analysis found that there was no significant correlation between DEZA, blood flow density and BCVA in patients with high myopia and MHRD at 1 mo after surgery(all P>0.05). However, CBFA was negatively correlated with BCVA(LogMAR; P<0.05); at 3 and 6 mo after surgery, CBFA and blood flow density were negatively correlated with BCVA(LogMAR)in patients with high myopia and MHRD, while DEZA was positively correlated with BCVA(LogMAR; all P<0.05). Multiple linear regression analysis showed that CBFA, blood flow density, and DEZA were important influencing factors of BCVA at 3 and 6 mo after surgery(all P<0.05).CONCLUSION:Visual function of patients with high myopia and MHRD gradually increases after surgery, and is closely related to postoperative CBFA, DEZA and blood flow density. It is recommended to regularly monitor changes in OCT and OCTA indicators after surgery.

Objective:To evaluate the effectiveness of a workshop-driven interactive teaching model in clinical alarm training for undergraduate nursing interns in the intensive care unit (ICU).Methods:A total of 120 undergraduate nursing students who interned in the ICU from November 2023 to April 2024 were enrolled and randomly assigned using a random number table into a control group ( n=60, traditional teaching) and an intervention group ( n=60, workshop-driven interactive teaching). Clinical alarm knowledge, attitudes, and practices (KAP); perception of patient safety culture; and training satisfaction were assessed before and after the training using validated questionnaires. Differences between groups were analyzed using independent sample t-test, paired sample t-test, chi-square test, and the Mann-Whitney U test with SPSS 22.0. Results:There were no significant differences between the two groups in clinical alarm KAP scores or patient safety culture perception scores before the training ( P>0.05). After the training, the intervention group showed significantly higher scores in clinical alarm KAP [(127.58±6.45) vs. (123.48±7.61), t=3.17, P=0.002] and patient safety culture perception [(99.44±9.17) vs. (95.45±12.03), t=-2.04, P=0.044] compared with the control group. Satisfaction with training content, teaching quality, and overall instructional design was significantly higher in the intervention group than in the control group ( P<0.05). Within-group comparisons showed that the intervention group had significant improvements in clinical alarm KAP [(127.58±6.45) vs. (120.10±10.25), t=-5.10, P<0.001] and patient safety culture perception [(99.44±9.17) vs. (94.46±12.12), t=-2.65, P=0.010] after training. No significant changes were observed in the control group after training ( P>0.05). Conclusions:The workshop-driven interactive teaching model can effectively enhance the clinical alarm KAP levels and patient safety culture perception among undergraduate nursing interns in the ICU. This teaching approach provides a scientific basis for optimizing clinical alarm education and cultivating high-quality nursing professionals.

Objective:To evaluate the effectiveness of a workshop-driven interactive teaching model in clinical alarm training for undergraduate nursing interns in the intensive care unit (ICU).Methods:A total of 120 undergraduate nursing students who interned in the ICU from November 2023 to April 2024 were enrolled and randomly assigned using a random number table into a control group ( n=60, traditional teaching) and an intervention group ( n=60, workshop-driven interactive teaching). Clinical alarm knowledge, attitudes, and practices (KAP); perception of patient safety culture; and training satisfaction were assessed before and after the training using validated questionnaires. Differences between groups were analyzed using independent sample t-test, paired sample t-test, chi-square test, and the Mann-Whitney U test with SPSS 22.0. Results:There were no significant differences between the two groups in clinical alarm KAP scores or patient safety culture perception scores before the training ( P>0.05). After the training, the intervention group showed significantly higher scores in clinical alarm KAP [(127.58±6.45) vs. (123.48±7.61), t=3.17, P=0.002] and patient safety culture perception [(99.44±9.17) vs. (95.45±12.03), t=-2.04, P=0.044] compared with the control group. Satisfaction with training content, teaching quality, and overall instructional design was significantly higher in the intervention group than in the control group ( P<0.05). Within-group comparisons showed that the intervention group had significant improvements in clinical alarm KAP [(127.58±6.45) vs. (120.10±10.25), t=-5.10, P<0.001] and patient safety culture perception [(99.44±9.17) vs. (94.46±12.12), t=-2.65, P=0.010] after training. No significant changes were observed in the control group after training ( P>0.05). Conclusions:The workshop-driven interactive teaching model can effectively enhance the clinical alarm KAP levels and patient safety culture perception among undergraduate nursing interns in the ICU. This teaching approach provides a scientific basis for optimizing clinical alarm education and cultivating high-quality nursing professionals.

AIM: To compare the outcome of C3F8 versus silicone oil tamponade after pars plana vitrectomy(PPV)and inverted internal limiting membrane(ILM)for the treatment of highly myopic macular hole retinal detachment(MHRD).METHODS: Retrospective clinical study. Totally 45 patients(45 eyes)with highly myopic MHRD who visited our hospital between January 2019 and August 2022 were selected as the research subjects. The patients were divided into two groups according to different intraocular tamponade agents: C3F8(22 eyes)and silicone oil(23 eyes)groups. All patients underwent conventional three-incision PPV, ILM was tamped, a venous blood clot was placed on the tamped ILM, and 15% C3F8 and silicone oil were used as tamponade, respectively. The best corrected visual acuity(BCVA), multifocal electroretinogram(mfERG), the closure of the macular hole, retinal reattachment and the complications were observed.RESULTS: The macular hole closure rate was 77% in the C3F8 group and 83% in the silicone oil group, respectively(P>0.05), and retinal reattachment rates were 95% and 96%, respectively(P>0.05). The visual acuity of the two groups significantly improved, which was 0.99±0.34 and 1.22±0.37, respectively, and the C3F8 group was better than that of the silicone oil group(t=-2.156, P=0.037). After operation, the response density of the first ring of P1 wave in the first order kernel in mfERG was 114.27±26.37 nV/deg2 for the C3F8 group and 98.08±24.36 nV/deg2 for the silicone oil group, and the response density of the second ring of P1 wave was 80.45±14.94 nV/deg2 for the C3F8 group and 67.73±15.33 nV/deg2 for the silicone oil group, all of which were significantly higher compared to pre-operation [the response density of the first ring of P1 wave: 58.13±13.96 nV/deg2 for the C3F8 group and 55.30±10.48 nV/deg2 for the silicone oil group, the response density of the second ring of P1 wave: 51.18±8.19 nV/deg2 for the C3F8 group and 47.43±11.97 nV/deg2 for the silicone oil group](all P<0.05). It was found that the response density of the first ring of P1 wave was lower in the silicone oil group than in the C3F8 group(P<0.05). There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).CONCLUSION: Silicone oil tamponade or C3F8 tamponade after PPV combined with ILM can both promote retinal reattachment and macular hole closure in patients with MHRD, and the C3F8 tamponade was superior to silicone oil in visual function recovery.

Standardized patient (SP) has been widely used for medical teaching and assessment in medical colleges at home and abroad. Pediatric consultations are mostly directed toward parents, so in pediatric education, SP is usually referred to as standardized family (Sfam), which is trained to portray the patient's family members. At present, the development of Sfam in pediatric teaching in China is relatively slow. Based on the characteristics of pediatric teaching, the paper summarizes the necessity of Sfam, the application of different types of Sfam, the integration of Sfam with other clinical teaching methods, and the value of Sfam in pediatric teaching, and also discusses the future direction and prospects of Sfam combined with artificial intelligence in pediatric teaching. After years of development, Sfam has been proved to be an effective teaching model. We hope this paper can help more pediatric clinical educators gain a deeper understanding of the Sfam teaching method, and promote the application of Sfam in pediatric teaching to maximize its role in advancing the development of pediatric education.

Objective:The purpose of this study was to analyze the pharmacoeconomic research progress on nutrition therapy for cancer patients in recent ten years and explore the research hotspots in this field.Method:Bibliometric analysis was conducted based on Web of Science core database using CiteSpace, VOSviewer, Gephi and Scimago Graphics.Results:A total of 647 researches in the field of pharmacoeconomics about nutrition therapy for cancer patients published from 2013 to 2022 were included, with the annual publication output peaking in 2022. A total of 286 authors from 94 countries or regions have conducted relevant research. Among the 306 institutions involved in our study, the World Health Organization was with the most citations, and the journal with the most citations was Clinical nutrition. The United States, China and the United Kingdom were the top three countries concerning publication outputs. Harvard University was the most important research institution in this field, and the authors with the highest publication volume was Carli Francesco. Keyword analysis identified colorectal cancer as the most important research topic. Keyword clustering resulted in 16 groups, among which enteral nutrition was the largest, and the burst keyword was enhanced recovery after surgery. Conclusions:This study found that research hotspots in nutrition therapy for cancer patients have mainly focused on colorectal cancer and enhanced recovery after surgery in the past decade, and enteral nutrition is also an important research topic in this field. With the emerging precision medicine, based on big data and individual patient conditions (especially patients with colorectal cancer), tailored whole-course perioperative nutrition management program with superior cost-effectiveness may represent the future research trend.

Objective:To explore the application effect of a multidisciplinary collaborative model led by stomatognathic therapists, utilizing a combination of platelet-rich plasma (PRP) and moist wound dressings in the comprehensive treatment of postoperative chronic wounds, and to provide references and guidance for improving the clinical practice and management level of patients with chronic wounds.Methods:This was a prospective randomized controlled trial. Eighty-eight patients with postoperative non-healing chronic wounds who visited the Chronic Wound Care Clinic of the Third Affiliated Hospital of Guangzhou Medical University from October 2018 to February 2023 were conveniently sampled. They were randomly divided into two groups using a coin toss method: the control group ( n = 41) received standard moist wound dressing therapy, while the experimental group ( n = 47) received comprehensive treatment based on PRP combined with moist wound dressings. This treatment, led by enterostoml therpist, involved the innovative nursing technique of simultaneous injection of PRP and coagulant mixture via a three-way connector and covering with ultra-thin foam dressing. The Pressure Ulcer Scale for Healing (PUSH) score, wound area healing index (WSHI), pain level during dressing change, wound healing time, and treatment satisfaction rate were observed in both groups. Results:Among 88 cases, there were 25 females and 16 males in the control group, aged 58.00 (37.00 ± 79.00) years old. There were 31 females and 16 males in the experimental group, aged 57.00 (35.00 ± 72.00) years old. The median PUSH scores of the experimental group on the 7th, 14th, and 21th day after wound treatment were 11.00, 9.00, and 7.00, respectively, which were better than those of the control group, which were 13.00, 11.00, and 9.00. The median WSHI scores were 0.35, 0.58, and 0.84 for the experimental group, respectively, which were better than those of the control group, which were 0.09, 0.30, and 0.50. The differences between the two groups were statistically significant ( Z values ranged from 4.08 to 8.20, all P<0.01). On the 7th, 14th, and 21st day of treatment, the pain scores of the experimental group were 3.00 (2.00,3.00), 2.00 (1.00, 2.00), 0.00 (0.00,1.00) points, respectively, which were lower than the 3.00 (3.00,3.50), 2.00 (2.00,3.00), and 2.00 (1.00, 2.00) points of the control group, and the differences were statistically significant ( Z values were 2.16, 3.38, 6.14, all P<0.05). The healing time in the experimental group was (37.04 ± 25.33) days, which was shorter than that in the control group, (52.88 ± 36.58) days, and the difference was statistically significant ( t = 5.53, P<0.05). The satisfaction rate in the experimental group was 97.87% (46/47), significantly higher than 87.80% (36/41) in the control group ( χ2 = 3.13, P<0.05). Conclusions:Under the leadership of stomatognathic therapists, the multidisciplinary collaborative model, employing comprehensive treatment techniques centered around PRP combined with moist wound dressings, demonstrated significant therapeutic efficacy for postoperative chronic wounds including shortening healing time, accelerating healing speed, reducing wound pain, and improving patient satisfaction, indicating high clinical application value and social benefits.

Pediatric idiopathic nephrotic syndrome (INS) is characterized by massive albuminuria, hypoproteinemia, edema and hyperlipidemia, with a long course and high probability of relapse and prolongation. Long-term complications caused by long-term usage of hormones and immunosuppressants in children with INS seriously affect their physical and mental health and quality of life. Most children with steroid-sensitive nephrotic syndrome can be cured before adulthood, while some of them relapse in adulthood. Long-term prognosis of children with steroid-resistant nephrotic syndrome is poor. There have been few studies in China followed the long-term outcomes and its related factors of children with INS over 10 years. The paper reviewed the literatures on the long-term outcomes of children with INS, including renal survival, growth, mental health, learning and work, marriage and fertility, disease recurrence and long-term related complications, to explore the factors related to the poor long-term outcomes of children with INS and to assist in clinical decision-making and follow-up management.

Objective:To analyze the effect of vitrectomy combined with internal limiting membrane (ILM) peeling on the prevention of post-vitrectomy epiretinal membrane (ERM) in macular-off rhegmatogenous retinal detachment (RRD) and its influence on visual outcomes.Methods:A cohort study was conducted.Seventy-four patients (74 eyes) with macular-off RRD, who realized retinal reattachment after vitrectomy and silicone oil tamponade from January 2015 to January 2018 in Baoding NO.1 Central Hospital, were enrolled.The patients were divided into the non-ILM peeling group (36 cases, 36 eyes) and ILM peeling group (38 cases, 38 eyes) according to whether they received ILM peeling or not.The patients underwent silicone oil removal within 3 to 5 months after the surgery.Best corrected visual acuity (BCVA), slit-lamp microscopy, indirect ophthalmoscopy, fundus photography and optical coherence tomography (OCT) were examined before and at 1, 6 and 12 months after the surgery.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Baoding NO.1 Central Hospital (No.[2019]042). Written informed consent was obtained from each patient.Results:There was no ERM found in the two groups at 1 month after the operation.There were 3 eyes (8.33%) with ERM in the non-ILM peeling group and 2 eyes (5.26%) in the ILM peeling group at 6 months after the operation, with no statistically significant difference between them ( P=0.067). There were 9 eyes (25.00%) with ERM in the non-ILM peeling group and 4 eyes (10.53%) in the ILM peeling group at 12 months postoperatively, with no statistically significant difference between them ( χ2=2.674, P=0.102). There was a significant difference in BCVA between before and after the operation in the two groups ( Ftime=31.692, P<0.001). Postoperative 1-, 6-and 12-month BCVA were all significantly better than the preoperative BCVA in the two groups (all at P<0.05). There was no significant difference in BCVA between the two groups ( Fgroup=0.117, P=0.773). OCT images showed that there were 25 eyes (77.78%) and 30 eyes (78.95%) with the intact ellipsoid zone in the non-ILM peeling group and ILM peeling group at 12 months after the operation, respectively, with no statistically significant difference between them ( χ2=0.875, P=0.350). Conclusions:Compared with vitrectomy alone, the vitrectomy combined with ILM peeling does not show better efficacy in the prevention of ERM occurrence in macula-off RRD patients and has no obvious influence on postoperative visual acuity.

Objective: To understand the situation of school health staff and the allocation of health equipment in primary and secondary schools in Jinan. Methods: A questionnaire survey was conducted in CDC and public primary and secondary schools to describe the situation of the school health staff and health equipment in primary and secondary schools. Results: There were 23 school health staffs in CDC, among which 26.1% were full time. The total staffing ratio of school doctors was 13.9%, with the compliance rate of 19.8%. The total allocation rate of health care teachers was 74.7%, 92.2% of them were part time. The total staffing ratio of school doctors in boarding schools was 20.0%, with a staffing compliance rate of 12.5%. The total allocation rate of school doctors and health care teachers in boarding schools was 66.7%. 16.8% of public primary and secondary schools and 23.3% of public boarding primary and secondary schools did not have any health staffs. 27.6% of public primary and secondary schools are equipped with infirmary, 70.8% with health rooms, and 10.3% without any. The configuration of necessary equipment in infirmary and health care rooms were less than 100%. Conclusion There is a serious shortage of school health staffs and health equipment in primary and secondary schools in Jinan. Attention and investment in school health should be strengthened, and resources should be rationally allocated to ensure the health of primary and secondary school students.