Objective:To explore the feasibility of obtaining three-dimensional (3D) models of intraosseous and periosteal arteries of hallux phalanx using micro-arteriography with micro-CT scan.Methods:From January 2022 to April 2025, the Department of Orthopaedic, the 988th Hospital of the Joint Logistics Support Force of the Chinese PLA conducted a study on 7 fresh-frozen specimens of distal lower limb (right lower limb) from an 85-year-old male, and both lower limbs from an 82-year-old male, a 78-year-old female and a 66-year-old male in the Department of Human Anatomy & Histology and Embryology, Peking University School of Basic Medical Sciences. Red lead oxide powder (Pb 3O 4) was ground and filtered through a 300 mesh, and then mixed with turpentine at ratios of 1 g ∶ 1.5 ml, 1 g ∶ 1.0 ml, and 1 g ∶ 0.5 ml to prepare lead-based contrast agent suspensions. After thawing the specimens at room temperature, the suspensions were injected via the popliteal artery in ascending order of concentration. After injections, the specimens were fixed in 10% methanal for 2 weeks. The proximal and distal phalanges of the hallux, with the surrounding periosteum preserved intact, were then harvested. The harvested specimens were scanned using micro-CT at an ultimate resolution of 12 μm. Subsequently, Mimics Medical software was used to reconstruct 3D models of the intraosseous and periosteal arteries within the phalanges. Results:Periosteal arteries in the proximal phalanx were primarily distributed near the joint region. A consistently large trunk artery entered from plantar side, supplying most of the diaphysis and head. There was a rich periosteal arterial network on both sides of the distal phalanx, which communicates with each other through the arterial arch in the bone groove. However, trunk intraosseous artery could be absent. Intraosseous arteries in the proximal ends of both the proximal and distal phalanges originated from periosteal arteries. These formed an interconnected arteriosomes and coursed parallel to the articular surfaces.Conclusion:The micro-arteriography acquired by micro-CT scan effectively visualizes intraosseous and periosteal arteries and enables the reconstruction and analysis of 3D models of the arteriosomes. The characteristics of arteriolar distribution provide a theoretical basis for osteotomy or internal fixation procedures involving a hallux phalanx.

This paper summarizes Li Fei's academic insights and clinical experience in treating intractable facial paralysis.Li Fei posits that prolonged illness inevitably leads to deficiency and stasis,and thus,the treatment of intractable facial paralysis should first focus on identifying the etiology and syndrome differentiation,resolving stasis and unblocking stagnation,and regulating qi and blood,with particular emphasis on the relaxation of the meridian sinew system.The meridian sinew system,affiliated with the meridian and collateral,serves as the framework through which qi and blood nourish muscles,tendons,and joints,playing a crucial role in facial paralysis treatment.Guided by the theory of the meridian sinew system,Li Fei employs syndrome-based treatment,integrating the anatomy of facial expression muscles.His approach includes needle-knife therapy to release adhesions and break stasis,acupuncture to harmonize qi and blood,and intradermal needle therapy for sustained stimulation.Through these methods,the meridian sinew system is relaxed,qi and blood are regulated,and facial muscles are nourished,leading to gradual recovery from facial paralysis.

Objective:To investigate the current situation of uncivilized behavior in workplace encountered by nurses in Xianyang City, and analyze its influencing factors, so as to provide a basis for formulating corresponding intervention measures.Methods:In May 2023, convenience sampling was used to investigate the general information, current situation of uncivilized behavior in workplace and coping style of 1310 nurses in 8 secondary and tertiary general hospitals in Xianyang City by using the general information questionnaire, the Chinese version of the Nurse Incivility Scale and the Simplified Coping Style Questionnaire. Multiple linear regression analysis was used to analyze the influencing factors of uncivilized behavior encountered by nurses.Results:A total of 1285 valid questionnaires were collected, with an effective recovery rate of 98.09%. The total score of uncivilized behavior encountered by nurses was (86.41±22.49) points. Among them, the scores of five dimensions were nurses' uncivilized behavior (19.95±4.70) points, patients' uncivilized behavior (23.66±8.96) points, supervisors' uncivilized behavior (13.25±4.87) points, doctors' uncivilized behavior (14.32±5.63) points and colleagues' uncivilized behavior (15.23±4.93) points. The multiple linear regression analysis results showed that the hospital level and coping style were the significant influencing factors of uncivilized behavior in workplace encountered by nurses ( β=0.104, 0.056; P<0.05) . Conclusion:The current situation of uncivilized behavior in workplace encountered by nurses needs to be improved. Hospital managers should focus on coping styles, such as setting up simulation scene exercises, team cooperation training, training and counseling, so as to reduce the uncivilized behavior in workplace encountered by nurses.

Objective To analyze the current status of outcome measures in randomized controlled trials(RCTs)of acupuncture treatment for vascular dementia(VD)and promote the development of a standardized set of outcome measures.Methods Chinese and English literature databases were searched,including the Chinese Medical Periodical Full-Text Database,the Chinese Biology Medicine disc,China National Knowledge Infrastructure,Wanfang Data,VIP Database,PubMed,Embase,the Cochrane Library,MEDLINE,Web of Science,Chinese Clinical Trials Registry,and the International Traditional Medicine Clinical Trial Registry.Two researchers independently screened RCT literature on acupuncture treatment for VD between January 1,2015 and January 1,2025,risk of bias was assessed using the Cochrane Risk of Bias 2 tool.Extract basic study information,intervention measures,diagnostic criteria for both Chinese and Western medicine,TCM syndromes,and outcome measures.Summarize the indicator domains of RCT studies on acupuncture treatment for VD,and analyze the basic information and outcome measures of the included studies.Results A preliminary search identified 2,898 articles,of which 93 RCTs were ultimately included.These studies involved 84 outcome measures,covering six indicator domains:symptoms/signs(23.81%),traditional Chinese medicine(TCM)syndromes(3.57%),medical checkups(60.71%),quality of life(5.95%),safety assessment(4.76%),and prognosis follow-up(1.19%).A total of 91(97.85%)RCTs reported treatment duration,ranging from 2 to 24 weeks;72(77.42%)RCTs used clinical efficacy as the outcome indicator;11 studies(11.83%)reported safety assessments and adverse events.Conclusion Currently,the RCT study design for acupuncture treatment of VD lacks unified standards and has numerous methodological issues.These include insufficient description of sample size estimation processes,strong reliance on subjective rating scales,ambiguous definitions of primary and secondary outcome measures,incomplete integration of Chinese and Western medical indicators,and insufficient reflection of individualized syndrome differentiation and treatment characteristics.In addition,safety assessments and follow-up mechanisms remain relatively weak.Future research should focus on the essential nature of VD,establish a core set of indicators aligned with the clinical characteristics of traditional Chinese medicine,promote the scientific and standardized development of acupuncture research for VD,and provide more compelling evidence-based support for clinical practice.

Objective:To gain an in-depth understanding of the willingness and needs of rural residents for emergency rescue training, so as to provide reference for improving their participation in emergency rescue training and the training effectiveness.Methods:Purposive sampling was used to select 16 rural residents in different streets of two townships in Binzhou City, Shandong Province from April to May 2024 as study subjects. Information was collected using face-to-face semi-structured in-depth interviews. After the interview, timely transcription and verification were conducted, and the Colaizzi 7-step analysis method was used to analyze and summarize the data.Results:The majority of residents had a strong willingness to participate in emergency rescue training, and some had a negative willingness. Rural residents' needs for emergency rescue training focused on five main areas of targeted, content, specialization, continuity, and implementation needs.Conclusions:The motivating factors for rural residents' willingness to participate in emergency rescue training are complex. The relevant departments and organizations should give full consideration to the actual needs of the residents and provide them with active and substantive guidance and assistance.

Objective To analyze the current status of outcome measures in randomized controlled trials(RCTs)of acupuncture treatment for vascular dementia(VD)and promote the development of a standardized set of outcome measures.Methods Chinese and English literature databases were searched,including the Chinese Medical Periodical Full-Text Database,the Chinese Biology Medicine disc,China National Knowledge Infrastructure,Wanfang Data,VIP Database,PubMed,Embase,the Cochrane Library,MEDLINE,Web of Science,Chinese Clinical Trials Registry,and the International Traditional Medicine Clinical Trial Registry.Two researchers independently screened RCT literature on acupuncture treatment for VD between January 1,2015 and January 1,2025,risk of bias was assessed using the Cochrane Risk of Bias 2 tool.Extract basic study information,intervention measures,diagnostic criteria for both Chinese and Western medicine,TCM syndromes,and outcome measures.Summarize the indicator domains of RCT studies on acupuncture treatment for VD,and analyze the basic information and outcome measures of the included studies.Results A preliminary search identified 2,898 articles,of which 93 RCTs were ultimately included.These studies involved 84 outcome measures,covering six indicator domains:symptoms/signs(23.81%),traditional Chinese medicine(TCM)syndromes(3.57%),medical checkups(60.71%),quality of life(5.95%),safety assessment(4.76%),and prognosis follow-up(1.19%).A total of 91(97.85%)RCTs reported treatment duration,ranging from 2 to 24 weeks;72(77.42%)RCTs used clinical efficacy as the outcome indicator;11 studies(11.83%)reported safety assessments and adverse events.Conclusion Currently,the RCT study design for acupuncture treatment of VD lacks unified standards and has numerous methodological issues.These include insufficient description of sample size estimation processes,strong reliance on subjective rating scales,ambiguous definitions of primary and secondary outcome measures,incomplete integration of Chinese and Western medical indicators,and insufficient reflection of individualized syndrome differentiation and treatment characteristics.In addition,safety assessments and follow-up mechanisms remain relatively weak.Future research should focus on the essential nature of VD,establish a core set of indicators aligned with the clinical characteristics of traditional Chinese medicine,promote the scientific and standardized development of acupuncture research for VD,and provide more compelling evidence-based support for clinical practice.

Objective:To gain an in-depth understanding of the willingness and needs of rural residents for emergency rescue training, so as to provide reference for improving their participation in emergency rescue training and the training effectiveness.Methods:Purposive sampling was used to select 16 rural residents in different streets of two townships in Binzhou City, Shandong Province from April to May 2024 as study subjects. Information was collected using face-to-face semi-structured in-depth interviews. After the interview, timely transcription and verification were conducted, and the Colaizzi 7-step analysis method was used to analyze and summarize the data.Results:The majority of residents had a strong willingness to participate in emergency rescue training, and some had a negative willingness. Rural residents' needs for emergency rescue training focused on five main areas of targeted, content, specialization, continuity, and implementation needs.Conclusions:The motivating factors for rural residents' willingness to participate in emergency rescue training are complex. The relevant departments and organizations should give full consideration to the actual needs of the residents and provide them with active and substantive guidance and assistance.

Objective:To explore the feasibility of obtaining three-dimensional (3D) models of intraosseous and periosteal arteries of hallux phalanx using micro-arteriography with micro-CT scan.Methods:From January 2022 to April 2025, the Department of Orthopaedic, the 988th Hospital of the Joint Logistics Support Force of the Chinese PLA conducted a study on 7 fresh-frozen specimens of distal lower limb (right lower limb) from an 85-year-old male, and both lower limbs from an 82-year-old male, a 78-year-old female and a 66-year-old male in the Department of Human Anatomy & Histology and Embryology, Peking University School of Basic Medical Sciences. Red lead oxide powder (Pb 3O 4) was ground and filtered through a 300 mesh, and then mixed with turpentine at ratios of 1 g ∶ 1.5 ml, 1 g ∶ 1.0 ml, and 1 g ∶ 0.5 ml to prepare lead-based contrast agent suspensions. After thawing the specimens at room temperature, the suspensions were injected via the popliteal artery in ascending order of concentration. After injections, the specimens were fixed in 10% methanal for 2 weeks. The proximal and distal phalanges of the hallux, with the surrounding periosteum preserved intact, were then harvested. The harvested specimens were scanned using micro-CT at an ultimate resolution of 12 μm. Subsequently, Mimics Medical software was used to reconstruct 3D models of the intraosseous and periosteal arteries within the phalanges. Results:Periosteal arteries in the proximal phalanx were primarily distributed near the joint region. A consistently large trunk artery entered from plantar side, supplying most of the diaphysis and head. There was a rich periosteal arterial network on both sides of the distal phalanx, which communicates with each other through the arterial arch in the bone groove. However, trunk intraosseous artery could be absent. Intraosseous arteries in the proximal ends of both the proximal and distal phalanges originated from periosteal arteries. These formed an interconnected arteriosomes and coursed parallel to the articular surfaces.Conclusion:The micro-arteriography acquired by micro-CT scan effectively visualizes intraosseous and periosteal arteries and enables the reconstruction and analysis of 3D models of the arteriosomes. The characteristics of arteriolar distribution provide a theoretical basis for osteotomy or internal fixation procedures involving a hallux phalanx.

Objective:To investigate the current situation of uncivilized behavior in workplace encountered by nurses in Xianyang City, and analyze its influencing factors, so as to provide a basis for formulating corresponding intervention measures.Methods:In May 2023, convenience sampling was used to investigate the general information, current situation of uncivilized behavior in workplace and coping style of 1310 nurses in 8 secondary and tertiary general hospitals in Xianyang City by using the general information questionnaire, the Chinese version of the Nurse Incivility Scale and the Simplified Coping Style Questionnaire. Multiple linear regression analysis was used to analyze the influencing factors of uncivilized behavior encountered by nurses.Results:A total of 1285 valid questionnaires were collected, with an effective recovery rate of 98.09%. The total score of uncivilized behavior encountered by nurses was (86.41±22.49) points. Among them, the scores of five dimensions were nurses' uncivilized behavior (19.95±4.70) points, patients' uncivilized behavior (23.66±8.96) points, supervisors' uncivilized behavior (13.25±4.87) points, doctors' uncivilized behavior (14.32±5.63) points and colleagues' uncivilized behavior (15.23±4.93) points. The multiple linear regression analysis results showed that the hospital level and coping style were the significant influencing factors of uncivilized behavior in workplace encountered by nurses ( β=0.104, 0.056; P<0.05) . Conclusion:The current situation of uncivilized behavior in workplace encountered by nurses needs to be improved. Hospital managers should focus on coping styles, such as setting up simulation scene exercises, team cooperation training, training and counseling, so as to reduce the uncivilized behavior in workplace encountered by nurses.

Objective:To investigate the application value of transanal intersphincteric resec-tion under direct vision in the Jackknife position in the anal preserving surgery for ultra-low rectal cancer.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 15 patients with ultra-low rectal cancer who underwent transanal intersphincteric resection under direct vision in the Jackknife position, combined with laparoscopic total mesorectal excision in Huizhou Municipal Central Hospital from September 2021 to November 2022 were collected. There were 9 males and 6 females, aged (63±9)years. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results:(1) Surgical and postoperative outcomes. All the 15 patients underwent operations successfully, without conversion to open abdo-minal operation. There were 5 cases of partial ISR and 10 cases of subtotal ISR. The operation time and volume of intraoperative blood loss of 15 patients were (260±30)minutes and 20(range, 10-30)mL, respectively. The distance from anastomosis to anal margin was (1.6±0.8)cm. The duration of post-operative hospital stay was 10(range, 8-13)days, and all 15 patients underwent colonic and anasto-mosis with staplers and protective ileostomy at the terminal ileum. Three patients had postoperative complications within 30 days after surgery, of whom 1 case with grade A anastomotic leakage was cured after conservative treatment and 2 cases with anastomotic membranous stenosis were cured by anal enlargement. (2) Postoperative pathological examination. The number of lymph nodes dissected of 15 patients was 18 ±6, and the distance between the tumor and distal resection margin was 1.3(range, 1.0-2.0)cm. The surgical specimens of all 15 patients showed complete mesorectum and negative for proximal, distal and circumferential margins. Results of postoperative pathological examination showed that there was 1 case in stage pT1N0M0, 9 cases in stage pT2N0M0, 1 case in stage pT2N1M0, 1 case in stage ypT0N0M0, 2 cases in stage ypT2N0M0, 1 case in ypT3N1M0 stage. The histological subtype showed 11 cases of moderately differentiated adenocarcinoma and 4 cases of well-differentiated adenocarcinoma. (3) Follow-up. All 15 patients were followed up for 15(range, 12-24)months. No local recurrence and distant metastasis of the tumor was found, and no tumor-related death occurred. All 15 patients underwent stoma closure. The postoperative anal function assessment of 15 patients showed no disorder in 5 cases, mild disorder in 8 cases and severe disorder in 2 cases.Conclusion:Transanal intersphincteric resection under direct vision in the Jackknife position in the anal preserving surgery for ultra-low rectal cancer is safe and feasible.