“Integrated elderly care and medical services” is a new model of elderly care that relies on medical care as a guarantee， rehabilitation as a support， and combines ongoing medical treatment with nurturing， offering comprehensive therapy. This new type of elderly care model also poses new job requirements for elderly care workers. However， there is currently a large shortage of elderly care workers， along with prevalent issues such as low professional quality， low education level， and an older average age. The main reasons for this situation are low welfare benefits， low social status， and an incomplete promotion system in the industry， resulting in low social recognition of the industry， a shortage of employees， and a high number of resignations. Based on this， it is suggested to expand the number of the elderly care team and enhance the quality of the elderly care team by improving the career development system， increasing salary and welfare benefits， and expanding social recognition.

Objective To evaluate the efficacy and safety of six kinds of commonly used traditional Chi-nese medicine combined with mesalazine in the treatment of ulcerative colitis(UC)based on frequency statis-tical network meta-analysis.Methods Randomized controlled trials(RCT)of oral Chinese medicine for the treatment of UC were searched from the establishment of the database to June 2024 of PubMed,CNKI,Wan-fang,VIP,Sinomed and other databases.The quality of the included literatures was evaluated by Cochrane bias risk assessment tool,and the data were statistically analyzed by Stata MP17.0 software.Results A total of 24 RCTs involving 1 939 patients were included,involving 6 kinds of traditional Chinese medicine and Chinese pa-tent medicine,including 4 macro and micro outcome indicators.In terms of improving the total clinical effec-tive rate,Shaoyao decoction,Gancao Xiexin decoction,Huangqin decoction granule,Baitouweng decoction,Kangfuxin liquid,Shenlingbaizhu powder+mesalazine were all superior to using mesalazine alone,and Kang-fuxin liquid+mesalazine had the best effect(P<0.05).In terms of down-regulation of interleukin(IL)-6 expression in colonic mucosa,Shaoyao decoction,Gancao Xiexin Decoction,Huangqin Decoction granules,Pul-satilla decoction,Kangfuxin Liquid+mesalazine were better than using mesalazine alone,and Pulsatilla De-coction+mesalazine had the best effect on reducing IL-6(P<0.05).In terms of down-regulation of colonic mucosal tumor necrosis factor(TNF)-α expression,Shaoyao decoction,Gancao Xiexin decoction,Huangqin decoction granule,Baitouweng decoction,Shenlingbaizhu decoction+mesalazine was better than using me-salazine alone,and Gancao Xiexin decoction+mesalazine had the best effect(P<0.05).In terms of down-regulation of IL-10 expression in colonic mucosa,Pulsatilla decoction+mesalazine was better than mesalazine alone(P<0.05).Conclusion Traditional Chinese medicine combined with mesalazine could alleviate the clin-ical symptoms of UC patients,improve inflammatory factor indicators,eliminate inflammation,and show a better treatment effect for UC than mesalazine used alone.

Objective:To analyze the diagnostic value of bedside capsule endoscopy in patients with acute or severe gastrointestinal bleeding.Methods:Clinical data from patients who underwent bedside capsule endoscopy due to acute or severe suspected gastrointestinal bleeding in Nanfang Hospital, Southern Medical University from June 2018 to September 2021 were analyzed retrospectively. The efficacy of capsule endoscopy in detecting upper gastrointestinal tract and small intestinal bleeding was evaluated.Results:A total of 74 patients underwent bedside capsule endoscopy for suspected acute or severe gastrointestinal bleeding. Five patients were excluded due to failure of examination due to retention of capsule endoscope in the gastric lumen, and 69 were included in the study, of whom 54 patients with a definitive diagnosis of gastrointestinal hemorrhage. The positive detection rate of the capsule endoscopy was 83.33% (45/54), including 17 cases of ulcer, 5 cases of erosion, 5 cases of vascular malformation, 4 protrusion mass, 4 diverticulum, 5 obscure gastrointestinal bleeding, 1 stenosis , 1 active mucosal blood exudation, 1 gastric retention, 1 mucosal swelling, and 1 mucosal wrinkle change. The sensitivity and specificity of capsule endoscopy in the diagnosis of upper gastrointestinal bleeding were 92.31% (12/13) and 75.00% (3/4) respectively. The sensitivity and specificity of capsule endoscopy for diagnosing small intestinal bleeding were 80.49% (33/41) and 90.91% (10/11) respectively.Conclusion:Bedside capsule endoscopy demonstrates high sensitivity and specificity in the diagnosis of gastrointestinal bleeding, showing potential advantages in bedside applications for acute and severe gastrointestinal bleeding.

Objective To validate the diagnostic performance and risk stratification ability of an AI-based recognition system(PE-AI)for pulmonary embolism(PE)using computed tomography pulmonary angiography(CTPA)so as to analyze its diagnostic value in clinical practice.Methods A total of 416 patients with suspected PE who underwent CTPA from January 1,2023 to December 10,2023 at our hospital were included in this study.Two junior radiologists and PE-AI separately detected and diagnosed emboli in the collected cases by double-blind method,and recorded the diagnosis time respectively.Three senior radiologists reviewing with clinical follow-up results were used as the gold standard in this study.Diagnostic performance was evaluated by using the receiver operating characteristic(ROC)curve analysis and Delong-t test.For positive cases,the pulmonary artery obstruction index(PAOI)calculated by AI and manually were collected respectively and consistency analysis was performed.Results The area under the curve(AUC)of PE-AI,manual and combined diagnosis was 85.6％,90.8％and 95.1％,respectively,which differed significantly(P＜0.05).The reading time of PE-AI[(0.16±0.07)min]was significantly lower than the time of manual[(4.42±1.85)min,P＜0.001]and combined diagnosis[(4.58±1.84)min,P＜0.001].The PAOI measured by PE-AI and manually had high consistency(intraclass correlation efficient,ICC=0.80)in the subgroup analysis of confirmed cases.Conclusion AI can quickly identify pulmonary artery emboli in a short time and assist radiologists to improve diagnostic efficiency.At the same time,through the intelligent detection of PAOI,it is helpful for the risk stratification of patients with PE and optimizing the diagnosis and treatment pathway for pulmonary embolism.

Objective To evaluate the diagnostic value of positive serum specific antibodies to Mycoplasma pneumoniae(MP)in children with Mycoplasma pneumoniae pneumonia(MPP).Methods PubMed,Cochrane Library,Embase,Sinomed,CNKI,Wanfang and VIP databases were searched for studies on the detection of MPP based on antibodies from the establishment of the database to March 31,2023.After literature screening and data extraction,STATA 16.0 software was used for Meta-analysis.Results A total of 9 literatures and 2 148 clinical samples were included.The combined sensitivities[M(95%CI)]of particle agglutination assay(PA)and enzyme-linked immunosorbent assay(ELISA)were 50%(31～69)and 88%(85～90),and the combined specificities[M(95%CI)]were 88%(76～95)and 88%(62～97).The combined diagnostic odds ratio(DOR)[M(95%CI)]were 5.61(3.30～9.53)and 43.82(12.78～150.19),and the summary receiver operating characteristic curve(SROC)area under the curve(AUC)were 0.80 and 0.88,respectively.Conclusion Serum MP specific antibody detection can be used for diagnosis and screening of children MPP,but needs to be combined with clinical symptoms improve the accuracy of the diagnosis.

Objective:To evaluate the effectiveness of a patient-family-centered visiting model in improving caregivers'beliefs and attitudes toward visiting patients with mental disorders.Methods:A total of 140 caregivers of inpatients diagnosed with mental disorders according to the ICD-10 were randomly assigned to an intervention group(n=71)and a control group(n=69).The intervention group participated a patient-family-centered visiting model for 4 weeks,while the control group followed routine visitation.Caregivers' beliefs and attitudes were assessed using the Beliefs and Attitudes toward Visitation in ICU Questionnaire(BAVIQ)was used to assess the improvement in caregivers' beliefs and attitudes before the intervention and at the end of the 1st,2nd,3rd,and 4th weeks after the intervention.Results:Repeated measures ANOVA showed that the belief score and attitude score of the BAVIQ questionnaire in the intervention group were significantly higher than those in the control group(Ps＜0.05)across time points.Chi-square test further confirmed that the improvement in the intervention group were significantly bet-ter than in the control group(Ps＜0.05).Conclusion:The patient-family-centered visiting model is more effective than routine visiting model in improving the caregivers' visiting beliefs and attitudes in mental health settings.

The patient,male,42 years old,was given 1.5 mg·kg-1·h-1 sodium valproate via intravenous infusion due to epilepsy,resulting in multiple organ failure.The diagnosis and treatment process of the patient was retrospectively analyzed.The relevance evaluation was carried out using Naranjo's ADR evaluation probability scale,and the relevant literatures were reviewed to provide a reference for the clinical safety of sodium valproate.

Objective:To investigate the clinical efficacy of radical gastrectomy with mesan-gientization via the inferior margin of the pancreas approach (GMIP).Methods:The retrospective cohort study was conducted. The clinicopathological data of 255 patients of Siewert Ⅱ and (or) Ⅲ adenocarcinoma of esophagogastric junction (AEG) who were admitted to Cancer Hospital Affiliated to Shanxi Medical University from March 2024 to March 2025 were collected. There were 191 males and 64 females, aged (62 ±7)years. Of 255 patients, 152 cases undergoing GMIP were allocated into the mesangientization radical resection group, 103 cases undergoing D 2 radical resection of gastric cancer were allocated into D 2 radical resection group. Observation indicators: (1) surgical and post-operative situations; (2) lymph node dissection status. Comparison of measurement data with normal distribution between groups was conducted using the t test. Comparison of measurement data with skewed distribution between groups was conducted using the Wilcoxon test. Comparison of count data between groups was conducted using the chi-square test or corrected chi-square test. Compari-son of ordinal data was conducted using the rank sum test. Results:(1) Surgical and postoperative situations. In the mesangientization radical resection group, the time of lymph node dissection was (115±14)minutes, volume of intraoperative blood loss was (81±37)mL. In the D 2 radical resection group, the above indicators were (97±13)minutes, (104±39)mL, respectively. There were significant differences in the above indicators between the two groups ( t=-8.68, -4.64, P<0.05). In the mesan-gientization radical resection group, the total number of examined lymph node was 40.00(10.00), the number of lymph node dissected (the total number of each group) was 29.00(5.00), the number of lymph node metastasis (the total number of each group) was 2.00(1.00). In the D 2 radical resection group, the above indicators were 27.00(9.00), 8.00(4.00), 1.00(1.00), respec-tively. There were significant differences in the above indicators between the two groups ( Z=-10.68, -13.57, -6.80, P<0.05). (3) Lymph node dissection status. There were significant differences in number of lymph node dissected of No.14v, 12a, 12p, 11d, 11p, 10, postgastric, 9, 8a, 8p lymph node between the mesangientization radical resection group and the D 2 radical resection group ( P<0.05). There were significant differences in number of lymph node metastasis of No.11d and postgastric lymph node between the mesangientization radical resection group and the D 2 radical resection group ( P<0.05). Conclusion:Compared with D 2 radical resection, the GMIP for Siewert Ⅱ or Ⅲ AEG has less volume of intraoperative blood loss and more complete lymph node dissection.

Objective To investigate the status and distribution characteristics of human immuno-deficiency virus(HIV)infection,and the relationship between sample value/cut-off value(S/CO value)and positive test when HIV is tested reactivity by chemiluminescence immunoassay(CLIA).Methods The data of 820 HIV reactivity samples screened by Abbott CLIA in the Department of Clinical Laboratory of Affiliated Hospital of Inner Mongolia Medical University from 2017 to 2023 were selected as the research objects.SPSS22.0 software was used for statistical analysis according to different years,genders and ages.The distribution characteristics of screening reactivity and confirmed positive immunoblot test was compared.The relationship between the confirmed positive,uncertain and negative results and their S/CO values,and the distribution of corresponding bands were retrospectively analyzed.Results From 2017 to 2023,the total number of HIV positive patients decreased first decreased and then increased.The positive rate was 31.95%(262/820),the ratio of males to females was 6.7∶1,the gender difference was statistically significant(χ2=126.8,P<0.05).The ratio of men to women who responded to the screening test was 1.4∶1.The age group with the most confirmed positives for both men and women was 30～50 years old.Divided into five groups according to S/CO value,the positive rate was 0%(0/436)in 1.0≤S/CO≤5.0 group,the positive rate was 6.90%(4/58)in 5.0＜S/CO≤10.0 group,the positive rate was 25.86%(15/58)in 10.0＜S/CO≤50.0 group,the positive rate was 82.09%(110/134)in 50.0＜S/CO≤500.0 group,and the positive rate was 99.25%(133/134)in S/CO＞500.0 group,there was statistical significance in the number of confirmed positives among the five groups(χ2=816.3,P<0.05).There were 473 confirmed negative cases,more women than men,the difference was statistically significant(χ2=98.3,P<0.05),among which the results of S/CO value≤10.0 accounted for 90.49%(428/473).There were 85 uncertain cases,the gender difference was not statistically significant(χ2=1.3,P>0.05),among which the results of S/CO value≤10.0 accounted for 72.94%(62/85).The positive bands gp120 and gp160 appeared in all the results,and p55 appeared the least,accounted for 51.91%(136/262).The uncertain bands were mainly p24,followed by gp160,etc.To a certain extent,the higher the S/CO value of chemiluminescence screening test,the more bands were present when the confirmative test was positive,and the more bands were present when the confirmative test was uncertain.Conclusion The higher the S/CO value of chemiluminescence test for HIV screening test,the higher the positive rate of the confirmation test and the more positive bands,they have practical value for laboratory analysis and early clinical diagnosis.

Objective:To summarize the clinicopathological features, evolving trends in treatment and surgical approaches, and survival outcomes of patients who underwent D2 radical gastrectomy for gastric cancer in Shanxi Provincial Cancer Hospital over the past 11 years with the goal of providing a reference for the clinical practice of gastric cancer in this region.Methods:A retrospective observational study was conducted to analyze the clinicopathological data of patients who underwent D2 radical gastrectomy for pathologically confirmed gastric malignancy at the Department of Gastrointestinal Surgery, Shanxi Provincial Cancer Hospital from January, 2013 to December, 2023. Exclusion criteria consisted of: (1) residual gastric cancer or recurrent gastric cancer after surgery; (2) emergency gastric cancer resection due to bleeding, perforation, obstruction, or other causes; (3) comorbidity with other primary malignant tumors; (4) severe preoperative cardiopulmonary insufficiency or hepatic and renal insufficiency who cannot tolerate radical surgery; and (5) inconsistent main diagnosis information across the medical record system, pathological system, and gastric cancer-specific database. Patients were divided into three groups based on treatment methods: the surgery-only group, the perioperative chemotherapy group, and the adjuvant chemotherapy group. Endpoints included: (1) baseline patient characteristics; (2) trends in tumor location and pathological features; (3) evolution of treatment modalities; and (4) survival outcomes.Results:A total of 15,644 patients were included in the analysis, with 12,591 males and 3,053 females, the male-to-female gender ration was approximately 4∶1; the mean age was (61.2±9.5) years. The tumor sites were mainly concentrated in the esophagogastric junction (EGJ) (57.4%), followed by the antrum (25.9%). The incidence of EGJ cancer initially rose and then declined. However, gastric antrum tumors remained stable, and gastric body tumors showed a slow upward trend after 2020, accounting for 16.7%. In terms of pathological types, poorly differentiated carcinoma was the most prevalent, accounting for 55.9%, followed by moderately differentiated carcinoma (24.2%), mucinous adenocarcinoma (or signet ring cell carcinoma,14.1%), neuroendocrine carcinoma (4.8%), and well-differentiated carcinoma (0.9%). The proportion of poorly differentiated adenocarcinoma showed a significant upward trend overall as well, peaking at 65.6% in 2022 and decreasing to 57.5% in 2023. Mucinous adenocarcinoma (or signet ring cell carcinoma) exhibited fluctuations with a first increase followed by a decrease: it peaked at 17.3% in 2018, dropped sharply to 8.4% in 2022, and rose back to 13.8% in 2023. The proportions of well-differentiated adenocarcinoma, moderately differentiated adenocarcinoma, and neuroendocrine tumors remained stable year by year. In terms of pathological staging, the overall proportions of gastric cancer at Stage 0, Stage I, Stage II, Stage III, and Stage IVa were 0.5%, 17.3%, 25.1%, 54.9%, and 2.3%, respectively. For Stage III, its proportion was 74.6% in 2013, which decreased to 46.4% by 2023. Stages I and II gastric cancer showed an upward trend, with their proportions rising from 10.2% and 12.1% in 2013 to nearly 21.0% and 29.6% in 2023, respectively. Between 2013 and 2023, the proportion of patients who received surgery alone continued to decrease, with this proportion dropping to 34.7% in 2023. In contrast, the number of patients who received adjuvant chemotherapy increased year by year, reaching 54.2% in 2023. Since 2017, the application of perioperative chemotherapy has gradually increased, rising to 11.1% in 2023. Immunotherapy showed an almost synchronous growth trend with perioperative chemotherapy. However, targeted therapy exhibited a downward trend after a period of growth. There were 10,704 cases of open surgery (68.4%), 4,744 cases of laparoscopic surgery (30.3%), and 193 cases of transthoracic surgery (1.2%). Pathological margin positivity was observed in 443 cases (2.8%), and the volume of gastric cancer surgeries gradually increased, peaked in 2021 before subsequently decreasing gradually. However, the volume of laparoscopic surgeries did not decrease; instead, it showed an upward trend. The main resection method for EGJ tumors was total gastrectomy, accounting for 78.5% of the total, followed by proximal gastrectomy, which accounted for 21.5%. After total gastrectomy, esophagojejunal Roux-en-Y anastomosis was the primary anastomotic method, and for proximal gastrectomy, the main anastomotic method was esophagogastric anastomosis, which accounted for 68.0% of the total. For distal gastrectomy, Billroth II anastomosis was the most common anastomotic technique, accounting for 92.7% of these procedures. The overall incidence of postoperative complications was 14.5% (2,264/15,644), among which the incidence of severe complications (grades III-IV) was 4.5% (706/15,644). The entire cohort was followed up with for (47.1±36.8) months, and the 1-year, 3-year, and 5-year overall survival rates were 86.4%, 65.9%, and 58.1%, respectively. For patients with stage 0, I, II, III, and IV gastric adenocarcinoma, the 1-year overall survival rates were 95.7%, 98.0%, 89.4%, 81.0%, and 49.1%, respectively; the 3-year overall survival rates were 92.1%, 94.6%, 81.9%, 51.4%, and 14.7%, respectively; and the 5-year overall survival rates were 89.4%, 91.7%, 75.1%, 41.5%, and 10.0%, respectively. For patients with stage I, II, III, and IV gastric neuroendocrine carcinoma, the 1-year overall survival rates were 96.7%, 91.1%, 73.8%, and 52.6%, respectively; the 3-year overall survival rates were 87.2%, 69.6%, 46.1%, and 32.1%, respectively; and the 5-year overall survival rates were 87.2%, 62.2%, 36.7%, and 32.1%, respectively.Conclusions:Gastric cancer in Shanxi Province is characterized by a male predominance, a high prevalence of tumors at the esophagogastric junction, a large proportion of poorly differentiated adenocarcinoma, and presentation at advanced stages (predominantly Stage III). The detection rate of early gastric cancer has been increasing year by year, the volume of laparoscopic surgeries has been on the rise annually, and the treatment model has shifted from single surgery to comprehensive treatment.