Objective To establish a predictive model for hepatic sinusoidal obstruction syndrome(HSOS)and Budd-Chiari syn-drome(BCS),and to evaluate the performance of the model.Methods From April 2016 to February 2024,20 patients with HSOS and 40 patients with BCS who were first discharged from the Beijing Friendship Hospital Affiliated to Capital Medical University hospital infor-mation system(HIS)system were retrospectively collected.The clinical data of all patients were extracted,and the independent risk fac-tors for HSOS were screened by multi-factor Logistic regression method,and the differential diagnosis model was established accordingly,and then the efficacy was evaluated by receiver operating characteristic(ROC)curve.Results Multivariate Logistic regression analysis showed that hepatic vein stenosis or unclear display(OR=39.441,95％CI:5.928-262.429)was an independent risk factor for HSOS,and paravertebral vein opening was an independent protective factor for HSOS(OR=0.026,95％CI:0.002-0.285).Based on the above two parameters,a prediction model for HSOS in patients with hepatic venous outlet tract obstruction was established.The ROC curve showed that the area under the curve(AUC)of the model was 0.922(95％CI:0.864-0.991),with the sensitivity of 85.0％and the specificity of 92.5％.Conclusion Hepatic vein stenosis or unclear display is an independent risk factor for HSOS in patients with hepatic vein outflow tract obstruction during hospitalization,and the model constructed can predict the risk of HSOS.

Purpose To compare the MRI features of hepatic sinusoidal obstruction syndrome(HSOS)and Budd-Chiari syndrome(BCS).Materials and Methods A total of 12 cases of HSOS and 12 cases of BCS diagnosed with liver biopsy or liver transplantation disease or digital subtraction angiography were retrospectively collected from April 2016 to November 2023 in Beijing Friendship Hospital,Capital Medical University.The clinical and MRI features of the two groups were analyzed,and the characteristic clinical and MRI features were summarized.Results The glutamic-oxaloacetic transaminase,total bilirubin and direct bilirubin in HSOS patients were significantly higher than those in BCS group,while albumin was significantly lower than that in BCS group,the difference was statistically significant(Z=-3.407,-2.078,-2.425,-2.252,all P<0.05).Of the 12 HSOS patients,ten patients with HSOS had a history of taking hebel medicine(gynura segetum),six patients with HSOS showed the second portal of liver characteristic trifolium-like enhancement,BCS features did not appear.Of the 12 BCS patients,ten had main portal vein widening,ten spleen enlargement,ten accessory hepatic vein,eight transverse hepatic vein,eleven perihepatic lateral branch and seven paravertebral varicose veins.In HSOS and BCS patients,the uneven proportion of liver parenchymal signals was identified by MRI plain scan(12 cases,10 cases,respectively),and the proportion of liver parenchymal signal mottle-like enhancement was also demonstrated in portal and delayed phases(12 cases,12 cases,respectively).Conclusion The characteristic MRI signs are helpful for the diagnosis of HSOS and BCS,and the history of taking hebel medicine(gynura segetum)is helpful for the differentiation of the two diseases.

Objective To establish a predictive model for hepatic sinusoidal obstruction syndrome(HSOS)and Budd-Chiari syn-drome(BCS),and to evaluate the performance of the model.Methods From April 2016 to February 2024,20 patients with HSOS and 40 patients with BCS who were first discharged from the Beijing Friendship Hospital Affiliated to Capital Medical University hospital infor-mation system(HIS)system were retrospectively collected.The clinical data of all patients were extracted,and the independent risk fac-tors for HSOS were screened by multi-factor Logistic regression method,and the differential diagnosis model was established accordingly,and then the efficacy was evaluated by receiver operating characteristic(ROC)curve.Results Multivariate Logistic regression analysis showed that hepatic vein stenosis or unclear display(OR=39.441,95％CI:5.928-262.429)was an independent risk factor for HSOS,and paravertebral vein opening was an independent protective factor for HSOS(OR=0.026,95％CI:0.002-0.285).Based on the above two parameters,a prediction model for HSOS in patients with hepatic venous outlet tract obstruction was established.The ROC curve showed that the area under the curve(AUC)of the model was 0.922(95％CI:0.864-0.991),with the sensitivity of 85.0％and the specificity of 92.5％.Conclusion Hepatic vein stenosis or unclear display is an independent risk factor for HSOS in patients with hepatic vein outflow tract obstruction during hospitalization,and the model constructed can predict the risk of HSOS.

Purpose To compare the MRI features of hepatic sinusoidal obstruction syndrome(HSOS)and Budd-Chiari syndrome(BCS).Materials and Methods A total of 12 cases of HSOS and 12 cases of BCS diagnosed with liver biopsy or liver transplantation disease or digital subtraction angiography were retrospectively collected from April 2016 to November 2023 in Beijing Friendship Hospital,Capital Medical University.The clinical and MRI features of the two groups were analyzed,and the characteristic clinical and MRI features were summarized.Results The glutamic-oxaloacetic transaminase,total bilirubin and direct bilirubin in HSOS patients were significantly higher than those in BCS group,while albumin was significantly lower than that in BCS group,the difference was statistically significant(Z=-3.407,-2.078,-2.425,-2.252,all P<0.05).Of the 12 HSOS patients,ten patients with HSOS had a history of taking hebel medicine(gynura segetum),six patients with HSOS showed the second portal of liver characteristic trifolium-like enhancement,BCS features did not appear.Of the 12 BCS patients,ten had main portal vein widening,ten spleen enlargement,ten accessory hepatic vein,eight transverse hepatic vein,eleven perihepatic lateral branch and seven paravertebral varicose veins.In HSOS and BCS patients,the uneven proportion of liver parenchymal signals was identified by MRI plain scan(12 cases,10 cases,respectively),and the proportion of liver parenchymal signal mottle-like enhancement was also demonstrated in portal and delayed phases(12 cases,12 cases,respectively).Conclusion The characteristic MRI signs are helpful for the diagnosis of HSOS and BCS,and the history of taking hebel medicine(gynura segetum)is helpful for the differentiation of the two diseases.

【Objective】 To supervise the clinical blood use of 19 hospitals, covering a district of Shanghai, during two years, and discover the problems in the process of blood transfusion, so as to put forward suggestions for corrective methods in grades and promote continuous improvement of clinical transfusion management. 【Methods】 A total of 19 hospitals were supervised in terms of hardware facilities, management level, professional and technical level, and blood typing test on the site, according to the Administrative Blood Management Measures for Medical Institutions, Technical Specification for Clinical Transfusion and Shanghai Medical Quality Supervision Score Statistical Table.All data were analyzed. 【Results】 These hospitals can properly perform clinical blood transfusion, but there were obvious differences.Tertiary hospitals were relatively better, yet need to strengthen the management of medical documents.Secondary hospitals remained to be improved, mainly in insufficient construction of Blood Transfusion Department (blood bank), the lack of management and maintenance of key equipment and the lack of standardization in medical documents writing.However, flaws in the supervision were general in private hospitals (most of which were affiliated hospitals), so the management of clinical blood use should be further strengthened. 【Conclusion】 For secondary hospitals or above, routinized writing of medical documents and promoted construction of Blood Transfusion Department (blood bank) should be strengthened.For private hospitals, especially affiliated hospitals, the management of clinical blood use should be further improved, including the examination rules corresponding to the blood use process and strict access and exit mechanism, so as to improve the overall management level of clinical blood use and ensure the safety of clinical blood use.

Objective:To explore the effects of "rain classroom" wisdom teaching on geriatric students′ autonomous learning ability and self-efficacy.Methods:From June to August, 2021, 61 nursing students who practiced in the department of gerontology of the Second Xiangya Hospital, Central South University were selected as research subjects, and divided into experimental group (30 students) and control group (31 students) by random number table method. In the experimental group, wisdom teaching based on "Rain classroom" was carried out at the same time as conventional teaching, while in the control group, conventional teaching was carried out, and the teaching effect was evaluated by the independent learning ability measurement scale and academic self-efficacy scale of nursing students.Results:The score of autonomous learning ability of nursing students in the experimental group was 68.55 ± 11.06, and that in the control group was 74.29 ± 9.16. The difference between the two groups was statistically significant ( t = -2.01, P<0.05). The academic self-efficacy scores of nursing students in experimental group and control group were 52.27 ± 11.56 and 52.64 ± 9.28 respectively. There was no significant difference between the two groups ( P>0.05). Conclusions:The wisdom teaching of "rain classroom" improves the independent learning ability of geriatric nursing students, and attaches importance to the cultivation of self-efficacy of nursing students, and the improvement of self-efficacy needs further research.

? Geriatric syndrome is closely related to chronic diseases in the aged which affects the treatment and prognosis of chronic diseases, and is an important risk factor of dysfunction of the aged. Frailty is the core content of geriatric syndrome and is common in elderly diabetes mellitus which has a prediction function for the adverse health outcomes in elderly diabetes mellitus. This paper reviewed four aspects including the epidemiology of elderly diabetes mellitus combined with frailty, correlations between elderly diabetes mellitus and frailty, assessment and blood glucose management of elderly diabetes mellitus combined with frailty so as to provide a reference for clinical practice in China.

Objective Toanalyzedrugfreeforpatientswithseverementalillnessandfollow-upof82cases, inordertoprovidebasisforthedivisionoffreedelivery.Methods 82severementalillnesspatientswhowereincon-formity with the conditions of rescue,were given free drug and followed up for 2 years.Before the admission and fol-lowed up for 2 years,the social function evaluation(SDSS)and compliance were evaluated,the recurrence rate was compared.Results Comparisonofcompliance:beforetheadmission,thecompletecompliancein33cases,thepartial compliance in 27 cases,22 cases of non-compliance;After 2 years follow-up,the complete compliance in 52 cases, the partial compliance in 21 cases,9 cases of non-compliance.The difference was statistically significant(u=3.34, P<0.01).Comparison of social function:social withdrawal:before the admission (1.32 ±0.75)points,after 2 years follow-up (0.96 ±0.34)points,the difference was statistically significant(t=3.93,P<0.001 );Family activities:before the admission (1.44 ±0.69)points,after 2 years follow-up (0.87 ±0.31)points,the difference was statisti-cally significant (t=6.78,P<0.001);Personal care:before the admission (1.29 ±0.68)points,after 2 years follow-up (0.95 ±0.62)points,the difference was statistically significant(t=3.33,P<0.001);Interest in the outside world:before the admission (1.23 ±0.63)points,after 2 years follow-up (0.97 ±0.41)points,the difference was statistically significant(t=3.05,P<0.025);The total score:before the admission (15.42 ±7.23)points,after 2 years follow-up (9.56 ±6.89)points,the difference was statistically significant(t=5.28,P<0.001).Compari-son of the recurrence rate:2 years before the admission,the recurrence in 33 cases (40.2%),after 2 years follow-up the recurrence in 15 cases(18.3%),the difference was statistically significant (χ2 =10.64,P<0.001).Conclusion Drug free for patients with severe mental illness and follow-up can improve the social function and the implementation of free administration of patients with severe mental illness,and reduce the recurrence rate and improve compliance.