Objective:To explore the relationship between irrational procrastination and compulsory citizenship behavior among clinical nurses,and to investigate the role of psychological entitlement in this relationship.Meth-ods:A sample of 413 clinical nurses from a tertiary hospital was selected for this study.The Irrational Procrastina-tion Scale(IPS),Compulsory Citizenship Behavior Scale(CCBS),and Psychological Entitlement Scale(PES)were used for evaluation.Results:The scores of IPS,CCBS and PES were positively correlated with each other(r=0.53,0.56,0.39,Ps＜0.01).Psychological entitlement partially mediated the relationship between compulsory citi-zenship behavior and irrational procrastination among clinical nurses,with an indirect effect of 0.17,accounting for 13.85％of the total effect.Conclusion:Psychological entitlement plays a partial mediating role in the relationship between compulsory citizenship behavior and irrational procrastination among clinical nurses.

Objective:To investigate the clinical features and predictive indicators of children with recurrent simple febrile seizures, providing theoretical guidance for the early identification of such patients in clinical practice.Methods:This study is a single-center, retrospective analysis. It included 152 children with febrile seizures who were admitted to Department of Emergency, Hangzhou Children's Hospital from January 2021 to December 2023. Based on whether multiple episodes of simple febrile seizures occurred within 24 hours, the children were divided into a recurrent simple febrile seizure group ( n = 44) and a simple febrile seizure group ( n = 108). Demographic characteristics, clinical data, and laboratory test results were collected. Statistical analysis was performed using univariate and multivariate logistic regression, correlation analysis, and receiver operating characteristic curves. Results:Among the 152 children with febrile seizures included in this study, 44 (28.95%) were diagnosed with recurrent simple febrile seizures. Children with recurrent simple febrile seizures had lower temperatures upon admission, were younger at the time of their first febrile seizure, and had a higher proportion of cases where the time interval from fever to seizure was < 12 hours ( t = 2.84, 4.25, 8.45, all P < 0.05). Pearson correlation analysis showed that recurrent simple febrile seizures were negatively correlated with admission temperature and age at first febrile seizure ( r = -0.599, -0.609, both P < 0.001) and positively correlated with the time interval from fever to seizure ( r = 0.568, P = 0.004). Logistic regression analysis indicated that age at first febrile seizure and a time interval from fever to seizure of ≥ 12 hours were influential factors of recurrent simple febrile seizures ( OR = 2.864, 2.145, P = 0.004, 0.007). Receiver operating characteristic curve analysis revealed that admission temperature, age at first febrile seizure, a time interval from fever to seizure of ≥ 12 hours, and their combination were all effective in detecting recurrent simple febrile seizures. However, the combined assessment had higher sensitivity and specificity than any single assessment, with a sensitivity of 88.60%, specificity of 89.80%, a cutoff value of 0.840, and an area under the curve of 0.886. Conclusions:Lower admission temperatures, younger age at the time of the first febrile seizure, and a time interval of < 12 hours from fever to seizure are associated with an increased likelihood of simple febrile seizures developing into recurrent simple febrile seizures.

Objective:To explore the relationship between irrational procrastination and compulsory citizenship behavior among clinical nurses,and to investigate the role of psychological entitlement in this relationship.Meth-ods:A sample of 413 clinical nurses from a tertiary hospital was selected for this study.The Irrational Procrastina-tion Scale(IPS),Compulsory Citizenship Behavior Scale(CCBS),and Psychological Entitlement Scale(PES)were used for evaluation.Results:The scores of IPS,CCBS and PES were positively correlated with each other(r=0.53,0.56,0.39,Ps＜0.01).Psychological entitlement partially mediated the relationship between compulsory citi-zenship behavior and irrational procrastination among clinical nurses,with an indirect effect of 0.17,accounting for 13.85％of the total effect.Conclusion:Psychological entitlement plays a partial mediating role in the relationship between compulsory citizenship behavior and irrational procrastination among clinical nurses.

This paper reports the clinical characteristics as well as diagnosis and treatment processes of a patient with mixed pulmonary infection of Rhizopus microspores and Aspergillus.The patient had history of type 2 diabe-tes mellitus,and was admitted to the hospital due to diabetes ketoacidosis complicated with pneumonia.Clinical manifestations included cough,expectoration,and fever.Imaging examination showed inflammatory lesions of bila-teral lungs(mainly in the right lung)associated with local consolidation.Bronchoalveolar lavage fluid(BALF)smears and galactomannan antigen test(GM test)were both negative.Nucleic acid sequences of Rhizopus micro-spores and Aspergillus were detected by metagenomic next-generation sequencing(mNGS)at the early stage,while complicated infection of Klebsiella pneumoniae and COVID-19 were also found.The final pathological diagnosis was pulmonary mucormycosis combined with invasive pulmonary aspergillosis.The patient achieved clinical curing through the combination of isaconazole antifungal treatment and lobectomy of the right middle-lower lobes.

Objective To explore the current status and its influencing factors of electronic health literacy of caregivers of total laryngectomy patients and its influencing factors.Methods A total of 145 caregivers of total laryngectomy patients who were admitted to The First Affiliated Hospital of Naval Medical University from August 2018 to August 2023 were selected by convenience sampling.A questionnaire survey was conducted on these caregivers by demographic data questionnaire,electronic health literacy scale(e-HLS),and general self-efficacy scale.Results The average total score of electronic health literacy among the caregivers was 25.09±5.31.One-way analysis of variance showed that there were significant differences in the scores of e-HLS among caregivers with different age,education level,self-efficacy,frequency of online health information search,and disease course(P<0.05).Multivariate logistic regression analysis showed that age,education level,self-efficacy,frequency of online health information search,and disease course were the main factors affecting the electronic health literacy of caregivers of total laryngectomy patients.Conclusion Electronic literacy of caregivers of total laryngectomy patients is at a low level,and it was affected by many factors.Appropriate guidance can be provided to caregivers with low electronic health literacy,so as to improve the electronic health literacy of caregivers and the quality of care for total laryngectomy patients.

The activation of Keap1-Nrf2 signaling pathway is an important mechanism for cells to resist oxidative stress.Under oxidative stress,Keap1 is affected by post-translational modification(PTM)such as glutathione,alky-lation and S-sulfhydrylation,which weakens its binding to Nrf2,leading to Nrf2 accumulation,nuclear translocation and the expression and transcription of downstream detoxification and antioxidant defense proteins.The PTM of Keap1 is involved in the regulation of a variety of oxidative stress-related diseases such as cancer,Parkin-son's disease and atherosclerosis.For example,alkylation inhibits abdominal aortic aneurysm formation,methylation promotes innate resistance of breast cancer,and S-sulfhydrylation improves atherosclerosis,which pro-vides a theoretical basis for finding new drug targets and biomarkers.

Objective:To explore the clinical phenotypes and hematological characteristics of β-thalassemia combined with α-globin gene triplet.Methods:A retrospective case analysis study was conducted, taking individuals diagnosed with thalassemia who sought for outpatient services in No 1 people′s hospital of Chenzhou affiliated to South China University from August 10, 2021, to December 31, 2023 as study objectives. Among them, there were 8 768 males and 11 707 females, aged 31.5 (23.0, 46.0) years old. Blood analysis were analyzed by hematology analyze.The hemoglobin(Hb) Hb A, HbA 2,Hb F bands were analyzed by Capillary electrophoresis method, and the genotypes of thalassemia were analyzed by high-throughput sequencing technology.Hematological parameters between different genotypes of thalassemia were analyzed using t-tests and calibrated t-tests for data analysis. Results:A total of 27 cases of beta thalassemia combined with alpha globin triplet were detected, The average hemoglobin (Hb) of 11 cases of β Codon41/42 (-CTTT)/β N combined with ααα anti 4.2 (3.7) (92±16)g/L was lower than that of β Codon41/42 (-CTTT)/β N(112±11)g/L, and the difference was statistically significant ( t=3.97, P0.05). The average Hb of 8 cases of β IVS-Ⅱ-654 (CT)/β N combined with ααα anti 4.2 (3.7)(85±21) g/L was lower than that of β IVS-Ⅱ-654 (CT)/β N(116±12) g/L, and the difference was statistically significant ( t=4.05, P0.05). Conclusion:When the mutation site is at Codon41/42 (-CTTT) or IVS-Ⅱ-654 (CT), β-thalassemia combined with alpha globin triplet can make the clinical manifestations of β-thalassemia at this site more pronounced.

Objective To establish a rapid on-site detection method for methamphetamine(MA)based on surface-enhanced Raman spectroscopy(SERS).Methods Laboratory-synthesized colloidal silver nanoparticles(AgNPs)were employed as SERS substrates to rapidly detect methamphetamine in typical crime scene matrices,including beer,cigarette ash,and plastic containers.Results The method requires no sample pretreatment,is simple to operate,and offers high sensitivity with fast detection speed.The limit of detection(LOD)reached 10 ppb(signal-to-noise ratio,S/N＞3).The qualitative results of methamphetamine analysis from forensic case samples were highly consistent with gas chromatography-mass spectrometry(GC-MS)findings.Conclusion Methamphetamine is frequently encountered in illicit settings and criminal activities.This study achieved rapid detection of methamphetamine in complex matrices(beer,cigarette ash,and plastic containers),demonstrating good application prospects in practice and providing important value for law enforcement,public safety,and criminal investigation.

The plant AT-rich sequence and zinc-binding protein (PLATZ) family is composed of plant-specific zinc finger-like transcription factors, which play important roles in plant growth, development, and stress tolerance. In this study, to gain a better understanding of the PLATZ gene in C. sinensis and elucidate its response under drought and high temperature conditions, the PLATZ gene family of the C. sinensis cultivar 'Tieguanyin' was systematically identified, and a total of 12 CsPLATZ family members were identified. Expasy online and other bioinformatics tools were used to analyze the members of the PLATZ gene family in terms of protein physicochemical properties, phylogenetic relationships, cis-acting elements, gene structures, and intra- and inter-species collinearity. The results of phylogenetic analysis classified the CsPLATZ family members into 2 subfamilies. The conserved domains and gene structures of PLATZ family members within the same subfamily had a high degree of consistency, whereas a certain degree of diversity was observed among the subfamilies. Twelve PLATZ genes were unevenly distributed across 7 chromosomes of C. sinensis and the promoter regions of these genes had multiple cis-acting elements related to hormone and stress responses. The collinearity analysis showed that there were 4 pairs of duplication events in the CsPLATZ gene family, all of which were segmental duplications. Based on this gene family, C. sinensis had a closer evolutionary relationship with A. thaliana than with O. sativa. The transcriptome analysis showed that the expression levels of CsPLATZ family members varied in different tissue samples of C. sinensis. 6 genes (CsPLATZ-1, CsPLATZ-2, CsPLATZ-3, CsPLATZ-4, CsPLATZ-6, and CsPLATZ-8) with high expression in shoots, young leaves, and roots were selected for high temperature and drought stress treatments, and their expression was quantified by qRT-PCR. The results indicated that the six genes might play important roles in the response to drought stress. In addition, CsPLATZ-2 and CsPLATZ-8 might have important functions in the response to high temperature stress. The results of this study will contribute to a better understanding of the biological functions of PLATZ genes and their possible roles in the growth, development, and stress responses of C. sinensis.
Droughts ; Camellia sinensis/physiology* ; Phylogeny ; Gene Expression Regulation, Plant ; Plant Proteins/genetics* ; Stress, Physiological/genetics* ; Multigene Family ; Transcription Factors/genetics* ; Hot Temperature ; Genes, Plant

Objective:To compare and analyze the efficacy of bilateral and unilateral posterior vocal cord resection with CO 2 laser under endoscopy in the treatment of bilateral vocal cord paralysis. Methods:This case series study retrospectively analyzed the data of 110 patients with bilateral vocal cord paralysis who underwent endoscopic CO 2 laser posterior cordotomy at the Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Naval Medical University, from October 2016 to January 2023. The cohort consisted of 36 males [mean age (45.5±9.1) years, range 24-72 years] and 74 females [mean age (47.2±10.1) years, range 22-67 years]. Among them, 47 patients underwent simultaneous bilateral posterior cordotomy (bilateral cordotomy group), while 63 patients underwent unilateral posterior cordotomy (unilateral cordotomy group). Pre-and postoperative indicators, including swallowing function, glottal size, and vocal function (subjective and objective assessments), were compared between the two surgical approaches. The Wilcoxon signed-rank test was used to analyze changes in swallowing function, glottal size, and vocal function (subjective and objective assessments) within each group before and after surgery, whereas the Mann-Whitney U test was utilized to assess differences between groups. Results:Postoperative follow-up was 1-5 years [median follow-up time was 1.6 (1.3, 2.0) years].The one-time extubation rate was 71.4%(45/63)in the unilateral posterior vocal cord resection group and 87.2%(41/47)in the bilateral posterior vocal cord resection group, significantly higher in the bilateral group ( χ2=3.94, P<0.05). One week after surgery, the swallowing function score of unilateral cordotomy group was 2 (1, 2.5) points, which was significantly better than that of bilateral cordotomy group [2 (1.5, 3) points, Z=-2.118, P<0.05], and the swallowing function score of both groups returned to normal 3 months after surgery. There were no significant differences in preoperative glottic closure during inhalation, auditory perceptual evaluation (GRBAS), objective voice analysis, and Voice Handicap Index-10 (VHI-10) between the two groups ( P>0.05). Postoperatively, the maximum transverse diameter of the posterior glottis during inspiration in the unilateral cordotomy group was 4.49 (4.24, 4.77) mm, significantly smaller than that in the bilateral cordotomy group, which was 5.05 (4.52, 5.62) mm ( Z=-4.103, P<0.05). Among the GRBAS parameters, G (grade of hoarseness), B (breathiness), and A (asthenia), as well as VHI-10 scores and objective voice analysis parameters [jitter, shimmer, harmonic-noise ratio (HNR), and maximum phonation time (MPT)], were significantly better in the unilateral cordotomy group compared to the bilateral cordotomy group, with statistically significant differences ( P<0.05). Conclusions:Unilateral posterior vocal cord resection using CO 2 laser is simple and feasible for the treatment of bilateral vocal cord paralysis, with shorter recovery time, maximal preservation of laryngeal phonatory function, and fewer complications compared to bilateral resection. However, the one-time extubation rate is higher with bilateral resection, reducing the need for a second surgery and associated patient discomfort. This study offers guidance for clinical decision-making in the surgical management of bilateral vocal cord paralysis.