Objective:To determine the pathogens causing viral diarrhea in children under 5 years of age and the epidemiological patterns in Chengdu from 2021 to 2024.Methods:Fecal samples were collected from hospitalized children under 5 years of age with diarrhea in a sentinel surveillance hospital for viral diarrhea in Chengdu from 2021 to 2024. Norovirus（NoV），sapovirus（SaV），astrovirus（AstV），and enteric adenovirus（EAdV）were detected by real-time PCR or real-time RT-PCR. Group A rotavirus（RVA）was detected by enzyme-linked immunosorbent assay. The results were analyzed statistically by using SPSS 20.0 software.Results:RVA，NoV，SaV，AstV，and EAdV were detected in 329 fecal samples from 719 hospitalized children with diarrhea under 5 years of age. The total detection rate was 48.8%（329/719）. The detection rate of RVA，NoV，SaV，AstV，and EAdV was 17.0%（122/719），20.9%（150/719），4.0%（29/719），2.8%（20/719），8.6%（62/719），separately. The detection rate of mixed infection with multiple pathogens was 7.1%（51/719），among which RVA combined with NoV infection was the most common（2.2%，16/719）. Except for EAdV（ χ2=14.368， P=0.002），there was no significant difference in the detection rates of RVA，NoV，SaV，and AstV in different years. Except for SaV and EAdV，the detection rates of RVA（ χ2=11.106， P<0.001），NoV（ χ2=65.164， P<0.001）and AstV（ χ2=19.612， P<0.001）were statistically significant in different quarters. There was no statistically significant difference in the detection rates of the five pathogens between males and females. Except for NoV，there were statistically significant differences in the detection rates of RVA（ χ2=32.209， P<0.001），SaV（ χ2=13.983， P=0.002），AstV（ χ2=9.56， P=0.015）and EAdV，（ χ2=8.992， P=0.029）in children of different months of age. Conclusion:RVA and NoV are the main pathogens causing viral diarrhea in children under 5 years of age in Chengdu. The peak infection period of viral diarrhea tends to occur in winter and spring and occurs most frequently in 12-24 months old and 24-59 months old children.

Objective To explore the gender differences in the relationship between depressive symptoms and cognitive functions in patients with depression.Methods From January 2021 to June 2024,375 patients meeting the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5)criteria for depression were selected by convenience sampling from the Affiliated Psychological Hospital of Anhui Medical University.Depressive symptom severity was assessed using the 24-item Hamilton depression scale(HAMD-24),while cognitive function was evaluated using a series of neuropsychological assessment tools,including the trail making test,logical memory,figure memory,digit symbol substitution test,digit span backward,and Wisconsin card sorting test.Network analysis was performed using R software to examine the relationships between symptoms and cognitive function.Results The core symptom factors and core cognitive domains for male depressive patients are sleep disturbances(strength=1.253)and information processing speed(strength=1.605),respectively;In contrast,female patients exhiboted emotional stagnation(strength=1.322)and working memory(strength=1.289).Sleep disturbances and emotional stagnation were the bridging nodes(bridge strength=1.253 and 1.322)for male and female patients,respectively.The correlation stability(CS)coefficients for the node strength centrality in male and female patient groups were 0.514 and 0.515,respectively,both exceeding threshold of 0.25,indicating good network stability.There were no significant differences between genders in terms of global network strength(male vs.female:2.22 vs.4.87;P=0.356)and edge weight distribution(P=0.293).Conclusion The network relationships between depressive symptoms and cognitive function in depression patients show significant gender differences.Sleep disturbance and information processing speed play central roles in males,whereas emotional retardation and working memory impairment are core features in females.These findings provide a theoretical basis for developing gender-specific intervention strategies.

Objective To explore the gender differences in the relationship between depressive symptoms and cognitive functions in patients with depression.Methods From January 2021 to June 2024,375 patients meeting the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5)criteria for depression were selected by convenience sampling from the Affiliated Psychological Hospital of Anhui Medical University.Depressive symptom severity was assessed using the 24-item Hamilton depression scale(HAMD-24),while cognitive function was evaluated using a series of neuropsychological assessment tools,including the trail making test,logical memory,figure memory,digit symbol substitution test,digit span backward,and Wisconsin card sorting test.Network analysis was performed using R software to examine the relationships between symptoms and cognitive function.Results The core symptom factors and core cognitive domains for male depressive patients are sleep disturbances(strength=1.253)and information processing speed(strength=1.605),respectively;In contrast,female patients exhiboted emotional stagnation(strength=1.322)and working memory(strength=1.289).Sleep disturbances and emotional stagnation were the bridging nodes(bridge strength=1.253 and 1.322)for male and female patients,respectively.The correlation stability(CS)coefficients for the node strength centrality in male and female patient groups were 0.514 and 0.515,respectively,both exceeding threshold of 0.25,indicating good network stability.There were no significant differences between genders in terms of global network strength(male vs.female:2.22 vs.4.87;P=0.356)and edge weight distribution(P=0.293).Conclusion The network relationships between depressive symptoms and cognitive function in depression patients show significant gender differences.Sleep disturbance and information processing speed play central roles in males,whereas emotional retardation and working memory impairment are core features in females.These findings provide a theoretical basis for developing gender-specific intervention strategies.

Objective:To determine the pathogens causing viral diarrhea in children under 5 years of age and the epidemiological patterns in Chengdu from 2021 to 2024.Methods:Fecal samples were collected from hospitalized children under 5 years of age with diarrhea in a sentinel surveillance hospital for viral diarrhea in Chengdu from 2021 to 2024. Norovirus（NoV），sapovirus（SaV），astrovirus（AstV），and enteric adenovirus（EAdV）were detected by real-time PCR or real-time RT-PCR. Group A rotavirus（RVA）was detected by enzyme-linked immunosorbent assay. The results were analyzed statistically by using SPSS 20.0 software.Results:RVA，NoV，SaV，AstV，and EAdV were detected in 329 fecal samples from 719 hospitalized children with diarrhea under 5 years of age. The total detection rate was 48.8%（329/719）. The detection rate of RVA，NoV，SaV，AstV，and EAdV was 17.0%（122/719），20.9%（150/719），4.0%（29/719），2.8%（20/719），8.6%（62/719），separately. The detection rate of mixed infection with multiple pathogens was 7.1%（51/719），among which RVA combined with NoV infection was the most common（2.2%，16/719）. Except for EAdV（ χ2=14.368， P=0.002），there was no significant difference in the detection rates of RVA，NoV，SaV，and AstV in different years. Except for SaV and EAdV，the detection rates of RVA（ χ2=11.106， P<0.001），NoV（ χ2=65.164， P<0.001）and AstV（ χ2=19.612， P<0.001）were statistically significant in different quarters. There was no statistically significant difference in the detection rates of the five pathogens between males and females. Except for NoV，there were statistically significant differences in the detection rates of RVA（ χ2=32.209， P<0.001），SaV（ χ2=13.983， P=0.002），AstV（ χ2=9.56， P=0.015）and EAdV，（ χ2=8.992， P=0.029）in children of different months of age. Conclusion:RVA and NoV are the main pathogens causing viral diarrhea in children under 5 years of age in Chengdu. The peak infection period of viral diarrhea tends to occur in winter and spring and occurs most frequently in 12-24 months old and 24-59 months old children.

Objective:To explore the effect of intervention model based on comprehensive nutrition management on glucose and lipid metabolism and pregnancy outcome in patients with gestational diabetes mellitus (GDM).Methods:104 GDM patients admitted to Shanxi Bethune Hospital from February 2022 to March 2023 were randomly divided into control group and experimental group, with 52 cases in each group. The control group implemented routine management measures and nutrition guidance, while the experimental group implemented an intervention model based on comprehensive nutrition management on the basis of routine management. The indexes of glucose and lipid metabolism (glycosylated hemoglobin, fasting blood glucose, 2 h postprandial blood glucose, total cholesterol, triglyceride and low density lipoprotein cholesterol), pregnancy outcome, self-management ability and self-efficacy were compared between the two groups before and after intervention.Results:Before the intervention, there was no significant difference in general situation, glucose and lipid metabolism index, self-management ability and self-efficacy between the two groups ( P>0.05). After the intervention, the level of glucose and lipid metabolism index in the experimental group was significantly lower than that in the control group, with statistical significance ( P<0.05). The incidence of adverse pregnancy outcome in the experimental group was significantly lower than that in the control group, with statistical significance ( P<0.05). The scores of self-management ability and self-efficacy in the experimental group were significantly higher than those in the control group, with statistical significance ( P<0.05). Conclusion:The intervention model based on comprehensive nutrition management can effectively improve the glucose and lipid metabolism index and pregnancy outcome of GDM patients, and significantly improve their self-management ability and self-efficacy related to nutrition management, which has high clinical application and promotion value.

Objective:To evaluate the clinical relevant effect of hospital-wide blood glucose management in perioperative cholelithiasis patients with type 2 diabetes.Methods:The subjects of the study were patients with type 2 diabetes mellitus complicated with cholelithiasis who were treated at the Baiqiu'en Hospital in Shanxi from September 2022 to October 2023. The patients were divided into hospital-wide blood sugar management group and conventional treatment group, according to different blood glucose management they received. The differences in preoperative blood glucose control, length of stay, postoperative complications, and hospitalization expenses between the two groups were compared.Results:Compare based on the median (quartiles) of the observed indicators, patients with cholelithiasis who underwent hospital-wide blood glucose management based on insulin pumps had a higher proportion of time in range [72.00(70.21, 82.90)% vs. 64.80 (61.55,70.50)%, P<0.001)], lower average blood glucose level [9.00 (8.55, 10.44) mmol/L vs. 11.50 (10.50, 12.50) mmol/L, P<0.001], and shorter hospital stay [8.00 (7.00,13.00) days vs. 10.00 (8.00, 12.00) ) days, P<0.05]. Moreover, the incidence of postoperative complications was lower [5(11.11)% vs. 15(33.33)%, P<0.05], and hospitalization expenses were lower [16 535.34 (14 271.44, 29 569.23) yuan vs. 18 633.85 (17 482.66) yuan , 22 855.02) yuan, P<0.05] in patients who received hospital-wide blood glucose management. Conclusion:Hospital-wide blood glucose management based on insulin pumps showed favorable effects in the perioperative clinical application in cholelithiasis patients with type 2 diabetes, and could contribute to shortening the average length of stay, reducing hospitalization costs, and reducing postoperative complications.

ObjectiveTo investigate the role and mechanism of DNA repair regulation in the process of hepatocellular carcinoma （HCC） recurrence. MethodsHCC tissue samples were collected from the patients with recurrence within two years or the patients with a good prognosis after 5 years， and the Tandem Mass Tag-labeled quantification proteomic study was used to analyze the differentially expressed proteins enriched in the four pathways of DNA replication， mismatch repair， base excision repair， and nucleotide excision repair， and the regulatory pathways and targets that play a key role in the process of HCC recurrence were analyzed to predict the possible regulatory mechanisms. The independent samples t-test was used for comparison of continuous data between two groups； a one-way analysis of variance was used for comparison between multiple groups， and the least significant difference t-test was used for further comparison between two groups. ResultsFor the eukaryotic replication complex pathway， there were significant reductions in the protein expression levels of MCM2 （P=0.018）， MCM3 （P=0.047）， MCM4 （P=0.014）， MCM5 （P=0.008）， MCM6 （P=0.006）， MCM7 （P=0.007）， PCNA （P=0.019）， RFC4 （P=0.002）， RFC5 （P<0.001）， and LIG1 （P=0.042）； for the nucleotide excision repair pathway， there were significant reductions in the protein expression levels of PCNA （P=0.019）， RFC4 （P=0.002）， RFC5 （P<0.001）， and LIG1 （P=0.042）； for the base excision repair pathway， there were significant reductions in the protein expression levels of PCNA （P=0.019） and LIG1 （P=0.042） in the HCC recurrence group； for the mismatch repair pathway， there were significant reductions in the protein expression levels of MSH2 （P=0.026）， MSH6 （P=0.006）， RFC4 （P=0.002）， RFC5 （P<0.001）， PCNA （P=0.019）， and LIG1 （P=0.042） in recurrent HCC tissue. The differentially expressed proteins were involved in the important components of MCM complex， DNA polymerase complex， ligase LIG1， long patch base shear repair complex （long patch BER）， and DNA mismatch repair protein complex. The clinical sample validation analysis of important differentially expressed proteins regulated by DNA repair showed that except for MCM6 with a trend of reduction， the recurrence group also had significant reductions in the relative protein expression levels of MCM5 （P=0.008）， MCM7 （P=0.007）， RCF4 （P=0.002）， RCF5 （P<0.001）， and MSH6 （P=0.006）. ConclusionThere are significant reductions or deletions of multiple complex protein components in the process of DNA repair during HCC recurrence.

Objective:To explore the risk factors of microvascular invasion (MVI) in hepatocellular carcinoma (HCC), and to predict MVI preoperatively, non-invasively and accurately.Methods:A total of 150 HCC patients (183 HCC lesions) were retrospectively collected in the First Affiliated Hospital of Xi′an Jiaotong University from January 2016 to June 2022.The clinical data and hematological data, gray-scale ultrasonography (US), contrast-enhanced ultrasonography (CEUS), enhanced magnetic resonance imaging with gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (EOB-MRI) and pathological data of these patients were recorded. According to the pathological diagnosis of MVI, the lesions were divided into MVI (+ ) group and MVI (-) group. The indicators between the two groups were compared. All 183 lesions were put into the training set, and the prediction model with nomogram was constructed according to the risk factors of MVI selected by multivariate Logistic regression. The internal verification was carried out by ten-fold cross-validation method.Results:There were significant statistical differences in the following parameters between MVI (+ ) group ( n=109) and MVI (-) group ( n=74) (all P<0.05). These were cirrhosis, serological parameters (alpha-fetoprotein, albumin, total bilirubin), qualitative indexes of US (size, boundary, internal echo), qualitative indexes of CEUS (hyper/iso/hypovascularity of lesions in arterial phase, portal phase, and delayed phase compared with hepatic parenchyma), and quantitative indexes of EOB-MRI [post enhancement rate (post ratio) and gadolinium disodium rate (EOB ratio)] calculated mainly in terms of lesions and surrounding liver parenchyma in hepatobiliary phase and unenhanced T1 images). Finally, cirrhosis of patients, the size, boundary, internal echo of lesions in US; arterial phase (AP), portal phase (PP), post-vascular phase (PVP) features in CEUS; the EOB rate and post rate of EOB-MRI entered the prediction model of MVI. The training set exhibited good calibration and net gain rate. The areas under the ROC curve for the training set and the validation set were 0.981 and 0.961, respectively, while the diagnostic accuracy were 92.9% and 85.8%, respectively. Conclusions:The model constructed mainly by multimodality imaging methods can achieve favorable predictive performance for MVI, which provides valuable ideas for noninvasively predicting the incidence of MVI and optimizing the MVI-related treatment of MVI in HCC patients.

Objective:To analyze and compare the effects of conventional treatment and the dynamic 3C therapy, continuous glucose monitoring system, and on outcomes, length of hospital stay and medical costs in patients with type 2 diabetes mellitus.Methods:A total of 122 type 2 diabetes mellitus patients who visited the Department of Endocrinology of Shanxi Baiqiu'en Hospital between June 2022 and December 2022 were selected and randomized at 1:1 into the control group and the experimental group using the randomized numerical table method. The t-test and non-parametric test were used as appropriate to compare the glycemic control, length of hospital stay and medical costs of the two groups.Results:Before treatment, there was no significant difference in the indicators for blood glucose levels and fluctuations between the two groups ( P>0.05). After treatment, the glycosylated hemoglobin, fasting plasma glucose, and 2-hour postprandial blood glucose decreased in both groups. Moreover, the glycosylated hemoglobin, fasting plasma glucose, and 2-hour postprandial blood glucose showed more significant decreases in the experimental group compared with the control group after treatment. The glycemic variability indicators, including the time out of range, standard deviation of blood glucose, and the largest amplitude of glycemic excursion, decreased after treatment in both groups. The time in range increased after treatment. After treatment, the standard deviation of blood glucose and the largest amplitude of glycemic excursion in the experimental group were lower than those in the control group, and the length of hospital stay in the experimental group was shortened (all P<0.05). Conclusion:3C therapy contributes to better glycemic control and shorter hospital stay in patients with type 2 diabetes mellitus.

Objective To investigate the nursing clinical practice of ICU ventilator-associated pneumonia(VAP)prevention and control of tertiary hospitals in China,and analyze relevant countermeasures.Methods A self-designed questionnaire consisted of 3 parts and 26 items.A questionnaire survey was conducted among nurses in 380 ICUs in 194 tertiary hospitals in 26 provinces from September 1 to 15,2021,using the convenient sampling method.Results A total of 380 valid questionnaires were collected,with an effective rate of 100%.In the system process,369(97.11%)ICUs had files to prevent VAP;291(76.58%)ICUs had a checklist of measures to prevent VAP clustering;274(72.11%)ICUs had continuous improvement projects about VAP in the last 3 years.In the aspect of body position management,semi-decubitus position was the first choice for the patients with invasive mechanical ventilation of 338(88.95%)ICUs.For nursing operation,224(58.95%)ICUs used Subglottic suction,and 128(33.68%)among them used air shock to remove the retention on the balloon;normal saline is still routinely injected before sputum aspiration in 72(18.95%)ICUs.In terms of balloon pressure monitoring,253(66.58%)ICUs did the oral care 3-4 times a day.In the balloon pressure monitoring,313(82.37%)ICUs use airbag pressure gauges to intermittently monitor airbag pressure;293(77.11%)ICUs replaced the ventilator pipeline once a week.There are significant differences in the current practice status of different types of ICUs in terms of compliance strategies for bed head lifting,subglottic secretion drainage,airbag pressure monitoring,and oral care(P<0.05).Conclusion At present,the relevant systems and procedures to prevent VAP have been improved,but the specific prevention and control measures need to be further unified.Therefore,it is suggested to analyze the weak links of VAP nursing prevention and control practice in various medical structures,carry out relevant training and quality control for the weak links,and further improve the working mechanism of continuous quality improvement,thus effectively reduce the incidence of VAP.