Objective: To determine the active components of Eupolyphaga sinensis Walker (Tu Bie Chong) and explore the mechanisms underlying its fracture-healing ability. Methods: A modified Einhorn method was used to develop a rat tibial fracture model. Progression of bone healing was assessed using radiological methods. Safranin O/fast green and CD31 immunohistochemical staining were performed to evaluate the growth of bone cells and angiogenesis at the fracture site. Methylthiazoletetrazolium blue and wound healing assays were used to analyze cell viability and migration. The Transwell assay was used to explore the invasion capacity of the cells. Tubule formation assays were used to assess the angiogenesis capacity of human vascular endothelial cells (HUVECs). qRT-PCR was used to evaluate the changes in gene transcription levels. Results: Tu Bie Chong fraction 3 (TF3) significantly shortened the fracture healing time in model rats. X-ray results showed that on day 14, fracture healing in the TF3 treatment group was significantly better than that in the control group (P = .0086). Tissue staining showed that cartilage growth and the number of H-shaped blood vessels at the fracture site of the TF3 treatment group were better than those of the control group. In vitro, TF3 significantly promoted the proliferation and wound healing of MC3T3-E1s and HUVECs (all P < .01). Transwell assays showed that TF3 promoted the migration of HUVECs, but inhibited the migration of MC3T3-E1 cells. Tubule formation experiments confirmed that TF3 markedly promoted the ability of vascular endothelial cells to form microtubules. Gene expression analysis revealed that TF3 significantly promoted the expression of VEGFA, SPOCD1, NGF, and NGFR in HUVECs. In MC3T3-E1 cells, the transcript levels of RUNX2 and COL2A1 were significantly elevated following TF3 treatment. Conclusion TF3 promotes fracture healing by promoting bone regeneration associated with the RUNX2 pathway and angiogenesis associated with the VEGFA pathway.

Objective To investigate the risk factors for pulmonary embolism (PE)in patients with acute spinal cord injury (ASCI).Methods A case-control design was adopted in this study.Basic information,injury cause,injury site,imaging and laboratory examination results and other relevant data of 840 ASCI patients admitted to 3 affiliated hospitals of Army Medical University from January 2018 to August 2023 were collected.According to occurrence of PE or not,these patients were divided a PE group (n=83) and a non-PE group (n=757).Univariate analysis was performed on 37 risk factors including gender,age,length of hospital stay,length of intensive care unit (ICU)stay,cause of injury,and so on,and then multivariate logistic regression analysis was applied to analyze these selected significant variables.Results Univariate analysis showed that 24 factors such as age,length of hospital stay,lower limb fracture,pulmonary contusion and infection,shock and number of operations were related to the occurrence of PE in ASCI patients (P<0.05).Binary logistic regression analysis indicated that age (P=0.000,OR=1.957,95％CI:1.532～2.499),length of ICU stay (P=0.000,OR=2.561,95％CI:1.728～3.794),number of operations (P=0.015,OR=1.814,95％CI:1.124～2.927),spinal fixation (P=0.004,OR=0.370,95％CI:0.189～0.724),restrictive position (P=0.000,OR=21.269,95％CI:5.276～85.740),platelet count (P=0.000,OR=1.553,95％CI:1.236～1.951),D-dimer level (P=0.000,OR=1.600,95％CI:1.376～1.860)and prothrombin time (P=0.025,OR=2.756,95％CI:1.138～6.670)were independent risk factors for PE in the patients.Conclusion The mortality of the ASCI patients with PE is significantly higher than those without.Age,length of ICU stay,number of operations,spinal fixation,restrictive position,platelet count,D-dimer level and prothrombin time are closely associated with PE in ASCI patients.

Objective To investigate the self-healing status of children with abnormal tongue root sounds at different age stages of 4 to 12 years old who have not received articulation training,and to provide correct guidance plans for patients.Methods Through retrospective analysis,114 cases of children diagnosed with functional dysar-thria and abnormal root of tongue in Kunming children's hospital from 2019 to 2020 who refused to do rehabilitation training but could receive long-term outpatient follow-up visit,were selected.The follow-up visit was conducted one year later to reevaluate the root of tongue of the children,and the relationship between the self-healing situation of the children's root of tongue and age and wrong form was statistically analyzed.Results Among the 114 children with abnormal root sound,35 cases(30.70％)healed by themselves.The self-healing rates of each age group were as follows:4～5 years old(45.24％),5～6 years old(27.08％),6～7 years old(14.29％),7～12 years old(10.00％).The self-healing rate of all age groups was significant(x2=8.254,P=0.041).There were 287 fre-quency of errors in 114 cases,among which the self-healing rate of consonant loss was the highest(41.46％),fol-lowed by consonant substitution(40.76％),and consonant distortion was the worst(16.67％).The overall differ-ence of the three error forms was statistically significant(x2=10.003,P=0.007).According to different root sounds,the self-healing rate of/h/sound was the highest(31/60.78％),followed by/k/sound(40,32.26％),and/g/sound was the worst(35,31.25％).There was significant difference among the three root sounds(x2=15.172,P＜0.001).There was no significant difference in the self-healing rate between male and female children(x2=1.311,P=0.252).Conclusion The rate of root sound healing in children with functional articulation disor-der was related to age,wrong form and wrong root sound,but not gender.

Objective:To exploring the application effect of doctors-nurses-patients theory of goal attainment combined with StMarys cluster intervention mode in patients with tracheotomy after stroke.Methods:Using convenient sampling method, a total of 130 stroke patients with tracheostomy who were admitted to Shangqiu First People's Hospital from August 2020 to February 2022 were selected as the research objects. The patients were divided into the control group and the observation group using the random number table method, with 65 cases in each group. The control group received routine nursing care, while the observation group applied doctors-nurses-patients theory of goal attainment combined with StMarys cluster nursing intervention mode on the basis of the control group. After intervention, scores of Self Rating Anxiety Scale (SAS) and Self Rating Depression Scale (SDS) and patient nursing satisfaction were compared between the two groups.Results:After intervention, the SAS and SDS scores of the observation group were lower than those of the control group, and the nursing satisfaction was higher than that of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The doctors-nurses-patients theory of goal attainment combined with StMarys cluster intervention mode can help improve the psychological state of patients and increase nursing satisfaction.

Objective:To explore the effects of FOCUS-PDCA management on the improvement of disinfection quality of flexible endoscopes.Methods:From January 2018 to February 2020, a total of 124 flexible endoscopes and 23 nurses in Endoscopy Center of The First People's Hospital of Shangqiu were selected as the research objects by the convenient sampling method. From January 2018 to January 2019, the flexible endoscopes that were disinfected by conventional methods were set as the control group ( n=62) . From February 2019 to February 2020, the flexible endoscopes treated with Focus-PDCA disinfection were set as the observation group ( n=62) . The implementation status of the cleaning and disinfection specifications, the incidence of validity management defects and the quality of disinfection management of flexible endoscopes were compared between the two groups. Results:The observation group's flexible endoscope cleaning, disinfection specifications, and management evaluation scores were higher than those of the control group, and the differences were statistically significant ( P<0.01) . The disinfection and management defects of the flexible endoscope in the observation group were lower than those in the control group, the completeness rate of cleaning and disinfection records, the standard rate of cleaning operations, the qualification rate of biological test results, and the implementation rate of disinfection protection measures in the observation group were all higher than those of the control group, the differences were statistically significant. ( P<0.05) . Conclusions:The FOCUS-PDCA management model can effectively improve the cleanliness and disinfection quality of flexible endoscopes, which is worthy of clinical promotion.

Pancreatic neuroendocrine neoplasms (pNENs) are highly heterogeneous, and the management of pNENs patients can be intractable. To address this challenge, an expert committee was established on behalf of the Chinese Pancreatic Surgery Association, Chinese Society of Surgery, Chinese Medical Association, which consisted of surgical oncologists, gastroenterologists, medical oncologists, endocrinologists, radiologists, pathologists, and nuclear medicine specialists. By reviewing the important issues regarding the diagnosis and treatment of pNENs, the committee concluded evidence-based statements and recommendations in this article, in order to further improve the management of pNENs patients in China.

Pancreatic neuroendocrine neoplasms (pNENs) are highly heterogeneous, and the management of pNENs patients can be intractable. To address this challenge, an expert committee was established on behalf of the Group of Pancreatic Surgery, Chinese Society of Surgery, Chinese Medical Association, which consisted of surgical oncologists, gastroenterologists, medical oncologists, endocrinologists, radiologists, pathologists, and nuclear medicine specialists. By reviewing the important issues regarding the diagnosis and treatment of pNENs, the committee concluded evidence-based statements and recommendations in this article, in order to further improve the management of pNENs patients in China.

Pancreatic neuroendocrine neoplasms (pNENs) are highly heterogeneous, and the management of pNENs patients can be intractable. To address this challenge, an expert committee was established on behalf of the Group of Pancreatic Surgery, Chinese Society of Surgery, Chinese Medical Association, which consisted of surgical oncologists, gastroenterologists, medical oncologists, endocrinologists, radiologists, pathologists, and nuclear medicine specialists. By reviewing the important issues regarding the diagnosis and treatment of pNENs, the committee concluded evidence-based statements and recommendations in this article, in order to further improve the management of pNENs patients in China.

Osteoporosis and atherosclerotic cardiovascular disease are common diseases in middle-aged and elderly people, but less attention has been paid to the link between them. Apolipoprotein E (ApoE) is one of the most popular genes in recent years, studies have shown that ApoE is involved in both bone metabolism and lipid metabolism. Based on ApoE genotype, this paper reviews the basic and clinical research progress of the relationship between osteoporosis and atherosclerotic cardiovascular disease then to provide guidance for clinical and research.

Objective:To explore the effects of post level management and secondary performance distribution in the Central Supply Service Department.Methods:From January 2019, the job categories, job labor intensity, technical risk level, division of professional staff, specialist training, job description revision, job capability and other aspects of all staff ( n=67) of Central Supply Service Department of the First People's Hospital of Shangqiu, Henan were set up, and the competitive employment mechanism was applied. Based on the total amount of performance issued by the Nursing Department according to the total number of people in the disinfection supply center, the scientific design and implementation of post performance secondary assessment distribution and post promotion were carried out according to post workload, work quality, technical research, service satisfaction and so on. Results:The difference in the results of comprehensive skills assessment of nurses before and after the performance of secondary assessment and distribution management was statistically significant ( P<0.05) . The difference of job satisfaction of disinfection and supply center among different departments was statistically significant ( P<0.05) . There was statistical significance in the comparison of quality control defects in quality control examination of department ( P<0.05) . In the democratic evaluation of staff, 43 were very satisfied with the performance distribution, 3 were dissatisfied. The content of dissatisfaction was the coefficient in lactation has no difference from other posts. Conclusions:The implementation of the post level management and secondary performance assessment in the Central Supply Service Department has stimulated the potential of nurses at all levels, aroused their enthusiasm for work, and set up goals for everybody. All staff participating in the management improved the work efficiency and quality, guaranteed the nursing safety and the work operation, achieving the satisfactory effect.