OBJECTIVE To investigate the clinical characteristics and risk factors for batroxobin-related severe hypofibrinogenemia （HFIB） and construct a risk prediction model. METHODS A retrospective analysis was conducted on inpatients treated with batroxobin in the First Medical Center of a tertiary hospital from January 1， 2020， to December 31， 2024. Patients were categorized into non-severe HFIB group and severe HFIB group based on the severity of HFIB. Univariate and multivariate Logistic regression analyses were performed to identify the independent influencing factors for batroxobin-related severe HFIB. A nomogram was developed using the “rms” package in R 4.5 software. The predictive performance of the model was evaluated using the receiver operating characteristic curve. Calibration was assessed via the Bootstrap resampling method， and goodness-of-fit was evaluated with the Hosmer-Lemeshow test. RESULTS A total of 1 472 patients were included in this study. Of these， 1 445 developed HFIB， yi elding an incidence of 98.17%. Furthermore， 895 were classified as severe HFIB， accounting for 60.80% of the cohort. Multivariate Logistic regression analysis showed that increased age， high initial dose per 10 kg body weight， use of maintenance dose， and concomitant glucocorticoid use were independent risk factors for batroxobin-related severe HFIB， while high baseline fibrinogen （FIB） level was identified as a protective factor. The model demonstrated an area under the curve of 0.760 （95% CI： 0.735-0.785）. The mean absolute error of the calibration curve was 0.006. The P value of the Hosmer-Lemeshow test was 0.609. CONCLUSIONS Batroxobin can rapidly and significantly reduce FIB levels and carries a risk of inducing severe HFIB. Patients with advanced age， high initial dose per 10 kg body weight， use of maintenance dose and concomitant glucocorticoid use had a higher risk of batroxobin-related severe HFIB， while high baseline FIB level had a lower risk of batroxobin-related severe HFIB. The risk prediction model developed based on these factors can be used to predict the likelihood of batroxobin-related severe HFIB.

Objective: To investigate the epidemiological characteristics and spatial-temporal clustering of severe fever with thrombocytopenia syndrome (SFTS) in Huai'an City, Jiangsu Province from 2011 to 2024, so as to provide a basis for optimizing local SFTS prevention and control strategies, and identifying high-risk areas and key populations. Methods: Data on SFTS incidence and deaths in Huai'an City from 2011 to 2024 were collected from the Infectious Disease Reporting Information System of the Chinese Disease Prevention and Control Information System. The reported incidence, mortality, and fatality rates were calculated. Descriptive analysis was performed on temporal, population, and regional distribution. The average annual percent change (AAPC) was used to analyze the trend in the reported incidence of SFTS. Global and local spatial autocorrelation analyses were employed to examine the spatial distribution patterns and spatial association patterns of SFTS incidence while spatio-temporal scanning analyses was used to assess the spatial-temporal clustering of SFTS. Results: A total of 337 SFTS cases were reported in Huai'an City from 2011 to 2024, with the reported incidence rising from 0.17/100 000 to 1.88/100 000. There were 20 deaths, with an average annual mortality of 0.03/100 000, and a fatality rate of 5.93%. The incidence showed obvious seasonality, with a peak in May and June (148 cases, accounting for 43.92%). Spring and summer accounted for 107 cases (31.75%) and 159 cases (47.18%), respectively. The reported SFTS cases were mainly male, farmers, and individuals aged ≥41 years, accounting for 56.38%, 79.23%, and 96.74%, respectively. The population distribution of death cases was basically consistent with that of incident cases. Xuyi County was a high-incidence area, with a total of 332 reported cases, accounting for 98.52%. All death cases were reported in this county. Spatial autocorrelation analyses revealed a positive spatial correlation in SFTS incidence from 2019 to 2024, with Moran's I values ranging from 0.214 to 0.336 (all P<0.05). Heqiao Town, Tianquanhu Town, and Guiwu Town in Xuyi County were identified as high-high clustering areas. Spatio-temporal scanning analyses showed that cluster 1 was consistent with the high-high clustering areas, with an aggregation time from the second quarter of 2019 to the second quarter of 2022. Conclusions From 2011 to 2024, the reported incidence of SFTS in Huai'an City showed an upward trend, with a high incidence in spring and summer. Males, farmers, and the middle-aged and elderly population were the key populations for prevention and control. Xuyi County was the key area for prevention and control.

Objective To describe and analyze the epidemiological characteristics of scrub typhus in Huai'an, Jiangsu Province from 2006 to 2024 and explore the long-term incidence trend and distribution of high-risk areas, and to formulate targeted prevention and control strategies. Methods The scrub typhus case report data of Huai'an from 2006 to 2024 in the Chinese Disease Prevention and Control Information System were extracted for descriptive analysis. Results A total of 898 cases of scrub typhus were reported in Huai'an, with an average annual incidence rate of 0.96 per 100 000 from 2006 to 2024. There was a turning point in the incidence trend of scrub typhus in 2011. From 2006 to 2011, the annual percentage change (APC) was 47.09% (95% CI: 7.53 - 859.39), and the upward trend was statistically significant (P < 0.05). From 2012 to 2024, the APC was -2.12% (95% CI: -29.09 - 3.75), and the downward trend was not statistically significant. October and November were the high-incidence months, and the total concentration from 2006 to 2024 was 0.93, indicating that scrub typhus had strict seasonality. The circular distribution method estimated that the peak period of the epidemic was from October 11th to November 25th, and the peak day of incidence was November 3rd. Jinhu County was a high-incidence area. The ratio of male to female cases was 1.03. The age group with the highest reported incidence was 40 to < 80 years old. The occupation with the highest proportion was farmers, accounting for 78.03%. Conclusion From 2006 to 2024, scrub typhus in Huai'an shows a peak every 3 - 4 years. Middle-aged and elderly farmers are the key population at risk, and Jinhu County is a key area. In the future, targeted health education should be carried out to effectively control the prevalence of scrub typhus.

The paper introduces the reconstruction of Professor JI Laixi's modern paradigm of thought, "making use of various therapeutic methods". Professor JI Laixi reveres the concept of "integration of western medicine and TCM" and advocates the "combination of advantageous techniques of acupuncture and moxibustion". Guided by the concept of "combination of superiority, and coordinated adjustment", a multi-mode intervention is delivered in treatment, including the operation with the nine needles, relaxation with acupotomy, acupoint thread-embedding, Chinese herbal compounds and adjuvant therapy with western medicines, so as to obtain dynamic adjustment of multiple targets and levels, "taking effectiveness as the first priority". The pathway of clinical practice is determined and clear, which provides a paradigm of "upholding the right and innovating" for the modernization of acupuncture and moxibustion.
Humans ; Acupuncture Therapy/methods* ; China ; Moxibustion/history* ; History, 20th Century ; Medicine, Chinese Traditional/history* ; Acupuncture/history*

Objective:Analyse the factors affecting whether the first two batches of centralized volume-based purchase of Proprietary Chinese Medicine were selected,the price difference and the rate of reduction,so as to provide a basis for improving the policy of centralized volume-based purchase of Proprietary Chinese Medicine.Methods:The first two batches of centralized volume-based purchase of Proprietary Chinese Medicine were selected for the study.Logistic regression was used to analyse the influencing factors of whether the selection was won or not.Multiple linear regression was used to analyse the influencing factors of price difference/reduction after being selected.Results:Proprietary Chinese Medicine with a high degree of acceptance by medical institutions and belonging to the category of essential medicines have a higher probability of being selected.The probability of selected products in the first batch of centralised purchase is greater for enterprises with a market share of more than 50%.In the first batch of centralized volume-based purchase of Proprietary Chinese Medicine,the price difference of injections and medicines belonging to the catalogue of essential medicines is greater.Price reductions were greater for those with low market share,low recognition by medical institutions,and a large number of enterprises in the A-competition unit and the same competition unit.In the second batch of centralised volume-based purchase of Proprietary Chinese Medicine,the price difference is greater for injections,and those with qualifications for the production of Chinese herbal medicines.the price reduction is greater in the B competitive unit.Conclusion:The centralized volume-based purchase of Proprietary Chinese Medicine has been both'quality-assured'and'price-reduced'.The centralized volume-based purchase of Proprietary Chinese Medicine has been gradually improved,and the tilt towards large enterprises has been reduced,so that the centralized volume-based purchase of Proprietary Chinese Medicine can achieve a'bottom price'.However,it is still necessary to start from the quality of identification,fair competition,and so on,and the centralized volume-based purchase of Proprietary Chinese Medicine fully linked to promote the centralized purchase of Traditional Chinese Medicine Decoction Pieces to a stable and far-reaching.

This study was aimed at evaluating the characteristics of H9N2 subtype avian influenza viruses(AIVs)origina-ting from wild birds in major wetlands in Fujian.Five H9N2 subtype AIVs isolated from fecal samples from wild birds in wet-lands of the Minjiang River,Jiulong River,Sandu Bay,Xinghua Bay,and Quanzhou Bay in Fujian were sequenced.Sequence a-nalysis of the HA genes of the five H9N2 subtype AIVs indicated that the five isolates shared 89.8％-99.4％nucleotide se-quence identity.All five isolates belonged to the same h9.4.2.5c evolutionary branch.The cleavage site motifs of HA were all PSRSSR ↓ GLF,thus indicating molecular characteristics of AIVs with low pathogenicity.The HA proteins of the viruses orig-inating from wild birds bore eight identical potential glycosylation sites,among which the glycosylation site at position 313 was located near the HA protein cleavage site.The 226th amino acid of HA in the receptor binding site was leucine in each virus,thus indicating that HAs of the five H9N2 subtype AIVs had mammalian sialic acid α-2,6 receptor binding affinity.In conclu-sion,the five H9N2 subtype AIVs originating from wild birds in Fujian had low pathogenicity,and the HAs had mammalian sialic acid α-2,6 receptor binding affinity.

The construction of the National Medical Center and the National Regional Medical Center in the Chengdu-Chongqing Economic Circle (referred to as the dual medical center construction) faces the challenges of insufficient integration of industry, academia, research, and medicine, as well as limited joint development and sharing of high-quality resources. It is urgent to promote the integration and coordinated development of regional education and technology talent resources through the integration of higher medical education, and to enhance the "four chains" synergy with the integration of industry and education as the core, thereby promoting the dual medical center construction. This study investigated and summarized the key issues in the dual medical center construction and the integration of higher medical education in the Chengdu-Chongqing Economic Circle. Based on the theoretical framework of four chain coordination (industry chain-talent chain-education chain-city chain), this study clarified the mechanisms by which integrated higher medical education can promote dual medical center construction. The study found that the integration of higher medical education can effectively promote the optimization of resources for dual medical center construction by constructing a collaborative mechanism of "industry education integration-joint talent cultivation-coordinated discipline construction-intercity cooperation". Based on the strengths in higher education resources in Chengdu and Chongqing, a five-dimension collaborative path was proposed: integrated development; technological leadership; talent oriented; government guidance; and market assistance. The research conclusion not only enhances the understanding of the integration of higher medical education, but also provides theoretical basis and practical reference for the dual medical center construction in the Chengdu-Chongqing Economic Circle. The proposed coordinated development also has reference value for the construction of medical centers in urban agglomerations such as the Beijing-Tianjin-Hebei Urban Agglomeration and the Yangtze River Delta.

Objective:To explore the alexithymia of patients with kinesiophobia after total knee arthroplasty (TKA) and analyze its influencing factors.Methods:Convenience sampling was used to select 221 patients with kinesiophobia after TKA admitted to the First Affiliated Hospital of Zhengzhou University in Henan Province between June and October 2024. A survey was conducted using the self-designed General Information Questionnaire, Tampa Scale of Kinesiophobia-11, Chinese version of Toronto Alexithymia Scale-20 (TAS-20), Social Support Rating Scale, and General Self-efficacy Scale. Multiple linear regression was used to analyze the factors influencing patients' alexithymia.Results:A total of 221 questionnaires were distributed, and 210 questionnaires were effectively collected, with an effective response rate of 95.02%. Chinese version of TAS-20 score of 210 patients with kinesiophobia after TKA were (60.70±8.16), and the incidence of alexithymia was 52.86% (111/210), mainly manifested as describing emotional feeling disorders and externally oriented thinking disorders. Multiple linear regression analysis showed that educational level, per capita monthly household income, personality types, score of kinesiophobia, self-efficacy, and social support were statistically significant factors influencing the alexithymia of patients with kinesiophobia after TKA ( P<0.05), explaining 83.50% of the total variance. Conclusions:Patients with kinesiophobia after TKA have a high level of alexithymia. Patients with low educational level, low per capita monthly household income, introverted personalities, high levels of kinesiophobia, low self-efficacy, and low levels of social support are prone to developing alexithymia. Healthcare professionals should pay attention to the alexithymia of patients with kinesiophobia after TKA. Effective measures should be formulated from the aspects of emotional education, disease cognition, social skill training, and social support to reduce the level of alexithymia in patients with kinesiophobia.

Objective:To explore the application effect of BOPPPS (Bridge-in, Objectives, Pre-assessment, Participatory learning, Post-assessment, and Summary) combined with scenario simulation in cultivating the humanistic care ability of undergraduate nursing interns.Methods:Undergraduate nursing students who were interning at the First Affiliated Hospital of Zhengzhou University were selected by convenience sampling. The 46 interns from June to December 2023 were set as the control group, and the 46 interns from June to December 2024 were set as the experimental group. The control group adopted the traditional lecture-based teaching method, while the experimental group adopted BOPPPS combined with scenario simulation. Theoretical and practical scores, humanistic care ability, empathy ability, and critical thinking ability of the two groups were compared.Results:After the intervention, the theoretical and practical scores, as well as humanistic care ability, empathy ability, and critical thinking ability scores of the experimental group were all higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:BOPPPS combined with scenario simulation plays a positive role in improving theoretical and practical scores, humanistic care ability, empathy ability, and critical thinking ability of undergraduate nursing interns, and it is worthy of further promotion and application.

Objective:To explore latent profile categories of pain catastrophizing in total knee arthroplasty patients and analyze differences in kinesiophobia among different categories of patients.Methods:Convenience sampling was used to select 340 patients who underwent total knee arthroplasty at the First Affiliated Hospital of Zhengzhou University from January 2023 to June 2024. The Pain Catastrophizing Scale (PCS) and Tampa Scale for Kinesiophobia (TSK) were used to assess patients' pain catastrophizing and kinesiophobia on the third postoperative day. Latent profile analysis was employed to simulate and categorize PCS, and to compare the kinesiophobia among patients in different categories.Results:A total of 340 questionnaires were distributed, with 327 valid responses collected, resulting in a valid response rate of 96.18%. The postoperative PCS score for 327 patients was (34.76±7.59) , with 33.33% (109/327) achieving a PCS score ≥38. The mean scores for the three dimension (exaggeration, helplessness, and rumination) items were (2.91±0.93) , (2.33±0.84) , and (2.51±0.79) , respectively. The TSK score was (48.39±9.42) , with 50.46% (165/327) scoring above 37. Three latent categories of pain catastrophizing were identified, including "high exaggeration-helplessness-rumination group", accounting for 28.75% (94/327) ; "high exaggeration-moderate helplessness-rumination group", accounting for 39.45% (129/327) ; "moderate exaggeration-helplessness-high rumination group", accounting for 31.80% (104/327) . The TSK scores of the three groups of patients were (51.75±8.49) , (46.83±8.76) , and (49.29±9.04) , respectively, with statistically significant differences ( P<0.05) . Conclusions:Patients undergoing total knee arthroplasty exhibit distinct categorical characteristics in postoperative pain catastrophizing, with varying levels of kinesiophobia observed across different pain catastrophizing characteristics. Healthcare providers should conduct early assessments to identify patients' pain catastrophizing characteristics and deliver targeted interventions to improve pain catastrophizing and kinesiophobia, thereby promoting early postoperative recovery.