Objective:To verify and compare the correlation and diagnostic efficacy of international bowel ultrasound segmental activity score（IBUS-SAS），bowel ultrasound score（BUSS），simple ultrasound score for Crohn's disease（SUS-CD），and simple ultrasound score（Simple-US）with endoscopic disease activity in Crohn's disease（CD）patients. To provide external validation of the diagnostic efficacy of intestinal ultrasound（IUS）score and theoretical basis for clinical selection of optimal IUS score.Methods:A total of 160 patients with clinical diagnosis of CD combined with IUS and intestinal endoscopy were retrospectively analyzed in the Second Affiliated Hospital of Zhejiang University School of Medicine from January 2022 to August 2024. IUS parameters were measured and scored with IBUS-SAS，SUS-CD，BUSS and Simple-US scores. Endoscopic SES-CD was used to evaluate intestinal disease activity in patients without history of intestinal resection，and Rutgeerts score was used to evaluate intestinal disease activity in patients with history of intestinal resection. Endoscopic remission in patients with CD was defined as SES-CD < 3 or Rutgeerts score i0 and i1，mild endoscopic disease activity was defined as 7 > SES-CD≥3 or Rutgeerts score = 2，moderate endoscopic disease activity was defined as 15 > SES-CD≥7 or Rutgeerts score i3，severe endoscopic disease activity was defined as SES-CD≥15 or Rutgeerts i4. The correlation and diagnostic efficacy of IBUS-SAS，SUS-CD，BUSS and Simple-US scores with endoscopic disease activity in patients with CD were compared and analyzed.Results:IUS scores including IBUS-SAS，SUS-CD，BUSS and Simple-US were significantly correlated with endoscopic intestinal disease activity，SES-CD and Rutgeerts scores in CD patients（ r s = 0.706，0.492，0.502，0.526；0.825，0.581，0.584，0.603；0.541，0.434，0.437，0.467；all P＜0.05）. Among them，IBUS-SAS showed better correlation than the other three IUS scores. ROC curve showed that IBUS-SAS，SUS-CD，BUSS，and Simple-US had high predictive values for endoscopic disease activity and endoscopic disease moderate-severe activity in patients with CD（AUC = 0.886，0.748，0.730，0.756；all P＜0.05）. The diagnostic efficacy of IBUS-SAS on the presence of endoscopic disease activity in patients with CD was significantly higher than those of the other three IUS scores . Conclusions:IBUS-SAS，SUS-CD，BUSS and Simple-US are significantly correlated with the endoscopic results of on intestinal disease activity of CD，and have high predictive values for intestinal disease activity status，among which IBUS-SAS is superior to the other three IUS scores. It is recommended that IBUS-SAS be used first to evaluate intestinal disease activity in patients with CD.

Objective:To investigate the development and job adaptability of specialized nurses in Liaoning Province, and to provide basis for further improving the job adaptability of specialized nurses.Methods:In August 2024, provincial-level or above specialized nurses from secondary and above hospitals in 14 cities of Liaoning Province were selected by convenient sampling method, and their job adaptation was investigated using General Information Questionnaire and Workers' Job Adaptation Scale to conduct cross-sectional research.Results:A total of 3 460 valid questionnaires were collected. Among the 3 460 specialized nurses, tertiary hospitals accounted for 91.01% (3 149/3 460), undergraduates accounted for 89.28% (3 089/3 460), and 51.13% (1 769/3 460) were aged from 36 to 45. The top three training specialties for specialized nurses were severe illness, operating room and intravenous infusion therapy, and the training duration was mostly 6 to 12 weeks, accounting for 58.70% (2 031/3 460). After training, they mostly engaged in specialized disease care/case care, accounting for 86.07% (2 978/3 460); In terms of hospital security, 71.16% (2 462/3 460) of the specialized nurses said that the working conditions provided by the hospital could meet their work needs, 43.93% (1 520/3 460) said that the hospital performance was reasonable, 43.29% (1 498/3 460) said that there were sufficient promotion opportunities, and 49.28% (1 705/3 460) said that the hospital has dedicated positions for specialized nurses. The score of the Job Fit Scale for Professional Nurses was (37.36 ± 6.30) points, including the attribute fit dimension (12.45 ± 2.32) points, the demand-supply fit dimension (11.84 ± 2.57) points and the ability-requirement fit dimension (13.06 ± 2.12) points.Conclusions:The post adaptability of provincial-level or above specialized nurses in Liaoning province is in the high level, but the distribution of specialized nurses is uneven, and the proportion of secondary hospitals is low. The training mechanism for specialized nurses has gradually matured, but some of them are not fully played, and there is little participation in scientific research and innovation activities after training. Therefore, it is suggested that in the future work, secondary hospitals should be encouraged to select nursing backbones according to their needs to participate in specialized training programs to improve nurses' professional skills; Nursing managers encourage specialized nurses to consciously participate in systematic scientific research training to enhance their nursing scientific research ability; rational use of specialist nurses in hospitals, giving full play to their professional advantages, and promoting the development of specialties.

Objective:To verify and compare the correlation and diagnostic efficacy of international bowel ultrasound segmental activity score（IBUS-SAS），bowel ultrasound score（BUSS），simple ultrasound score for Crohn's disease（SUS-CD），and simple ultrasound score（Simple-US）with endoscopic disease activity in Crohn's disease（CD）patients. To provide external validation of the diagnostic efficacy of intestinal ultrasound（IUS）score and theoretical basis for clinical selection of optimal IUS score.Methods:A total of 160 patients with clinical diagnosis of CD combined with IUS and intestinal endoscopy were retrospectively analyzed in the Second Affiliated Hospital of Zhejiang University School of Medicine from January 2022 to August 2024. IUS parameters were measured and scored with IBUS-SAS，SUS-CD，BUSS and Simple-US scores. Endoscopic SES-CD was used to evaluate intestinal disease activity in patients without history of intestinal resection，and Rutgeerts score was used to evaluate intestinal disease activity in patients with history of intestinal resection. Endoscopic remission in patients with CD was defined as SES-CD < 3 or Rutgeerts score i0 and i1，mild endoscopic disease activity was defined as 7 > SES-CD≥3 or Rutgeerts score = 2，moderate endoscopic disease activity was defined as 15 > SES-CD≥7 or Rutgeerts score i3，severe endoscopic disease activity was defined as SES-CD≥15 or Rutgeerts i4. The correlation and diagnostic efficacy of IBUS-SAS，SUS-CD，BUSS and Simple-US scores with endoscopic disease activity in patients with CD were compared and analyzed.Results:IUS scores including IBUS-SAS，SUS-CD，BUSS and Simple-US were significantly correlated with endoscopic intestinal disease activity，SES-CD and Rutgeerts scores in CD patients（ r s = 0.706，0.492，0.502，0.526；0.825，0.581，0.584，0.603；0.541，0.434，0.437，0.467；all P＜0.05）. Among them，IBUS-SAS showed better correlation than the other three IUS scores. ROC curve showed that IBUS-SAS，SUS-CD，BUSS，and Simple-US had high predictive values for endoscopic disease activity and endoscopic disease moderate-severe activity in patients with CD（AUC = 0.886，0.748，0.730，0.756；all P＜0.05）. The diagnostic efficacy of IBUS-SAS on the presence of endoscopic disease activity in patients with CD was significantly higher than those of the other three IUS scores . Conclusions:IBUS-SAS，SUS-CD，BUSS and Simple-US are significantly correlated with the endoscopic results of on intestinal disease activity of CD，and have high predictive values for intestinal disease activity status，among which IBUS-SAS is superior to the other three IUS scores. It is recommended that IBUS-SAS be used first to evaluate intestinal disease activity in patients with CD.

Objective:To investigate the development and job adaptability of specialized nurses in Liaoning Province, and to provide basis for further improving the job adaptability of specialized nurses.Methods:In August 2024, provincial-level or above specialized nurses from secondary and above hospitals in 14 cities of Liaoning Province were selected by convenient sampling method, and their job adaptation was investigated using General Information Questionnaire and Workers' Job Adaptation Scale to conduct cross-sectional research.Results:A total of 3 460 valid questionnaires were collected. Among the 3 460 specialized nurses, tertiary hospitals accounted for 91.01% (3 149/3 460), undergraduates accounted for 89.28% (3 089/3 460), and 51.13% (1 769/3 460) were aged from 36 to 45. The top three training specialties for specialized nurses were severe illness, operating room and intravenous infusion therapy, and the training duration was mostly 6 to 12 weeks, accounting for 58.70% (2 031/3 460). After training, they mostly engaged in specialized disease care/case care, accounting for 86.07% (2 978/3 460); In terms of hospital security, 71.16% (2 462/3 460) of the specialized nurses said that the working conditions provided by the hospital could meet their work needs, 43.93% (1 520/3 460) said that the hospital performance was reasonable, 43.29% (1 498/3 460) said that there were sufficient promotion opportunities, and 49.28% (1 705/3 460) said that the hospital has dedicated positions for specialized nurses. The score of the Job Fit Scale for Professional Nurses was (37.36 ± 6.30) points, including the attribute fit dimension (12.45 ± 2.32) points, the demand-supply fit dimension (11.84 ± 2.57) points and the ability-requirement fit dimension (13.06 ± 2.12) points.Conclusions:The post adaptability of provincial-level or above specialized nurses in Liaoning province is in the high level, but the distribution of specialized nurses is uneven, and the proportion of secondary hospitals is low. The training mechanism for specialized nurses has gradually matured, but some of them are not fully played, and there is little participation in scientific research and innovation activities after training. Therefore, it is suggested that in the future work, secondary hospitals should be encouraged to select nursing backbones according to their needs to participate in specialized training programs to improve nurses' professional skills; Nursing managers encourage specialized nurses to consciously participate in systematic scientific research training to enhance their nursing scientific research ability; rational use of specialist nurses in hospitals, giving full play to their professional advantages, and promoting the development of specialties.

Objective To investigate the laboratory and clinical features of anemia in patients with alcoholic liver cirrhosis. Methods A retrospective analysis was performed for the patients who were hospitalized in Beijing YouAn Hospital, Capital Medical University, from December 2020 to May 2021 and were found to have anemia based on reticulocyte hemoglobin (Hb) content (Ret-He) and whole blood cell analysis, and 106 patients with the discharge diagnosis of alcoholic liver cirrhosis who had no history of upper gastrointestinal bleeding or blood transfusion were screened out as subjects. Clinical features and related influencing factors were retrospectively analyzed based on the severity of anemia, the cytomorphological classification of anemia, and Ret-He. The independent samples t -test was used for comparison of normally distributed continuous data between two groups; a one-way analysis of variance was used for comparison between multiple groups, and the SNK- q test and the least significant difference t -test were used for further comparison between two groups. The Mann-Whitney U test was used for comparison of continuous data with skewed distribution between two groups, and the Kruskal-Wallis H test was used for comparison between multiple groups. The chi-square test was used for comparison of categorical data between groups. A Spearman correlation analysis was performed to investigate the correlation of different classification criteria for anemia with laboratory markers and clinical features. Results Among the 106 patients, there were 103 male patients (97.2%), with a mean age of 55.07±10.18 years and a mean Hb level of 87.16±18.55 g/L; there were 49 patients (46.2%) with mild anemia, 49 (46.2%) with moderate anemia, and 8(7.5%) with severe anemia; mean Ret-He was 33.65(13.3-46.4) pg, and there were 33 patients (31.1%) with ≤29 pg and 73 patients (68.9%) with Ret-He > 29 pg; among these patients, 46(43.4%) had macrocytic anemia, 34(32.1%) had normocytic anemia, 2(1.9%) had simple microcytic anemia, and 24 (22.6%) had microcytic hypochromic anemia; among these patients, 87(82.1%) had ascites and/or intra-abdominal infection, 82(77.4%) had splenomegaly and/or hypersplenism, 65(61.3%) had esophageal and gastric varices, and 31(29.2%) had hepatic encephalopathy. Compared with the control group (moderate/severe anemia), the mild anemia group had significantly higher Ret-He, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular-hemoglobin concentration (MCHC), serum iron (SI), and transferrin saturation (TS) (all P < 0.05), a significantly higher proportion of patients with Ret-He > 29 pg (83.7% vs 56.1%, P =0.002) or normocytic anemia (44.9% vs 21.1%, P =0.009), a significantly lower unsaturated iron-binding capacity (UIBC) ( P < 0.05), and a significantly lower proportion of patients with microcytic hypochromic anemia (6.1% vs 36.8%, P < 0.05). Compared with the microcytic anemia group, the macrocytic anemia group had significantly higher alanine aminotransferase (ALT), Hb, and proportion of patients with ascites and/or intra-abdominal infection (91.3% vs 65.4%, P c < 0.05) and a significantly lower proportion of patients with severe anemia (2.2% vs 19.2 %, P c < 0.05) or esophageal and gastric varices (52.2% vs 84.6%, P c < 0.05); the macrocytic anemia group had significantly higher aspartate aminotransferase (AST) and AST/ALT ratio than the microcytic anemia group and the normocytic anemia group (all P c < 0.05); the microcytic anemia group had a significantly lower proportion of patients with mild anemia than the macrocytic anemia group and the normocytic anemia group, as well as a significantly higher proportion of patients with moderate anemia than the normocytic anemia group (all P c < 0.05); compared with the other two groups, the macrocytic anemia group had significantly higher Ret-He, MCV, MCH, MCHC, SI, and TS (all P c < 0.05) and significantly lower total iron-binding capacity (TIBC) and UIBC (all P c < 0.05). Compared with the Ret-He > 29 pg group, the Ret-He ≤29 pg group had significantly lower Hb, MCV, MCH, MCHC, SI, TS, and proportion of patients with mild anemia or ascites and/or intra-abdominal infection (all P < 0.05), a significantly higher UIBC ( P < 0.05), and a significantly higher proportion of patients with microcytic hypochromic anemia or esophageal and gastric varices ( P < 0.05). Hb, Ret-He, MCV, MCH, MCHC, UIBC, SI, and TS were correlated with the severity of anemia, the cytomorphological classification of anemia, and iron deficiency (all P < 0.05), and esophageal and gastric varices and ascites and/or abdominal infection were correlated with the cytomorphological classification of anemia and iron deficiency (all P < 0.05). Conclusion The degree of anemia is mostly mild and moderate in the decompensated stage of alcoholic liver cirrhosis, and macrocytic anemia and normocytic anemia are more common. The incidence rate of iron deficiency increases with the severity of anemia, and esophageal and gastric varices and ascites and/or intra-abdominal infection are correlated with the cytomorphological classification of anemia and iron deficiency; therefore, it is necessary to enhance the monitoring of iron deficiency anemia in such patients in clinical practice.

OBJECTIVE To establish the de tection method for the adulteration of Bupleurum marginatum in Ganmao qingre granules，and to determine the adulteration limit . METHODS HPLC-MS/MS method was used to detect the content of nepasaikosaponin K in commercial and self -made samples of Ganmao qingre granules ，using electrospray ionization ，and the analysis was carried out under multiple reaction monitoring model in negative mode with m/z 943.6→635.5 as the quantitative ion pair. The calculation method was established for the adulteration proportion of B. marginatum in Ganmao qingre granules . Taking nepasaikosaponin K as the index ，the adulteration limit was determined . RESULTS The linear range of nepasaikosaponin K were 0.051-20.200 μg/mL（r＝0.999 1）. RSDs of precision ，repeatability and stability （24 h）tests were all lower than 2.50%. The average recoveries were 97.58%（RSD＝2.09%，n＝9）. The limit of detection was 0.60 μg/g，the limit of quantitation was 1.80 μg/g. The adulteration ratio of B. marginatum in Ganmao qingre granules had a good linear relationship to the peak area of nepasaikosaponin K in the range of 5%-100%（r＝0.990 9）. The contents of nepasaikosaponin K in 15 batches of Ganmao qingre granules were 2.584-56.661 μg/g. One batch of samples exceeded the proposed adulteration limit （10%），and the unqualified rate was 6.67%. CONCLUSIONS The established analytical method can be used to detect the adulteration of B. marginatum in Ganmao qinggre granules ，the proposed adulteration limit is 10%.

Objective: To understand the characteristics and clinical significance of anti-soluble liver antigen antibody (anti-SLA) in patients with liver diseases. Methods: Serum samples from seventy-seven patients with anti-SLA were collected from Beijing You'An Hospital during the period between January 2010 and December 2018. Anti-SLA, anti-liver cytosol type 1 antibody (anti-LC1), anti-glycoprotein 210 antibody(anti-gp210) and anti-nuclear body protein sp100 antibody(anti-sp100) were detected by immunoblotting; indirect immunofluorescence assay used for detecting anti-nuclear antibody (ANA), anti-mitochondrial antibody (AMA), anti-smooth muscle antibody (SMA), and anti-liver kidney microsome antibody (anti-LKM). One-way analysis of variance was used to compare the ages of different anti-SLA groups. The non-parametric rank sum test was used to compare the liver function indexes and immunoglobulins in different intensity groups of anti-SLA. P<0.05 was considered statistically significant. Further comparisons were made between the two groups, the correction level α′=0.008 3, P<0.008 3 was considered statistically significant. Results: The average age of 77 anti-SLA positive patients was (52.50±1.25) years old, 70 females (90.9%) and 7 males (9.1%). 80.5% of anti-SLA-positive patients (62/77 cases) were strongly positive at the time of initial diagnosis (+++ to ++++).The Alanine aminotransferase (ALT) level in the SLA++ group was higher than that in the SLA++++ group (232.7 U/L vs 65.6 U/L,χ²=7.751,P=0.005) and the immunoglobulin M(IgM) level in the SLA+++ group was lower than that in the SLA++++ group (1 270 mg/L vs 2 270 mg/L,χ²=8.337,P=0.004).There was no significant difference in age, other liver function and immunological indicators among the different groups.Seventy cases (90.9%) were both anti-SLA and ANA positive, 13 cases (16.9%) were positive with SMA, and none positive with anti-LKM and anti-LC1. Among anti-SLA positive patients, 58 cases were diagnosed with autoimmune hepatitis (AIH), 12 were AIH/primary biliary cholangitis (PBC) overlap syndrome (OS), 2 were drug-induced liver injury, 2 were chronic hepatitis B, and 3 were hepatitis A, hepatitis E and acquired immune deficiency syndrome (AIDS) with liver injury, respectively.Cases of AIH and AIH/PBC OS accounted for 90.9% (70/77 cases) of anti-SLA-positive patients, and 5 of 7 patients diagnosed with non-AIH (and OS) had elevated IgG, showing AIH feature.92.3% (12/13 cases) of anti-SLA with high titers of AMA were diagnosed as AIH/PBC overlap syndrome. Of the 77 anti-SLA-positive patients, 28 (36.4%) had advanced or end-stage liver disease, including decompensated cirrhosis (22 cases), chronic acute liver failure (4 cases), and liver transplantation (1 case) and death from liver failure (1 case). Conclusions Anti-SLA has high diagnostic specificity for AIH;anti-SLA positive in patients with PBC should be an important biomarker for the diagnosis of AIH/PBC overlap syndrome.

Objective: To describe the status of non-steroidal anti-inflammatory drugs (NSAIDs) use in areas with a high incidence of upper gastrointestinal cancer in China. Methods: This study was based on the National Key Research and Development Program of "National Precision Medicine Cohort of Esophageal Cancer" and "Study on Identification and Prevention of High-risk Populations of Gastrointestinal Malignancies (Esophageal cancer, Gastric cancer and Colorectal cancer)" . From January 2017 to August 2018, 212 villages or communities with a high incidence of esophageal cancer or gastric cancer were selected from 12 regions in 6 provinces. A total of 35 910 residents aged between 40 and 69 years old who met the inclusion criteria and signed the informed consent were investigated and enrolled in this study. The use of NSAIDs, demographic characteristics, health-related habits, height, weight, and blood pressure were collected by the questionnaire and physical examination. The status of main NSAIDs (aspirin, acetaminophen and ibuprofen) use with the difference varying in genders, age groups and regions were analyzed by using χ² test and Cochran-Armitage trend analysis method. Results: Of 35 910 subjects, the mean age was (54.6±7.1) years old and males accounted for 43.42% (15 591). The overall prevalence of NSAIDs intake was 4.56% (1 638), but it significantly varied in different provinces (P<0.001). The overall prevalence of NSAIDs intake was 4.87% (1 750) in females, which was significantly higher than that in males 4.24% (1 524) (P<0.001). The prevalence of NSAIDs intake increased with age (P for trend <0.001). As the frequency of NSAIDs intake increased, the incidence of gastrointestinal symptoms, gastrointestinal ulcers and black stools increased (P for trend <0.05 for all). Conclusion The use of NSAIDs is prevalent in some areas with a high incidence of upper gastrointestinal cancer in China. The increased use of NSAIDs may lead to more adverse effects related to the gastrointestinal tract.

Objective To describe the status of non?steroidal anti?inflammatory drugs (NSAIDs) use in areas with a high incidence of upper gastrointestinal cancer in China. Methods This study was based on the National Key Research and Development Program of "National Precision Medicine Cohort of Esophageal Cancer" and "Study on Identification and Prevention of High?risk Populations of Gastrointestinal Malignancies (Esophageal cancer, Gastric cancer and Colorectal cancer)". From January 2017 to August 2018, 212 villages or communities with a high incidence of esophageal cancer or gastric cancer were selected from 12 regions in 6 provinces. A total of 35 910 residents aged between 40 and 69 years old who met the inclusion criteria and signed the informed consent were investigated and enrolled in this study. The use of NSAIDs, demographic characteristics, health?related habits, height, weight, and blood pressure were collected by the questionnaire and physical examination. The status of main NSAIDs (aspirin, acetaminophen and ibuprofen) use with the difference varying in genders, age groups and regions were analyzed by using χ2 test and Cochran?Armitage trend analysis method. Results Of 35 910 subjects, the mean age was (54.6 ± 7.1) years old and males accounted for 43.42% (15 591). The overall prevalence of NSAIDs intake was 4.56% (1 638), but it significantly varied in different provinces (P<0.001). The overall prevalence of NSAIDs intake was 4.87% (1 750) in females, which was significantly higher than that in males 4.24% (1 524) (P<0.001). The prevalence of NSAIDs intake increased with age (P for trend<0.001). As the frequency of NSAIDs intake increased, the incidence of gastrointestinal symptoms, gastrointestinal ulcers and black stools increased (P for trend<0.05 for all). Conclusion The use of NSAIDs is prevalent in some areas with a high incidence of upper gastrointestinal cancer in China. The increased use of NSAIDs may lead to more adverse effects related to the gastrointestinal tract.

Objective To describe the status of non?steroidal anti?inflammatory drugs (NSAIDs) use in areas with a high incidence of upper gastrointestinal cancer in China. Methods This study was based on the National Key Research and Development Program of "National Precision Medicine Cohort of Esophageal Cancer" and "Study on Identification and Prevention of High?risk Populations of Gastrointestinal Malignancies (Esophageal cancer, Gastric cancer and Colorectal cancer)". From January 2017 to August 2018, 212 villages or communities with a high incidence of esophageal cancer or gastric cancer were selected from 12 regions in 6 provinces. A total of 35 910 residents aged between 40 and 69 years old who met the inclusion criteria and signed the informed consent were investigated and enrolled in this study. The use of NSAIDs, demographic characteristics, health?related habits, height, weight, and blood pressure were collected by the questionnaire and physical examination. The status of main NSAIDs (aspirin, acetaminophen and ibuprofen) use with the difference varying in genders, age groups and regions were analyzed by using χ2 test and Cochran?Armitage trend analysis method. Results Of 35 910 subjects, the mean age was (54.6 ± 7.1) years old and males accounted for 43.42% (15 591). The overall prevalence of NSAIDs intake was 4.56% (1 638), but it significantly varied in different provinces (P<0.001). The overall prevalence of NSAIDs intake was 4.87% (1 750) in females, which was significantly higher than that in males 4.24% (1 524) (P<0.001). The prevalence of NSAIDs intake increased with age (P for trend<0.001). As the frequency of NSAIDs intake increased, the incidence of gastrointestinal symptoms, gastrointestinal ulcers and black stools increased (P for trend<0.05 for all). Conclusion The use of NSAIDs is prevalent in some areas with a high incidence of upper gastrointestinal cancer in China. The increased use of NSAIDs may lead to more adverse effects related to the gastrointestinal tract.