Objective To investigate the microbial contamination and its influencing factors of indoor air in public places in Xi'an City, to assess the health risk of employees, and to provide a scientific basis for improving the indoor environment of public places. Methods Total bacterial count and total fungal count in indoor air were monitored in hotels/inns, shopping malls/supermarkets, gyms, and waiting rooms in Xi'an from 2023 to 2024. The health risk assessment of employees was evaluated according to the Chinese Population Exposure Parameters Manual (Adult Volume). Results Overall, the standard-exceeding rate of total bacterial count in Xi'an was 3.85%, and the median values of total bacterial count and total fungal count were 350 CFU/m3 and 300 CFU/m3, respectively. The results of the generalized linear model showed that high indoor temperature and PM10 levels were associated with increased indoor bacterial concentrations (β>0, P<0.05), while high daily passenger flow, and high indoor relative humidity and PM₁₀ levels were associated with increased indoor fungal concentrations (β>0, P<0.05). The multivariate logistic regression showed that high levels of indoor bacterial and fungal concentrations were risk factors for respiratory discomfort among employees. The hazard quotient (HQ) values for all types of public places were less than 1, indicating that the health risk of microbial aerosol exposures for employees was relatively low. Conclusion The indoor microbial pollution in public places in Xi'an is relatively mild, but countermeasures still need to be taken to reduce indoor air microbial contamination.

Objective: To understand the current status and associated factors of sleep problems among preschool children in Hainan Province, so as to provide scientific evidence for improving sleep health in this population. Methods: From January 2021 to June 2022, a total of 4 105 preschool children aged 3-6 years from 62 kindergartens in Hainan Province were selected using stratified cluster random sampling method. Demographic information and lifestyle habits were collected through the Hainan Province Child Growth and Development Survey Questionnaire. The Children s Sleep Habits Questionnaire (CSHQ) was employed to assess sleep status. Unconditional binary Logistic regression model was applied to investigate the associated factors of sleep problems among preschool children. Results: The overall CSHQ score for children was 58.03±18.84, with 80.95% of preschool children exhibiting sleep related issues. The top three most prevalent sleep problem domains were bedtime resistance (72.42%), sleep anxiety ( 54.88 %), and parasomnias (38.86%). Logistic regression analysis revealed that higher family annual income ( OR=0.60, 95%CI = 0.45-0.79), higher maternal education level ( OR=0.53, 95%CI =0.32-0.89), regular or daily vitamin D supplementation ( OR=0.77, 95%CI =0.60-0.99), and fully self initiated eating behavior ( OR=0.71, 95%CI =0.59-0.85) were negatively related with children s sleep problems; in addition, screen exposure ( OR=1.27, 95%CI =1.06-1.51) and picky eating ( OR= 1.47 , 95%CI =1.21-1.78) were positively related to children s sleep problems (all P <0.05). Conclusion The high detection rate of sleep problems among preschool children in Hainan Province is multifactorially associated with family environment, dietary habits, and lifestyle behaviors.

Objective: To evaluate the feasibility of dynamic contrast-enhanced MRI (DCE-MRI) in differentiating tumor deposits (TDs) from metastatic lymph nodes (MLNs) in rectal cancer. Materials and Methods: A retrospective analysis was conducted on 70 patients with rectal cancer, including 168 lesions (70 TDs and 98 MLNs confirmed by histopathology), who underwent pretreatment MRI and subsequent surgery between March 2019 and December 2022. The morphological characteristics of TDs and MLNs, along with quantitative parameters derived from DCE-MRI (K trans , kep, and v e) and DWI (ADCmin, ADCmax, and ADCmean), were analyzed and compared between the two groups.Multivariable binary logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic performance of significant individual quantitative parameters and combined parameters in distinguishing TDs from MLNs. Results: All morphological features, including size, shape, border, and signal intensity, as well as all DCE-MRI parameters showed significant differences between TDs and MLNs (all P < 0.05). However, ADC values did not demonstrate significant differences (all P > 0.05). Among the single quantitative parameters, v e had the highest diagnostic accuracy, with an area under the ROC curve (AUC) of 0.772 for distinguishing TDs from MLNs. A multivariable logistic regression model incorporating short axis, border, v e, and ADC mean improved diagnostic performance, achieving an AUC of 0.833 (P = 0.027). Conclusion The combination of morphological features, DCE-MRI parameters, and ADC values can effectively aid in the preoperative differentiation of TDs from MLNs in rectal cancer.

Objective To investigate the relationship between serum levels of tumor necrosis factor-related protein 5(CTRP5),fibronectin-3(Ficolin-3),and CXC chemokine ligand 12(CXCL12)and microvascular lesions in patients with type 2 diabetes mellitus(T2DM).Methods A total of 75 patients with T2DM microangiopathy admitted to the Seventh People's Hos-pital of Zhengzhou from January 2023 to June 2024 were selected as the observation group.At the same time,150 T2DM pa-tients without microangiopathy were included as the control group according to the principle of 1∶2 matching of age,gender and body mass index(BMI).The general information,blood glucose indicators,Homa-insulin resistance(HOMA-IR),and serum CTRP5,Ficolin-3,and CXCL12 levels of the two groups were statistically analyzed by hospital medical staff.The Logistic re-gression equation was used to analyze the influencing factors of the onset of microvascular lesions in T2DM.The relationship be-tween the levels of serum CTRP5,Ficolin-3,and CXCL12 and microvascular lesions in T2DM was analyzed using smooth curve fitting method.The receiver operating characteristic(ROC)curve and area under the curve(AUC)were used to analyze the pre-dictive value of serum CTRP5,Ficolin-3,and CXCL12 for T2DM microvascular lesions.Results There were no significant differences in gender,age,BMI,duration of T2DM,abdominal circumference,DBP,SBP,TC,HDL-C,TG,LDL-C,smoking his-tory and drinking history between the two groups(all P＞0.05).FPG,2hPG,HbA1c and HOMA-IR in the observation group were significantly higher than in the control group(all P＜0.05).The serum levels of CTRP5,Ficolin-3 and CXCL12 in the ob-servation group were significantly higher than in the control group(all P＜0.05).Logistic regression analysis showed that FPG,2hPG,HbA1c,HOMA-IR,CTRP5,Ficolin-3 and CXCL12 were the influencing factors of T2DM microangiopathy(all P＜0.05).After adjusting for FPG,2hPG,HbA1c,HOMA-IR and other confounding factors,the relationship between serum Fico-lin-3,CTRP5,CXCL12 and T2DM microangiopathy was analyzed by curve fitting,the results showed that serum Ficolin-3,CTRP5,CXCL12 were linearly positively correlated with T2DM microangiopathy,with the increase of their levels,the risk of T2DM microangiopathy increased.The ROC curve showed that the AUC of serum Ficolin-3,CTRP5 and CXCL12 levels in pre-dicting T2DM microvascular lesions was 0.756,0.761 and 0.791,respectively.The AUC of combined prediction was 0.931,and the sensitivity and specificity were 90.67％and 80.00％,respectively.Delong test showed that the AUC of combined prediction was significantly greater than that of single prediction(Z=32.123,P＜0.01).Conclusion The changes in serum levels of CTRP5,Ficolin-3,and CXCL12 are closely related to microvascular lesions in patients with T2DM,providing a reference for ear-ly clinical prediction and evaluation of microvascular lesions in patients with T2DM,as well as for the development of corre-sponding intervention strategies.

Aim To design and synthesize a series of glycyrrhetinic acid derivatives by using glycyrrhetinic acid as the parent nucleus,screen their antitumor activ-ities,and investigate the in vitro and in vivo antitumor effects and mechanisms of the most active compound.Methods MTT assay was used to screen for the com-pound with the most potent antitumor activity.MTT as-say,wound healing assay,colony formation assay and Transwell migration assay were used to evaluate the effects of the compound on tumor cell viability and mi-gration.Flow cytometry was employed to assess the im-pact of the compound on tumor cell cycle progression and apoptosis.Western blot was conducted to verify the effects on the expression of pro-apoptotic proteins Bax,caspase-3 and cleaved caspase-3.A mouse model of hepatocellular carcinoma ascites tumor was estab-lished to examine the antitumor effects of the compound in vivo.Results Compound C22 was identified as having the most significant inhibitory effect on hepato-cellular carcinoma cells.C22 inhibited the viability and migration of hepatocellular carcinoma cells in a time and concentration-dependent manner.C22 upreg-ulated the expression of pro-apoptotic proteins Bax,caspase-3 and cleaved caspase-3 in hepatocellular car-cinoma cells,induced apoptosis,and arrested the cell cycle in the G0/G1 and S phases.C22 significantly re-duced the growth of mouse hepatocellular carcinoma as-cites tumors and prolonged survival.Conclusion Glycyrrhetinic acid derivative C22 significantly inhibits the viability and migration of hepatocellular carcinoma cells in vitro and in vivo,and induces cell cycle arrest and apoptosis.

Objective To construct a medical consumables selection indicator system based on analytic hierarchy process(AHP)and fuzzy cluster method.Methods Firstly,a medical consumables selection indicator system was established preliminarily with the literature research results and actual situation of hospital consumables management;secondly,13 experts in related fields were selected to execute two rounds of online questionnaires,the expert weights were determined with AHP,the importance of each selection indicator was scored by the expert evaluation method and fuzzy cluster method,and consistency analysis was carried out on the two rounds of expert evaluation results;finally,the final medical consumables selection indicator system was built with the 100-point scale.Results The constructed medical consumables selection indicator system was composed of 5 primary indicators,12 secondary indicators and 38 tertiary indicators.The primary indicators included consumables quality,clinical demand,cost-effectiveness,supply capacity and after-sales service,with the percentage-based scores being 27,25,14,26 and 8,respectively.Conclusion The medical consumables selection indicator system based on AHP and fuzzy cluster method with high reliability provides effective and reliable references for medical institutions to select medical consumables.

Objective:To retrieve, evaluate and summarize relevant evidence on communication strategies for families with perinatal loss, and to provide an evidence-based basis for communication practice among clinical health professionals.Methods:The system searches for evidence related to the loss of family doctor-patient communication strategies during the perinatal period in computer decision support systems such as UpToDate, BMJ Best Clinical Practice, International Guidelines Network, UK National Institute for Health and Clinical Excellence, PubMed, Web of Science, CINAHL, China National Knowledge Infrastructure, Wanfang Data, as well as in Chinese and English databases and related websites.The search was conducted between January 2012 and December 2022. The literature ′s quality and extracted evidence were independently evaluated by two researchers according to professional judgement. Results:A total of 13 articles were included, including 1 clinical decision, 2 guidelines, 4 national standards, 2 expert consensus, and 4 systematic reviews. 30 pieces of evidence have been summarized across five aspects, comprising communication environment, communication skills, timing and key points of communication, communication for special populations, and system-level communication support.Conclusions:This study summarizes the relevant evidence on communication strategies for family doctor-patient communication strategies for perinatal loss. Clinical professionals should carefully select and apply relevant evidence based on available medical resources and parental preferences, Develop and implement practical standards for family doctor-patient communication strategies for perinatal loss at the system level, further harmonize communication behaviors, and improve communication quality.

Objective:To explore the characteristics of nutrition self-management of home-based elderly chronic obstructive pulmonary disease (COPD) patients based on user persona, in order to provide reference for accurate home nutrition management.Methods:From July to December 2023, home-based elderly COPD patients in the Department of Respiratory and Critical Care Medicine of General Hospital of Ningxia Medical University were selected by convenience sampling method. The Mini Nutritional Assessment, COPD Assessment Test, Modified Medical Research Council Dyspnea Scale, Physical Activity Rating Scale-3, COPD Patients Self-Management Scale were used to conduct questionnaire survey. The SPSS 26.0 software was used to analyze the influencing factors of patients′ self-management of nutrition. Attributes with statistical significance ( P<0.05) were extracted as labels, and the visualization of patients′ self-management of nutrition portraits was completed in the form of pictures combined with labels. Results:A total of 320 questionnaires were distributed, and 309 valid questionnaires were collected. Among 309 home-based elderly COPD patients, there were 210 males and 99 females with an age of (69.14 ± 6.84) years old. According to the data analysis results, three dimensions of natural attributes, social attributes, and behavioral tracks were artificially extracted to construct three types of nutritional self-management user persona for home-based elderly COPD patients, respectively namely blind management type, independent attempt type, and powerless type.Conclusions:There are great differences in the nutritional status and self-management of home-based elderly patients with COPD. Accurate management measures can be developed based on user persona analysis to improve their nutritional status.

Objective:To construct a scientific, systematic, and clinically applicable evaluation system of quality-sensitive indicators for nursing care of patients with tracheostomy and swallowing disorders following brain injury, providing a basis for evaluating nursing care quality in this patient population.Methods:By reviewing the literature and qualitative studies, a draft evaluation indicator was formed based on nursing issues related to patients with swallowing disorders during their hospital stay, employing the "structure-process-outcome" three-dimensional quality management model as the theoretical foundation. Between July and September 2023, two rounds of Delphi method expert consultations were conducted to add, delete, and modify indicators, and the analytic hierarchy process was used to determine indicator weights.Results:A total of 18 experts participated in two rounds of consultations, with a questionnaire return rate of 18/18. All 18 experts were female, with an average age of (47.61 ± 8.17) years. The expert authority coefficients were 0.895 and 0.910, while the Kendall concordance coefficients were 0.304 and 0.138 (all P<0.001). The average importance values assigned to each level of indicators ranged from 4.28 to 5.00. The final nursing evaluation indicators for patients with tracheostomy and swallowing disorders following brain injury included 4 first-level indicators, 21 second-level indicators, and 45 third-level indicators. Conclusions:By combining evidence-based research, current situation surveys, qualitative studies, and the Delphi method, a successful nursing quality evaluation indicator system was established for patients with tracheostomy and swallowing disorders following brain injury. These indicators are scientific, systematic, and clinically operable, playing an important role in improving the quality of nursing care for patients with tracheostomy and swallowing disorders following brain injury.