Objective:To analyze the time to reach full enteral feedings (TFEF) among preterm infants with gestational age (GA)<32 weeks admitted to the neonatal intensive care unit (NICU) of Chinese Neonatal Network (CHNN).Methods:This was a retrospective analysis based on the database from the CHNN 89 participating centers between January 1 st, 2019 and December 31 st, 2022. All 16 155 preterm infants with a GA <32 weeks and a birth weight <1 500 g, admitted to the NICU within 24 h after birth, hospitalization for at least 7 d and achieved full enteral feedings before discharge were included. According to the birth weight, these infants were divided into extremely low birth weight (ELBW) group and very low birth weight (VLBW) group. The practice characteristics of TFEF across different GA, the severity of neonatal admission, the NICU interventions before reaching full enteral feeding, and relevant neonatal diseases were described. Mann-Whitney U tests or Kruskal-Wallis H tests was used for comparison between groups. Results:Among the 16 155 preterm infants with a GA <32 weeks, 8 505 case (52.6%) were male. The TFEF in 3 374 cases of ELBW groups was 32 (22, 46) d, 351 cases (10.4%) with TFEF ≤2 weeks, 1 050 cases (31.1%) with TFEF >2-4 weeks, 964 cases (28.6%) with TFEF >4-6 weeks, and 1 009 cases (29.9%) with TFEF >6 weeks. The TFEF in 12 781 cases of VLBW group was 22 (15, 32) d, 439 cases (3.4%) with TFEF ≤1 week, 2 565 cases (20.1%) with TFEF >1-2 weeks, 5 526 cases (43.2%) with TFEF >2-4 weeks, and 4 251 cases (33.3%) with TFEF >4 weeks. The TFEF was 36(23, 52) d of 625 preterm infants at a GA ≤25 weeks and 20 (13, 28) d of 2 606 preterm infants at a GA 31 weeks. Inborn infants had a shorter TFEF than those outborn infants and the infants with breast-fed achieved shorter than formula and mixed feeding both in ELBW and VLBW groups (all P<0.001). The earlier enteral feeding started, the shorter TFEF will be both in ELBW and VLBW groups (both P<0.001). The TFEF of preterm infants who were treated before full enteral feeding like peripherally inserted central catheters, and blood transfusions and blood product providers were all longer than those who were not treated (all P<0.001). The TFEF of preterm infants with complications like hemodynamically significant patent ductus arteriosus, necrotizing enterocolitis, late onset sepsis, severe retinopathy of prematurity and bronchopulmonary dysplasia were all longer than those without (all P<0.001). Conclusions:The distribution of TFEF in VLBW and ELBW has a large difference. The TFEF of preterm infants varies with different GA, treatment measures and complications. Further quality improvement is required to shorten TFEF.

Objective:To observe the clinical efficacy of immediate repair of extracranial branch defects in the facial nerve through transplantation of the great auricular nerve.Methods:A retrospective inclusion was carried out on 17 patients with extracranial branch defects of the facial nerve caused by parotid malignant tumors and neurogenic tumors in the Department of Stomatology of Xuzhou Central Hospital from June 2021 to January 2023, including 10 males and 7 females, with the age ranged from 28 to 68 (42.4±11.4) years old. All patients underwent immediate transplantation of the greater auricular nerve during the operation. The facial nerve function was evaluated according to the House-Brackmann (HB) facial paralysis grading standard at the last follow-up. Grade Ⅰ-Ⅲ was considered effective, and grade Ⅳ-Ⅵ was considered ineffective. The quality of life was evaluated using the physical function score (FDIP) and social function score (FDIS).Results:The follow-up time was 6-30 (18.3 ±6.6) months. The facial nerve function was classified as grade Ⅰ in four cases, grade Ⅱ in six cases, grade Ⅲ in four cases, and grade Ⅳ in three cases. This resulted in an effective rate of 14/17. The FDIP score at the final follow-up was (84.7 ±9.1) points, which was higher than the (54.1 ±20.6) points recorded at the immediate moment of repair ( P<0.001). In contrast, the FDIS score was (11.8 ±8.9) points, which was lower than the (57.5 ±11.7) points recorded at the immediate moment of repair ( P<0.001). Conclusion:The transplantation of the auricular great nerve can effectively enhance facial nerve function and improve the life quality in the immediate repair of defects in the extracranial branches of the facial nerve.

[Objective]To investigate the research landscape,predominant themes and emerging trends in scientific research competency cultivation for traditional Chinese medicine(TCM)professional degree postgraduates in China over the past decade,in order to provide a reference for in-depth research on the cultivation of scitifin research capabilities of postgraduates in the professional degree in TCM.[Methods]A systematic literature review was conducted by using the China National Knowledge Infrastructure(CNKI)from January 1,2015 to December 31,2024,focusing on publications related to research capacity development for TCM professional degree programs.CiteSpace 6.4.R1 software was employed to perform bibliometric analyses of authorship patterns,institutional collaborations and keyword co-occurrence networks.[Results]A total of 103 eligible studies were included.The overall publication volume showed a significant increasing trend,with a rapid growth phase from 2020 to 2024,peaking at 18 articles in 2022,reflecting rising attention to this field.Author collaboration network analysis indicated that JIANG Youming and MO Jie topped the list with 3 publications each,while most other authors conducted research independently with limited cooperation.The institutional collaboration network had a density of 0.0096,indicating low inter-institutional cooperation,with Hu'nan University of Chinese Medicine leading in publications(5 articles).Keyword co-occurrence analysis revealed core research hotspots such as"training model""teaching reform""double-track integration".Keyword burst analysis showed prominent terms like"curriculum system""medical-education collaboration""clinical thinking""new medical discipline"from 2015 to 2024,with"new medical discipline"emerging as a recent hotspot reflecting interdisciplinary integration trends.[Conclusion]The number of articles on the scientific research ability cultivation for postgraduates of TCM professional degrees in China has generally increased,and the research scope has continuously expanded.However,there are differences in research levels among different regions.It is necessary to strengthen the cooperation between multi-disciplines and multi-regions,conduct broader and deeper research,and formulate scientific research ability training programs suitable for postgraduates of TCM professional degrees in China to further improve their scientific research ability.

Objective To evaluate the application of evidence-based perioperative patient-controlled analgesia(PCA)management in patients with liver cancer receiving transcatheter arterial chemoembolization(TACE)treatment.Methods By using the application model of clinical evidence-based practice,the review indicators were formulated based on the best evidence.The baseline assessment was conducted,the barrier factors were analyzed,the best clinical decision was made,the implementation steps of PCA management,including training,monitoring,education,etc.were refined,and two rounds of clinical review were carried out.The knowledge-belief-practice level and the implementation of review indicators in 50 medical and nursing staff engaged in PCA management,as well as the changes in pain scores,the incidence of adverse reactions due to PCA management,and the patient's satisfaction in 159 patients after the application of evidence were compared with their corresponding values determined before the application of evidence.Results After implementing the evidence-based practice plan and applying the evidence,at multiple time points the pain scores and the incidences of adverse reactions were decreased significantly(P＜0.05),the patient's satisfaction increased remarkably(P＜0.01),the execution rate of medical and nursing staff for the review indicators were strikingly increased(P＜0.01),and the knowledge-belief-practice level concerning PCA management was prominently improved(P＜0.01).Conclusion The implementation of perioperative PCA management in patients with liver cancer receiving TACE treatment can help to reduce the perioperative pain level,improve the patient discomfort,increase the patient's satisfaction degree,and improve the ability of medical staff in performing PCA management and evidence-based practices.

Objective:To investigate the efficacy of the combination of sintilimab and docetaxel in the treatment of cervical cancer and its impact on laboratory indicators.Methods:A total of 86 patients with advanced cervical cancer treated at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from July 2019 to June 2022 were selected as the study subjects. The patients were divided into a study group ( n=43) and a control group ( n=43) according to the treatment method. The study group was treated with a combination of sintilimab and docetaxel, while the control group was treated with docetaxel. After 6 cycles of treatment, the clinical efficacy, vascular endothelial growth factor receptor (VEGFR) levels, tumor marker levels, immune function indicators, programmed death-1 (PD-1), programmed death-ligand 1 (PD-L1) levels, and adverse reactions during treatment between the two groups were compared. 1-year progression-free survival (PFS) rate and overall survival (OS) rate between the two groups of patients were compared. Results:After 6 cycles of treatment, the objective response rates (ORR) of the study group and the control group were 48.84% (21/43) and 30.23% (13/43), respectively, with no statistically significant difference ( χ2=3.11, P=0.078); the disease control rates (DCR) of the two groups were 86.05% (37/43) and 62.79% (27/43), respectively, with a statistically significant difference ( χ2=6.11, P=0.013). Before treatment, the levels of VEGFR2 and VEGFR3 in the study group were (223.42±57.89), (3.25±1.22) ng/L, respectively, while those in the control group were (220.56±58.45), (3.31±1.17) ng/L, respectively, with no statistically significant differences ( t=0.23, P=0.820; t=0.23, P=0.817). After treatment, the VEGFR2 and VEGFR3 levels in the study group were (123.21±36.97), (0.81±0.21) ng/L, respectively, while those in the control group were (151.22±37.34), (1.33±0.37) ng/L, respectively, with statistically significant differences ( t=3.50, P=0.001; t=8.02, P<0.001). However, the levels of VEGFR2 and VEGFR3 in both groups of patients decreased after treatment compared to before treatment (all P<0.05). Before treatment, the levels of carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), and squamous cell carcinoma antigen (SCC-Ag) in the study group were (8.73±1.02) ng/ml, (29.73±5.88) U/ml, and (7.23±1.34) ng/ml, respectively, while those in the control group were (8.41±1.23) ng/ml, (30.12±5.93) U/ml, and (7.37±1.43) ng/ml, respectively, with no statistically significant differences ( t=1.31, P=0.193; t=0.31, P=0.760; t=0.47, P=0.641). After treatment, the CEA, CA125, and SCC-Ag levels in the study group were (3.52±0.78) ng/ml, (13.28±1.82) U/ml, and (2.33±0.49) ng/ml, respectively, while those in the control group were (3.87±0.62) ng/ml, (14.12±1.72) U/ml, and (2.65±0.54) ng/ml, respectively, with statistically significant differences ( t=2.30, P=0.024; t=2.20, P=0.031; t=2.88, P=0.005). However, the levels of CEA, CA125, and SCC-Ag in both groups of patients decreased after treatment compared to before treatment (all P<0.05). Before treatment, the T cell subsets CD4 +, CD8 +, and CD4 +/CD8 + in the study group were (27.53±2.23) %, (29.34±3.78) %, and 0.93±0.33, respectively, while those in the control group were (28.32±2.31) %, (30.03±3.27) %, and 0.94±0.42, respectively, with no statistically significant differences ( t=1.61, P=0.110; t=0.91, P=0.368; t=0.12, P=0.903). After treatment, the T cell subsets CD4 +, CD8 +, and CD4 +/CD8 + in the study group were (35.33±3.36) %, (44.32±4.33) %, and 0.80±0.22, respectively, while those in the control group were (30.31±3.23) %, (42.21±4.31) %, and 0.71±0.19, respectively, with statistically significant differences ( t=7.06, P<0.001; t=2.27, P=0.026; t=2.03, P=0.046). After treatment, the CD4 + and CD8 + T cell subsets in both groups were higher than before treatment, while the CD4 +/CD8 + was lower than before treatment (all P<0.05). Before treatment, the levels of PD-1 and PD-L1 mRNA in peripheral blood mononuclear lymphocytes of the study group were 1.21±0.21 and 0.73±0.15, respectively, while those in the control group were 1.23±0.25 and 0.79±0.14, respectively, with no statistically significant differences ( t=0.40, P=0.689; t=1.92, P=0.059). After treatment, the levels of PD-1 and PD-L1 mRNA in peripheral blood mononuclear lymphocytes of the study group were 0.77±0.13 and 0.52±0.13, respectively, while those in the control group were 0.93±0.19 and 0.66±0.17, respectively, with statistically significant differences ( t=4.56, P<0.001; t=4.29, P<0.001). However, the levels of PD-1 and PD-L1 mRNA in both groups of patients decreased after treatment compared to before treatment (all P<0.05). The 1-year PFS rate and OS rate of the study group patients were 60.47% and 72.09%, respectively; while those in the control groups were 51.16% and 65.12%, respectively, with no statistically significant differences ( χ2=1.31, P=0.253; χ2=0.82, P=0.365). The incidences of digestive system response, abnormal liver and kidney function, hematuria, bone marrow suppression, and rash in the study group were 39.53% (17/43), 13.95% (6/43), 13.95% (6/43), 23.26% (10/43), and 37.21% (16/43), respectively, while those in the control group were 32.56% (14/43), 9.30% (4/43), 11.63% (5/43), 18.60% (8/43), and 30.23% (13/43), respectively, with no statistically significant differences ( χ2=0.45, P=0.500; χ2=0.45, P=0.501; χ2=0.10, P=0.747; χ2=0.28, P=0.596; χ2=0.47, P=0.494) . Conclusions:Compared with monotherapy with docetaxel, the combination of sintilimab and docetaxel has a higher DCR in the treatment of advanced cervical cancer. To a certain extent, it effectively reduces the expression levels of VEGFR, serum tumor markers, and PD-1, PD-L1 in peripheral blood mononuclear lymphocytes, improves the immune function of patients, and has comparable drug safety. However, the two treatment options have comparable 1-year survival rates.

Severe Chlamydia psittaci(C.psittaci)pneumonia with sudden sensorineural hearing loss(SSNHL)as the initial symptom is clinically rare.This paper reports a case of C.psittaci pneumonia whose initial symptom was hearing loss.During the disease course,clinical manifestations such as high fever,cough,and shortness of breath appeared successively.Chest CT results suggested pulmonary infection.After metagenomic next-generation sequencing of bronchoalveolar lavage fluid,the diagnosis of C.psittaci pneumonia was confirmed.After anti-infec-tion treatment with moxifloxacin combined with doxycycline,hearing loss and pulmonary infection improved signifi-cantly.Combined with literature review,this study systematically explores the epidemiological characteristics,clini-cal manifestations,diagnostic methods,treatment schemes,and prevention strategies of C.psittaci pneumonia,ai-ming to provide diagnostic and treatment references for clinicians and microbiology laboratories to achieve early diag-nosis and treatment,avoid misdiagnosis and underdiagnosis,and improve patient prognosis.

Severe Chlamydia psittaci(C.psittaci)pneumonia with sudden sensorineural hearing loss(SSNHL)as the initial symptom is clinically rare.This paper reports a case of C.psittaci pneumonia whose initial symptom was hearing loss.During the disease course,clinical manifestations such as high fever,cough,and shortness of breath appeared successively.Chest CT results suggested pulmonary infection.After metagenomic next-generation sequencing of bronchoalveolar lavage fluid,the diagnosis of C.psittaci pneumonia was confirmed.After anti-infec-tion treatment with moxifloxacin combined with doxycycline,hearing loss and pulmonary infection improved signifi-cantly.Combined with literature review,this study systematically explores the epidemiological characteristics,clini-cal manifestations,diagnostic methods,treatment schemes,and prevention strategies of C.psittaci pneumonia,ai-ming to provide diagnostic and treatment references for clinicians and microbiology laboratories to achieve early diag-nosis and treatment,avoid misdiagnosis and underdiagnosis,and improve patient prognosis.

[Objective]To investigate the research landscape,predominant themes and emerging trends in scientific research competency cultivation for traditional Chinese medicine(TCM)professional degree postgraduates in China over the past decade,in order to provide a reference for in-depth research on the cultivation of scitifin research capabilities of postgraduates in the professional degree in TCM.[Methods]A systematic literature review was conducted by using the China National Knowledge Infrastructure(CNKI)from January 1,2015 to December 31,2024,focusing on publications related to research capacity development for TCM professional degree programs.CiteSpace 6.4.R1 software was employed to perform bibliometric analyses of authorship patterns,institutional collaborations and keyword co-occurrence networks.[Results]A total of 103 eligible studies were included.The overall publication volume showed a significant increasing trend,with a rapid growth phase from 2020 to 2024,peaking at 18 articles in 2022,reflecting rising attention to this field.Author collaboration network analysis indicated that JIANG Youming and MO Jie topped the list with 3 publications each,while most other authors conducted research independently with limited cooperation.The institutional collaboration network had a density of 0.0096,indicating low inter-institutional cooperation,with Hu'nan University of Chinese Medicine leading in publications(5 articles).Keyword co-occurrence analysis revealed core research hotspots such as"training model""teaching reform""double-track integration".Keyword burst analysis showed prominent terms like"curriculum system""medical-education collaboration""clinical thinking""new medical discipline"from 2015 to 2024,with"new medical discipline"emerging as a recent hotspot reflecting interdisciplinary integration trends.[Conclusion]The number of articles on the scientific research ability cultivation for postgraduates of TCM professional degrees in China has generally increased,and the research scope has continuously expanded.However,there are differences in research levels among different regions.It is necessary to strengthen the cooperation between multi-disciplines and multi-regions,conduct broader and deeper research,and formulate scientific research ability training programs suitable for postgraduates of TCM professional degrees in China to further improve their scientific research ability.

Objective:To analyze the time to reach full enteral feedings (TFEF) among preterm infants with gestational age (GA)<32 weeks admitted to the neonatal intensive care unit (NICU) of Chinese Neonatal Network (CHNN).Methods:This was a retrospective analysis based on the database from the CHNN 89 participating centers between January 1 st, 2019 and December 31 st, 2022. All 16 155 preterm infants with a GA <32 weeks and a birth weight <1 500 g, admitted to the NICU within 24 h after birth, hospitalization for at least 7 d and achieved full enteral feedings before discharge were included. According to the birth weight, these infants were divided into extremely low birth weight (ELBW) group and very low birth weight (VLBW) group. The practice characteristics of TFEF across different GA, the severity of neonatal admission, the NICU interventions before reaching full enteral feeding, and relevant neonatal diseases were described. Mann-Whitney U tests or Kruskal-Wallis H tests was used for comparison between groups. Results:Among the 16 155 preterm infants with a GA <32 weeks, 8 505 case (52.6%) were male. The TFEF in 3 374 cases of ELBW groups was 32 (22, 46) d, 351 cases (10.4%) with TFEF ≤2 weeks, 1 050 cases (31.1%) with TFEF >2-4 weeks, 964 cases (28.6%) with TFEF >4-6 weeks, and 1 009 cases (29.9%) with TFEF >6 weeks. The TFEF in 12 781 cases of VLBW group was 22 (15, 32) d, 439 cases (3.4%) with TFEF ≤1 week, 2 565 cases (20.1%) with TFEF >1-2 weeks, 5 526 cases (43.2%) with TFEF >2-4 weeks, and 4 251 cases (33.3%) with TFEF >4 weeks. The TFEF was 36(23, 52) d of 625 preterm infants at a GA ≤25 weeks and 20 (13, 28) d of 2 606 preterm infants at a GA 31 weeks. Inborn infants had a shorter TFEF than those outborn infants and the infants with breast-fed achieved shorter than formula and mixed feeding both in ELBW and VLBW groups (all P<0.001). The earlier enteral feeding started, the shorter TFEF will be both in ELBW and VLBW groups (both P<0.001). The TFEF of preterm infants who were treated before full enteral feeding like peripherally inserted central catheters, and blood transfusions and blood product providers were all longer than those who were not treated (all P<0.001). The TFEF of preterm infants with complications like hemodynamically significant patent ductus arteriosus, necrotizing enterocolitis, late onset sepsis, severe retinopathy of prematurity and bronchopulmonary dysplasia were all longer than those without (all P<0.001). Conclusions:The distribution of TFEF in VLBW and ELBW has a large difference. The TFEF of preterm infants varies with different GA, treatment measures and complications. Further quality improvement is required to shorten TFEF.

Objective:To observe the clinical efficacy of immediate repair of extracranial branch defects in the facial nerve through transplantation of the great auricular nerve.Methods:A retrospective inclusion was carried out on 17 patients with extracranial branch defects of the facial nerve caused by parotid malignant tumors and neurogenic tumors in the Department of Stomatology of Xuzhou Central Hospital from June 2021 to January 2023, including 10 males and 7 females, with the age ranged from 28 to 68 (42.4±11.4) years old. All patients underwent immediate transplantation of the greater auricular nerve during the operation. The facial nerve function was evaluated according to the House-Brackmann (HB) facial paralysis grading standard at the last follow-up. Grade Ⅰ-Ⅲ was considered effective, and grade Ⅳ-Ⅵ was considered ineffective. The quality of life was evaluated using the physical function score (FDIP) and social function score (FDIS).Results:The follow-up time was 6-30 (18.3 ±6.6) months. The facial nerve function was classified as grade Ⅰ in four cases, grade Ⅱ in six cases, grade Ⅲ in four cases, and grade Ⅳ in three cases. This resulted in an effective rate of 14/17. The FDIP score at the final follow-up was (84.7 ±9.1) points, which was higher than the (54.1 ±20.6) points recorded at the immediate moment of repair ( P<0.001). In contrast, the FDIS score was (11.8 ±8.9) points, which was lower than the (57.5 ±11.7) points recorded at the immediate moment of repair ( P<0.001). Conclusion:The transplantation of the auricular great nerve can effectively enhance facial nerve function and improve the life quality in the immediate repair of defects in the extracranial branches of the facial nerve.