Objective:To develop the Adolescent Mental Health Computerized Adaptive Test(AMH-CAT)for assessing psychological crises in adolescents using item response theory(IRT).Methods:A total of 8 679 students,aged 9 to 19 years,were sampled from 14 primary and secondary schools.The item bank was constructed by examining unidimensionality,independence,discrimination,and Differential Item Functioning(DIF).The AMH-CAT algorithm was developed using R software and validated for reliability and validity through real and simulated data.The School Psychological Interview Evaluation Form served as the criterion tool to assess the predictive validi-ty of AMH-CAT in evaluating psychological crises levels.Results:The item bank,consisting of 43 items,demon-strated unidimensionality and independence,with discrimination values＞0.80 and no DIF across genders.Under va-rious stopping rules,AMH-CAT showed ABS values＜0.40,RMSE values＜0.50,and a correlation(r)＞0.87(P＜0.001)between estimated and true psychological crises levels.Real participants answered an average of 10 items under the SE(θ)≤0.4 stopping rule,with a reliability of 0.89,and the scores were positively correlated with the complete item bank scores(r=0.95,P＜0.001).The predictive accuracy for Level 1 and Level 2 concerns was 0.89 and 0.90,respectively.Conclusion:The Adolescent Mental Health Computerized Adaptive Test(AMH-CAT)demonstrates excellent validity,reliability and assessment efficiency for evaluating adolescent psychological crises.

Objective:To develop the Adolescent Mental Health Computerized Adaptive Test(AMH-CAT)for assessing psychological crises in adolescents using item response theory(IRT).Methods:A total of 8 679 students,aged 9 to 19 years,were sampled from 14 primary and secondary schools.The item bank was constructed by examining unidimensionality,independence,discrimination,and Differential Item Functioning(DIF).The AMH-CAT algorithm was developed using R software and validated for reliability and validity through real and simulated data.The School Psychological Interview Evaluation Form served as the criterion tool to assess the predictive validi-ty of AMH-CAT in evaluating psychological crises levels.Results:The item bank,consisting of 43 items,demon-strated unidimensionality and independence,with discrimination values＞0.80 and no DIF across genders.Under va-rious stopping rules,AMH-CAT showed ABS values＜0.40,RMSE values＜0.50,and a correlation(r)＞0.87(P＜0.001)between estimated and true psychological crises levels.Real participants answered an average of 10 items under the SE(θ)≤0.4 stopping rule,with a reliability of 0.89,and the scores were positively correlated with the complete item bank scores(r=0.95,P＜0.001).The predictive accuracy for Level 1 and Level 2 concerns was 0.89 and 0.90,respectively.Conclusion:The Adolescent Mental Health Computerized Adaptive Test(AMH-CAT)demonstrates excellent validity,reliability and assessment efficiency for evaluating adolescent psychological crises.

Objective:To assess the efficacy and safety profile of antaitasvir phosphate combined with yiqibuvir in the treatment of chronic hepatitis C (CHC) of various genotypes, without cirrhosis or with compensated cirrhosis.Methods:394 cases with CHC from 22 centers were collected from October 2021 to April 2023. They were randomly assigned to receive either the experimental drugs (antaitasvir phosphate 100 mg+yiqibuvir 600 mg) or placebo treatment in a 3∶1 ratio. The patients were administered drugs once a day for 12 consecutive weeks, and then followed up for 24 weeks after treatment cessation. All subjects were unblinded at the four-week follow-up following drug discontinuation, with the experimental drug group continuing to complete subsequent post-discontinuation follow-up. The placebo group was switched to receive the experimental drugs for a repeated 12-week treatment period and followed up for another 24 weeks after discontinuation of the drug (placebo delayed treatment phase).The sustained virologic response rate (SVR12) was observed for subjects in the double-blind phase and the placebo delayed-treatment phase at 12 weeks after treatment cessation.Virological resistance analysis was performed on subjects who failed treatment. The primary efficacy endpoint was SVR12. The number and percentage of subjects who achieved "HCV RNA

Objective:To assess the efficacy and safety profile of antaitasvir phosphate combined with yiqibuvir in the treatment of chronic hepatitis C (CHC) of various genotypes, without cirrhosis or with compensated cirrhosis.Methods:394 cases with CHC from 22 centers were collected from October 2021 to April 2023. They were randomly assigned to receive either the experimental drugs (antaitasvir phosphate 100 mg+yiqibuvir 600 mg) or placebo treatment in a 3∶1 ratio. The patients were administered drugs once a day for 12 consecutive weeks, and then followed up for 24 weeks after treatment cessation. All subjects were unblinded at the four-week follow-up following drug discontinuation, with the experimental drug group continuing to complete subsequent post-discontinuation follow-up. The placebo group was switched to receive the experimental drugs for a repeated 12-week treatment period and followed up for another 24 weeks after discontinuation of the drug (placebo delayed treatment phase).The sustained virologic response rate (SVR12) was observed for subjects in the double-blind phase and the placebo delayed-treatment phase at 12 weeks after treatment cessation.Virological resistance analysis was performed on subjects who failed treatment. The primary efficacy endpoint was SVR12. The number and percentage of subjects who achieved "HCV RNA

As a new type of immunosuppressant，iguratimod can mediate the anti-inflammatory signaling pathway by inhibiting the proliferation of inflammatory cells and reducing the release of inflammatory cytokines， and play the role of anti-inflammatory. It can affect the proliferation of immune cells and the expression of immune factors，reduce the production and deposition of immune complexes in the body，and play the role of immune regulation. It can regulate bone metabolism by mediating signaling pathways such as Wnt/β-catenin，Toll-like receptor 4/nuclear factor-κB and osteoprotegerin/nuclear factor-κB receptor activating factor ligand， and play a role in bone protection. It can inhibit pulmonary fibrosis by inhibiting the expression of transforming growth factor β1/ Smad2/3 signaling pathway，tumor necrosis factor-α，interleukin-1，interleukin-6，matrix metalloproteinase-9 and other inflammatory cytokines in lung tissue，and inhibiting the expression of collagen and fibronectin. Its efficacy and safety have been confirmed in the clinical application of rheumatoid arthritis and primary Sjogren syndrome and included in the diagnosis and treatment of the disease. It has also shown good efficacy in the clinical application of other connective tissue diseases such as systemic lupus erythematosus and ankylosing spondylitis，and no obvious safety risks have been found.

Background and aims:Promoting gastrointestinal function recovery is one of the key aspects of enhanced recovery after surgery(ERAS)for colorectal cancer(CRC).Many ancient Chinese medical texts suggest that acupuncture at four acupoints—Zusanli,Shangjuxu,Sanyinjiao,and Neiguan—helps promote gastrointestinal peristalsis.However,there is currently no systematic study on multi-point acupuncture to promote postoperative gastrointestinal function recovery in CRC patients.Therefore,this study was conducted to evaluate the clinical efficacy of multi-point acupuncture in promoting gastrointestinal function recovery in CRC patients through a prospective study to provide new options for implementing ERAS in CRC patients in clinical practice. Methods:Using a prospective,randomized,controlled design,a total of 100 eligible patients who underwent laparoscopic CRC radical surgery at the Department of Gastrointestinal Surgery,Third Xiangya Hospital of Central South University,between January 2021 and February 2022,were randomly divided into an observation group and a control group,with 50 patients in each group.Both groups underwent the same ERAS protocols and radical surgery during the perioperative period.The observation group received acupuncture treatment from the day of surgery to the third postoperative day,once per day,while the control group did not receive acupuncture.Primary outcomes included the time to bowel sound recovery,time to first flatus,and time to first defecation.Secondary outcomes included abdominal pain scores,incidence of bloating,nausea,vomiting,white blood cell count,neutrophil percentage,C-reactive protein,hemoglobin,serum albumin,blood potassium levels,postoperative hospital stay,and incidence of postoperative complications. Results:A total of 96 patients completed the study,with 48 in each group.There were no statistically significant differences in baseline characteristics such as age,gender,or surgery time between the two groups(all P＞0.05).Compared with the control group,the observation group had a significantly shorter time for bowel sound recovery,first flatus,first defecation,and postoperative hospital stay(all P＜0.05).Additionally,the observation group showed reduced abdominal pain scores on postoperative day(POD)2 and 3,a lower incidence of bloating on POD 1 and 2,and a reduced incidence of nausea and vomiting on POD 3(all P＜0.05).There were no statistically significant differences in the remaining comparisons between the two groups(all P＞0.05). Conclusion:Multi-point acupuncture treatment can promote the recovery of gastrointestinal function in patients undergoing minimally invasive CRC surgery without increasing postoperative complications,and it is recommended for integration into routine ERAS protocols.

Objective This paper aims to investigate and analyze the baseline conformity rate of bacterial culture exami-nation records in a tertiary specialized hospital.By doing this,this paper seeks to understand the current situation of medical re-cord writing of bacterial culture examination and explore the improvement path and relevant measures for enhancing the conformity rate of bacterial culture examination records.Methods According to the requirements of"Quality Control Index of Medical Re-cord Management(2021 Edition)",a retrospective analysis was conducted on 6 317 medical records that underwent bacterial culture examination in 2022.Results The execution rate of medical orders was 100.00％,the completeness rate of the report sheet was 100.00％,the record rate of medical records was 81.05％,the analysis rate of results was 33.07％,and the conformi-ty rate of bacterial culture examination records was 33.07％.Conclusion It is imperative to enhance the conformity rate of bac-terial culture examination records and improve the quality of medical records in terms of content.

Objective:To explore the application effect of cardiac respiratory arrest scenario simulation exercise combined with four-step disk method in the teaching practice of standardized nurses in the department of anesthesiology, and to provide teaching plan and reference for the training of core competence of standardized nurses.Methods:A randomized controlled study was conducted to select 127 standardized trained nurses in rotation anesthesia and intoxication department of West China Hospital, Sichuan University from July 2020 to December 2023 by cluster sampling method. A total of 64 first-year standardized training nurses from three batches of rotation anesthesiology department from July 2020 to December 2021 were selected as the control group, and the conventional teaching method was applied to their teaching practice. A total of 63 first-year standardized training nurses from three batches of rotation anesthesiology department in 2022 and from July to December 2023 were selected as the observation group. On the basis of routine teaching, the cardio-respiratory arrest scenario simulation exercise combined with four-step review method was implemented to carry out teaching practice. One week before leaving the course, the theoretical test scores, skill operation scores (6 operations including anesthesia machine, intravenous induration needle infusion, open sputum aspiration, defibrillation apparatus, simple respiratory sac ventilation and single cardiopulmonary resuscitation), post competency scores and teaching satisfaction scores of the two groups of standardized training nurses were assessed and compared.Results:The control group included 11 males and 53 females, aged (23.25 ± 0.78) years. In the observation group, there were 12 males and 51 females, aged (23.29 ± 0.81) years. The average score of skill operation in the observation group was (93.54 ± 0.92) points, which was higher than that in the control group (91.02 ± 1.08) points, and the difference between the two groups was statistically significant ( t=-14.10, P<0.01). The total theoretical score of the observation group (81.32 ± 3.84) points was higher than that of the control group (61.86 ± 2.05) points, and the difference between the two groups was statistically significant ( t=-35.69, P<0.01). The scores of self-evaluation of post competence and other evaluation and teaching satisfaction of the observation group were (95.81 ± 2.69), (94.22 ± 2.57) and (96.81 ± 2.75) points, which were higher than those of the control group (88.47 ± 5.56), (91.64 ± 3.10) and (91.52 ± 3.50) points. The differences between the two groups were statistically significant ( t=-9.49, -5.10, -9.47, all P<0.01). Conclusions:The application of heart-respiratory arrest scenario simulation and GRAI repetition method in the teaching practice of standardized nurses can improve the theoretical mastery level of standardized nurses and their operational performance, enhance their post competency, improve their teaching satisfaction, enhance their self-confidence and self-awakening ability, improve their learning enthusiasm, and their theoretical connection with practice level. To promote the improvement of teaching program and teaching quality, it is worth applying and popularizing in teaching practice.

Objective:To explore the application effect of cardiac respiratory arrest scenario simulation exercise combined with four-step disk method in the teaching practice of standardized nurses in the department of anesthesiology, and to provide teaching plan and reference for the training of core competence of standardized nurses.Methods:A randomized controlled study was conducted to select 127 standardized trained nurses in rotation anesthesia and intoxication department of West China Hospital, Sichuan University from July 2020 to December 2023 by cluster sampling method. A total of 64 first-year standardized training nurses from three batches of rotation anesthesiology department from July 2020 to December 2021 were selected as the control group, and the conventional teaching method was applied to their teaching practice. A total of 63 first-year standardized training nurses from three batches of rotation anesthesiology department in 2022 and from July to December 2023 were selected as the observation group. On the basis of routine teaching, the cardio-respiratory arrest scenario simulation exercise combined with four-step review method was implemented to carry out teaching practice. One week before leaving the course, the theoretical test scores, skill operation scores (6 operations including anesthesia machine, intravenous induration needle infusion, open sputum aspiration, defibrillation apparatus, simple respiratory sac ventilation and single cardiopulmonary resuscitation), post competency scores and teaching satisfaction scores of the two groups of standardized training nurses were assessed and compared.Results:The control group included 11 males and 53 females, aged (23.25 ± 0.78) years. In the observation group, there were 12 males and 51 females, aged (23.29 ± 0.81) years. The average score of skill operation in the observation group was (93.54 ± 0.92) points, which was higher than that in the control group (91.02 ± 1.08) points, and the difference between the two groups was statistically significant ( t=-14.10, P<0.01). The total theoretical score of the observation group (81.32 ± 3.84) points was higher than that of the control group (61.86 ± 2.05) points, and the difference between the two groups was statistically significant ( t=-35.69, P<0.01). The scores of self-evaluation of post competence and other evaluation and teaching satisfaction of the observation group were (95.81 ± 2.69), (94.22 ± 2.57) and (96.81 ± 2.75) points, which were higher than those of the control group (88.47 ± 5.56), (91.64 ± 3.10) and (91.52 ± 3.50) points. The differences between the two groups were statistically significant ( t=-9.49, -5.10, -9.47, all P<0.01). Conclusions:The application of heart-respiratory arrest scenario simulation and GRAI repetition method in the teaching practice of standardized nurses can improve the theoretical mastery level of standardized nurses and their operational performance, enhance their post competency, improve their teaching satisfaction, enhance their self-confidence and self-awakening ability, improve their learning enthusiasm, and their theoretical connection with practice level. To promote the improvement of teaching program and teaching quality, it is worth applying and popularizing in teaching practice.