Objective:To investigate the effect of a rapid rehabilitation nursing model under the theoretical framework of Rogers' Science of Unitary Human Beings in the postoperative care of children undergoing radical operation on Hirschsprung's disease.Methods:A total of 91 children with Hirschsprung's disease and their parents who underwent radical surgery at the Children's Hospital Affiliated to Zhengzhou University (Henan Children's Hospital, Zhengzhou Children's Hospital) between January 2022 and January 2024 were selected by convenience sampling. Using a computer-generated random number table, they were randomly divided into an intervention group ( n=46) and a control group ( n=45). The control group received routine surgical nursing, while the intervention group received a rapid rehabilitation nursing model based on Rogers' theoretical framework in addition to routine care. Postoperative pain stress, anorectal function, gastrointestinal functional recovery, and parental satisfaction were compared between the two groups. Results:On the third postoperative day, the intervention group had lower scores on the FLACC scale, better anorectal function, and shorter times to first bowel sound, first anal exhaust, and first defecation than the control group. The overall parental satisfaction rate in the intervention group was 86.96% (40/46), higher than 51.11% (23/45) in the control group, and the differences were statistically significant (all P<0.05) . Conclusions:The rapid rehabilitation nursing model under the theoretical framework of Rogers' Science of Unitary Human Beings showed significant effectiveness in children undergoing radical operation on Hirschsprung's disease. It reduced postoperative pain, promoted recovery of anorectal and gastrointestinal function, and improved parental satisfaction.

Objective:To investigate the effect of a rapid rehabilitation nursing model under the theoretical framework of Rogers' Science of Unitary Human Beings in the postoperative care of children undergoing radical operation on Hirschsprung's disease.Methods:A total of 91 children with Hirschsprung's disease and their parents who underwent radical surgery at the Children's Hospital Affiliated to Zhengzhou University (Henan Children's Hospital, Zhengzhou Children's Hospital) between January 2022 and January 2024 were selected by convenience sampling. Using a computer-generated random number table, they were randomly divided into an intervention group ( n=46) and a control group ( n=45). The control group received routine surgical nursing, while the intervention group received a rapid rehabilitation nursing model based on Rogers' theoretical framework in addition to routine care. Postoperative pain stress, anorectal function, gastrointestinal functional recovery, and parental satisfaction were compared between the two groups. Results:On the third postoperative day, the intervention group had lower scores on the FLACC scale, better anorectal function, and shorter times to first bowel sound, first anal exhaust, and first defecation than the control group. The overall parental satisfaction rate in the intervention group was 86.96% (40/46), higher than 51.11% (23/45) in the control group, and the differences were statistically significant (all P<0.05) . Conclusions:The rapid rehabilitation nursing model under the theoretical framework of Rogers' Science of Unitary Human Beings showed significant effectiveness in children undergoing radical operation on Hirschsprung's disease. It reduced postoperative pain, promoted recovery of anorectal and gastrointestinal function, and improved parental satisfaction.

Objective:To explore the predictive value of systemic immune inflammation index combined with stress response index for postoperative urinary tract infection in patients with complicated kidney stones.Methods:From June 2021 to June 2023,97 patients who underwent treatment for urinary tract infection after complex kidney stone operation in Cangzhou Hospital of Integrated Traditional and Western Medicine were selected as infected group,and 87 patients who did not develop urinary tract infection after complex kidney stone operation were selected as uninfected group.Systemic immunoinflammatory index(SII),neutrophils,lympho-cyte,platelet,malondialdehyde(MDA),superoxide dismutase(SOD),catalase(CAT)levels were detected.Multivariate Logistic regression analysis was performed to analyze risk factors of postoperative urinary tract infection,and ROC curve was drawn to analyze the predictive value of SII,MDA,SOD and CAT alone and combined detection for postoperative urinary tract infection in patients with complex kidney stones.Results:Compared with uninfected group,levels of SII,neutrophils and MDA were increased in infected group,while levels of SOD and CAT were decreased(P<0.05).Levels of lymphocytes and platelets were decreased,the difference was not statistically significant(P>0.05).Multivariate Logistic regression analysis showed that presence of urinary tract history,opera-tion time≥100 min,urinary catheter retention time≥7 d,presence of preoperative urinary tract infection,stone load≥1 000 mm2,combined renal dysfunction,and preoperative blood glucose≥6.15 mmol/L were main risk factors for postoperative urinary tract infection in patients with complex kidney stones.ROC curve showed that combined detection was significantly more effective than single detec-tion of SII,MDA,SOD and CAT in the diagnosis of postoperative urinary tract infection in patients with precomplex kidney stones.Conclusion:Patients with urinary tract infection after complicated kidney stones have increased SII and MDA,decreased SOD and CAT levels,and the abnormal increased or decreased expression level are the predictors of risk of urinary tract infection after compli-cated kidney stones,which may be related with the diagnosis,development and prognosis of the disease.

Objective:To explore the predictive value of systemic immune inflammation index combined with stress response index for postoperative urinary tract infection in patients with complicated kidney stones.Methods:From June 2021 to June 2023,97 patients who underwent treatment for urinary tract infection after complex kidney stone operation in Cangzhou Hospital of Integrated Traditional and Western Medicine were selected as infected group,and 87 patients who did not develop urinary tract infection after complex kidney stone operation were selected as uninfected group.Systemic immunoinflammatory index(SII),neutrophils,lympho-cyte,platelet,malondialdehyde(MDA),superoxide dismutase(SOD),catalase(CAT)levels were detected.Multivariate Logistic regression analysis was performed to analyze risk factors of postoperative urinary tract infection,and ROC curve was drawn to analyze the predictive value of SII,MDA,SOD and CAT alone and combined detection for postoperative urinary tract infection in patients with complex kidney stones.Results:Compared with uninfected group,levels of SII,neutrophils and MDA were increased in infected group,while levels of SOD and CAT were decreased(P<0.05).Levels of lymphocytes and platelets were decreased,the difference was not statistically significant(P>0.05).Multivariate Logistic regression analysis showed that presence of urinary tract history,opera-tion time≥100 min,urinary catheter retention time≥7 d,presence of preoperative urinary tract infection,stone load≥1 000 mm2,combined renal dysfunction,and preoperative blood glucose≥6.15 mmol/L were main risk factors for postoperative urinary tract infection in patients with complex kidney stones.ROC curve showed that combined detection was significantly more effective than single detec-tion of SII,MDA,SOD and CAT in the diagnosis of postoperative urinary tract infection in patients with precomplex kidney stones.Conclusion:Patients with urinary tract infection after complicated kidney stones have increased SII and MDA,decreased SOD and CAT levels,and the abnormal increased or decreased expression level are the predictors of risk of urinary tract infection after compli-cated kidney stones,which may be related with the diagnosis,development and prognosis of the disease.

Objective:To explore the changes in acoustic features of 9-10-year-old primary school students with depressive symptoms, and based on these features and the random forest (RF) algorithm, construct a model for identifying depressive symptoms in primary school students, so as to provide an intelligent psychological health screening tool for schools and education departments.Methods:This was a case-control study.A total of 1 186 primary school students aged 9-10 from three primary schools in three regions of Jiangsu Province were selected as research subjects for psychological health screening from October 26, 2022 to February 13, 2023.Their demographic data, Depression-Anxiety-Stress Scale (DASS-21) scores, Insomnia Severity Index scores, and voice recordings were collected.Based on the DASS-21 scores, the participants were divided into a control group ( n=1 086) and a depression group ( n=100).Voice recordings were made using the neutral text " The North Wind and the Sun". openSMILE was used to extract 523 acoustic features from the pre-processed voice recordings.Group differences were assessed using independent-samples t-tests or chi-square tests.Pearson correlation analysis was conducted to examine the relationship between acoustic features and depression scores.Depressive symptoms were set as the dependent variable, and the correlated acoustic features were set as the independent variable to construct a classification model using the RF algorithm.The model performance was assessed using the receiver operating characteristic (ROC) curve, the area under the curve (AUC), precision, accuracy, recall, and F1 score. Results:Compared with the control group, the depression group showed significant differences in 105 acoustic features (44 spectral features, 49 source features, and 12 prosodic features) (all P<0.05).Correlation analysis showed that 12 acoustic features (7 spectral features, 4 source features, and 1 prosodic feature) were significantly correlated with the depression score (all P<0.05).Among the RF algorithm-based classification models, the spectral features demonstrated superior performance compared to source features and prosodic features (AUC=0.793), and the performance of the model based on the combination of these features was the best (AUC=0.818). Conclusions:Acoustic features may be an objective indicator to identify the depression of 9-10-year-old primary school students, and the classification model established based on acoustic features can identify the depressed primary school students.

【Objective】 To analyze the predictive value of serum β-defensin-3 (HBD-3) and decoy receptor 3 (DCR3) for urinary tract infection after percutaneous nephrolithotomy (PCNL) in patients with complex kidney calculi. 【Methods】 A prospective study was conducted on 112 patients treated with PCNL at our hospital during Jan.2020 and Dec.2022.The patients were divided into the non-infection group (52 cases) and infection group (60 cases).The general data, HBD-3 and DCR3 levels of the two groups were compared.Receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of C reactive protein (CRP), procalcitonin (PCT), HBD-3 and DCR3 levels for postoperative urinary tract infection. 【Results】 Compared with the non-infection group, the infection group had higher levels of HBD-3 [(0.77±0.08) ng/mL vs. (1.36±0.25) ng/mL, P=0.001] and DCR3 [(4.68±0.53) ng/mL vs.(13.21±0.28) ng/mL, P=0.001].Multivariate logistic regression showed that a history of urinary tract surgery, preoperative urinary tract infection, operation time, catheterization time, stone load, type of antibiotics, concomitant renal dysfunction, intraoperative channel type, CRP, PCT, HBD-3 and DCR3 were risk factors of postoperative urinary tract infection (P<0.05).The ROC curve showed that the accuracy of CRP, PCT, and CRP plus PCT were 70.54%, 72.32%, and 78.57%, respectively; the accuracy of HBD-3, DCR3, and HBD-3 plus DCR3 were 69.64%, 75.89%, and 86.61%, respectively. 【Conclusion】 Postoperative urinary tract infection in patients with complex kidney calculi is associated with multiple factors, especially high expression levels of HBD-3 and DCR3.Combined detection has high predictive value.

Objective:To investigate the clinical effects and related mechanism of antibiotic bone cement in treating diabetic foot ulcer (DFU).Methods:A prospective randomized controlled study was conducted. From August 2020 to August 2022, 24 patients with DFU who met the inclusion criteria were admitted to the First Affiliated Hospital of Air Force Medical University. According to the block randomization, the patients were divided into 2 groups, with 12 patients in each group. In antibiotic bone cement group, there were 7 male and 5 female patients, aged (64±8) years, with the ulcer area of (41±21) cm 2. In silver sulfadiazine group, there were 8 male and 4 female patients, aged (62±8) years, with the ulcer area of (38±19) cm 2. Under the condition of ensuring the patency of at least one main inferior genicular artery in each patient, the continuous vacuum sealing drainage was performed for 3-5 days after thorough debridement. Thereafter, the wounds in antibiotic bone cement group were treated with gentamicin-laden bone cement, and the wounds in silver sulfadiazine group were treated with silver sulfadiazine cream for dressing change. After 3 weeks of dressing change, the wound was covered with split-thickness skin graft from the lateral thigh on the affected side. Before debridement and after 3 weeks of dressing change, the blood flow intensities of wound tissue and normal skin tissue in foot were measured using laser Doppler flowmeter, and then, the percentage of relative blood flow intensity of wound and the change rate of blood flow intensity were calculated. After 3 weeks of dressing change, the wound margin tissue was taken, the number of CD31-positive neovascular and the vascular morphology were observed and detected by immunohistochemical staining, the morphology of blood vessels surrounded by CD31 and α-smooth muscle actin (α-SMA) double-positive cells was observed by immunofluorescence staining, the cell proliferation activity was evaluated by immunofluorescence staining (denoted as the ratio of Ki67 positive cells), and the protein expression of vascular endothelial growth factor receptor 2 (VEGFR2) was detected by Western blotting. The skin graft survival was observed 3-5 days after skin grafting, and the wound healing time was recorded. Data were statistically analyzed with independent sample t test and Fisher's exact probability test. Results:The percentages of relative blood flow intensity of wounds of patients before debridement were similar between the two groups ( P>0.05). After 3 weeks of dressing change, the percentage of relative blood flow intensity of wounds and the change rate of blood flow intensity of patients in antibiotic bone cement group were (44.7±2.0)% and (129±12)%, respectively, which were significantly higher than (28.3±1.2)% and (41±8)% in silver sulfadiazine group (with t values of 24.15 and 20.97, respectively, P<0.05). After 3 weeks of dressing change, compared with those in silver sulfadiazine group, the number of CD31-positive neovascular in the wound margin tissue of patients in antibiotic bone cement group was significantly increased ( t=33.81, P<0.05) with larger diameter and more regular arrangement, the vascular wall continuity surrounded by CD31 and α-SMA double-positive cells was better, and the ratio of Ki67 positive cells and protein expression of VEGFR2 were significantly increased (with t values of 40.97 and 47.38, respectively, P<0.05). On post skin grafting day 3-5, all the patients in antibiotic bone cement group and 8 patients in silver sulfadiazine group had good skin graft survival, while 4 patients in silver sulfadiazine group showed spotted/patchy skin graft necrosis, which were cured after corresponding treatment. The wound healing time of patients in antibiotic bone cement group was (47.1±2.9) d, which was significantly shorter than (58.8±2.3) d in silver sulfadiazine group ( t=10.86, P<0.05). Conclusions:Compared with silver sulfadiazine, clinical application of antibiotic bone cement for treating DFU has the characteristics of accelerating wound healing and better reconstruction of local blood flow, which may be closely related to the fact that antibiotic bone cement promoted the local angiogenesis effectively in the wound through enhancing the expression of VEGFR2.

As a representative chemotherapeutic drug, docetaxel (DTX) has been used for breast cancer treatment for decades. However, the poor solubility of DTX limits its efficacy, and the DTX based therapy increases the metastasis risk due to the upregulation of C-X-C chemokine receptor type 4 (CXCR4) expression during the treatment. Herein, we conjugated CXCR4 antagonist peptide (CTCE) with DTX (termed CTCE-DTX) as an anti-metastasis agent to treat breast cancer. CTCE-DTX could self-assemble to nanoparticles, targeting CXCR4-upregulated metastatic tumor cells and enhancing the DTX efficacy. Thus, the CTCE-DTX NPs achieved promising efficacy on inhibiting both bone-specific metastasis and lung metastasis of triple-negative breast cancer. Our work provided a rational strategy on designing peptide-drug conjugates with synergistic anti-tumor efficacy.

Objective:To analyze the influencing factors for depression in primary school children aged 9-10 years in Jiangsu Province, and to construct a risk prediction model.Methods:A retrospective study.A total of 1 162 primary school children aged 9-10 years from 3 primary schools in 3 regions of Jiangsu Province were recruited.Their demographic data were collected, and they were surveyed by the Depression Anxiety Stress Scales-21 (DASS-21), the Strengths and Difficulties Questionnaire (SDQ), and the Family Environment Scale (FES). Children were divided into control group (1 059 cases) and depression group (103 cases) based on the depression scores obtained from the DASS-21 scale.Multivariate Logistic regression analysis was used to analyze the influencing factors for depression in primary school students aged 9-10 and construct a risk prediction model. Results:There were significant differences in the economic development region, physical activities, academic performance, student cadres, parents′ education level, frequency of parental quarrels, SDQ and FES dimension scores between control group and depression group (all P<0.05). Among them, economic development areas (Northern Jiangsu and Southern Jiangsu), student cadres, father′s education level (elementary school and below) and intimacy of the FES scale were protective factors for depression in elementary school children; while emotional symptoms, peer problems and the total difficulty score in the SDQ scale, and the conflict in the FES scale were the risk factors for depression in elementary school children.The prediction model was created based on the influencing factors: Logit ( P)=-1.390×economic development area (Northern Jiangsu) -1.508×economic development area (Southern Jiangsu) -1.248×student cadres -2.206×father′s education level (primary school and below) -1.145×father′s education level (junior high school)+ 3.316×emotional symptoms in the SDQ+ 0.979×peer problems in the SDQ+ 2.520×total difficulty score in the SDQ -1.697×cohesion in the FES + 0.760×conflict in the FES -0.678.The area under the curve of receiver operating characteristic was 0.931, with the sensitivity and specificity of 85.42% and 91.83%, respectively. Conclusions:The regional level of economic development, class or school cadres, father′s education level, peer problems, total difficulty score, cohesion and conflict in the family are influencing factors for depression among primary school children aged 9-10 years in Jiangsu Province.The created prediction model can effectively assess the depressive risk factors in this population, which is conductive to achieve the early recognition and intervention of depression in them.

Objective:To explore the speech features of female patients with anhedonic depression and their recognition of pleasure deficient symptoms.Methods:A total of 102 female depression patients who were hospitalized at Nanjing Brain Hospital from September 2020 to October 2021 were selected, including 62 anhedonic depression patients (anhedonic group) and 40 non-anhedonic depression patients (non-anhedonic group). A total of 50 female healthy controls were recruited during the same period.All participants were evaluated by the 17-item Hamilton depression scale (HAMD-17), Snaith-Hamilton pleasure scale (SHAPS), and the temporal experience of pleasure scale (TEPS), as well as voice acquisition.SPSS 23.0 software was used for data processing.Statistical analysis was conducted using one-way ANOVA, non-parametric tests, Logistic regression, and receiver operating characteristic curve.Results:Compared with the non-anhedonic group, the anhedonic group showed significant changes in 15 voice features(all P<0.05), including Mel-frequency cepstral coefficients, formant frequencies, intensity, and energy features.Among these features, Mel-frequency cepstral coefficients exhibited the highest accuracy in identifying anhedonic depression, with sensitivity of 47.5%, specificity of 91.9%, area under curve (AUC) of 0.751, 95% CI=0.686-0.866.Formant frequencies could identify female anhedonic depression, with a sensitivity of 90.0%, a specificity of 40.3%, an AUC of 0.647, and 95% CI=0.605-0.824.Energy features could identify anhedonic deficient depression, with a sensitivity of 60.0%, a specificity of 74.2%, an AUC of 0.679, and 95% CI=0.587-0.804.Intensity features could identify female anhedonic depression, with a sensitivity of 70.0%, a specificity of 58.1%, an AUC of 0.640, and 95% CI=0.554-0.769. Conclusion:Mel-frequency cepstral coefficients, formant frequencies, intensity features, and energy features may have specific changes in female patients with anhedonic depression.The Mel-frequency cepstral coefficients has the highest recognition accuracy for anhedonic symptoms in female depression patients, and is expected to become an objective evaluation index for female anhedonic depression.