Objective To explore the diagnostic value of ultrasound imaging parameters combined with ser-um progranulin(PGRN)and programmed cell death ligand 1(PD-L1)for lymph node metastasis of non-small cell lung cancer(NSCLC).Methods A total of 135 NSCLC patients admitted to Hengshui Cardiovascu-lar Hospital from February 2022 to May 2024 were selected as the NSCLC group.According to whether lymph node metastasis occurred,the NSCLC patients were divided into the metastasis group(52 cases)and the non-metastasis group(83 cases).Another 135 patients with benign lung diseases who were admitted to the hospi-tal during the same period were selected as the control group.The levels of serum PGRN and PD-L1 were de-tected by enzyme-linked immunosorbent assay.Multivariate Logistic regression analysis was conducted to ana-lyze the factors influencing lymph node metastasis of NSCLC.The receiver operating characteristic curve was used to analyze the diagnostic value of ultrasound imaging parameters[end-diastolic velocity(EDV),peak systolic velocity(PSV),and minimum axial diameter(MAD)]combined with serum levels of PGRN and PD-L1 for lymph node metastasis of NSCLC.Results Compared with the control group,the levels of serum PGRN and PD-L1 in the NSCLC group were significantly increased,and the difference was statistically signifi-cant(P<0.05).Compared with the non-metastasis group,the levels of serum PGRN and PD-L1 in the metas-tasis group were significantly increased,and the difference was statistically significant(P<0.05).Compared with the non-metastasis group,the ultrasound imaging parameters EDV,PSV and MAD in the metastasis group were significantly increased,and the difference was statistically significant(P<0.05).The results of multivariate Logistic regression analysis showed that PGRN,PD-L1,EDV,PSV,and MAD were all independ-ent risk factors affecting lymph node metastasis of NSCLC(P<0.05).The area under the curve(AUC)of serum PGRN,PD-L1 and ultrasound imaging parameters EDV,PSV and MAD for the diagnosis of lymph node metastasis of NSCLC separately was 0.805,0.792,0.745,0.738 and 0.737,respectively.The AUC of com-bined diagnosis for lymph node metastasis of NSCLC was 0.938,which was superior to that of single diagnosis(ZPGRN-combination=3.424,ZPD-L1-combination=4.076,ZEDV-combination=3.891,ZPSV-combination=4.755,ZMAD-combination=4.400,P<0.05).Conclusion Ultrasound imaging parameters combined with serum PGRN and PD-L1 have certain diagnostic value for lymph node metastasis of NSCLC.

Objective:To investigate the clinical characteristics, bleeding site distribution, and factors associated with hospitalization for surgical management in patients with refractory posterior epistaxis.Methods:This cross-sectional study retrospectively analyzed data from 3 473 patients with refractory posterior epistaxis treated at ENT department or Emergency Department of Affiliated Zhangzhou Hospital of Fujian Medical University, between January 2018 and December 2024. The demographic and clinical data of patients were collected. Univariate analyses and multivariable logistic regression were applied to identify factors associated with hospitalization for surgical intervention.Results:Among 3 473 patients (65.94%(2 290 cases) male; mean age (54±21) years), 46.96% (1 631 cases)were aged 41-69 years. Bleeding predominantly occurred at night (89.66%, 3 114 cases) and in winter (29.92%, 1 039 cases). The most frequent bleeding sites were the olfactory cleft (25.22%,876 cases) and inferior meatus vault (25.63%,890 cases), followed by the posterior regions of middle meatus (11.26%,391 cases), the foremost regions of nasal cavity (11.20%,389 cases), the nasal septum surface (11.23%,390 cases), the bottom of nasal cavity (9.42%,327 cases), and the others or uncertain sites (6.05%,210 cases). Endoscopic electrocautery was performed in 75.01% of cases. Overall, 2 715 patients required hospitalization for surgery. Univariate analysis identified older age (≥70 years), male sex, alcohol use, nighttime onset, winter season, hypertension, diabetes, and anticoagulant use as significantly associated with hospitalization ( χ2=6.51, 8.03, 5.11, -0.17, 7.53, 12.52, 6.83, 5.18, all P<0.05). Multivariable logistic regression confirmed older age ( OR=2.45, 95% CI: 1.81-7.50), winter season ( OR=9.55, 95% CI: 2.26-9.38), nighttime onset ( OR=6.78, 95% CI: 1.84-6.96), alcohol use ( OR=27.71, 95% CI: 11.97-64.14), hypertension ( OR=7.93, 95% CI: 1.64-11.84), and anticoagulant use ( OR=6.39, 95% CI: 1.06-9.47) as independent positive factors associated with hospitalization for surgical management (all P<0.05). Conclusions:Refractory posterior epistaxis most commonly affects individuals aged 41-69 years, with bleeding frequently originating from the olfactory cleft or inferior meatus vault, and exhibits seasonal (winter) and diurnal (nighttime) patterns. Independent factors significantly associated with the need for hospitalization and surgical intervention include older age, winter onset, nighttime onset, alcohol use, hypertension, and anticoagulant use. Identifying these factors may aid in risk stratification and clinical decision-making.

Objective To investigate preventive effect of Huanshao capsule on postoperative re-currence of moderate to severe intrauterine adhesion and its impact on postoperative pregnancy rates.Methods A total of 163 patients with moderate to severe intrauterine adhesion after surgery were se-lected as study subjects,and randomly divided into observation group(n=82)and control group(n=81).The control group received conventional treatment,while the observation group additionally took Huanshao capsule postoperatively.Serum fibronectin(FN),laminin(LN),vascular endothelial growth factor(VEGF)and transforming growth factor-β1(TGF-β1)levels were compared between two groups at 1 month,3 and 6 months postoperatively.Endometrial thickness,uterine artery blood flow resistance index(RI),postoperative pregnancy rates and quality of life scores were also com-pared.Results At 3 and 6 months postoperatively,serum FN,LN and VEGF levels in the observa-tion group were lower than those in the control group(P＜0.05).At 6 months postoperatively,serum TGF-β1 in the observation group was lower than that in the control group,with statistically significant difference(P＜0.05).At 3 and 6 months after surgery,endometrial thickness in the observation group was significantly higher,uterine artery flow RI was significantly lower than,and scores of various quality of life(physiological function,physical pain,social function and mental health)were signifi-cantly higher than those in the control group(P＜0.05).At 6 and 9 months postoperatively,the pregnancy rate in the observation group was higher than that in the control group,with statistically sig-nificant differences(P＜0.05).Conclusion Huanshao capsule can significantly reduce serum FN,LN,VEGF and TGF-β1 levels in patients with moderate to severe intrauterine adhesion after surgery,improve the postoperative endometrial environment,and increase postoperative pregnancy rates.

Objective:To construct an evidence-based practice program for dietary management of patients with non-dialysis chronic kidney disease (CKD) based on best evidence and to evaluate the effectiveness of its application.Methods:The best evidence for dietary management of non-dialysis CKD patients was summarized. From September to October 2022, following the evidence clinical transformation model of the Fudan University Centre for Evidence-based Nursing, the best evidence was screened and evidence-based practice program were developed, taking into account patients' wishes, expert opinions, and clinical contexts. From November 2022 through March 2023, baseline reviews, analysis of barriers and facilitators were implemented. Between April 2023 and April 2024, evidence-based practice was carried out in the Department of Nephrology of the Second Affiliated Hospital of Guangzhou Medical University to compare the implementation rate of review indicators at the system, practitioner, and patient levels, and practitioners' knowledge before and after the application of evidence.Results:A total of 14 review indicators were developed. The implementation rate of the 12 review indicators and the practitioners' knowledge of the CKD diet were elevated after the evidence-based practice ( P<0.05) . Conclusions:Evidence-based practice program for dietary management of patients with non-dialysis CKD has a positive effect on improving practitioners' knowledge of non-dialysis CKD diets, implementation rate of dietary management behaviors, and patients' dietary behaviors.

Objective:To characterize the brain structure of Chinese children with autism spectrum disorder (ASD) using artificial intelligence automatic brain segmentation technique, and to analyze the correlation between the characteristics of the brain structure and the degree of brain development.Methods:A case-control study.The data of 52 children who were diagnosed with ASD according to the diagnostic criteria for ASD in the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition of the United States at the Department of Psychology of Qingdao University Affiliated Women and Children′s Hospital from January 2023 to April 2024 were prospectively analyzed.Meanwhile, 48 gender- and age-matched typically developing (TD) children in Qingdao were also included.The three-dimensional T1 weighted imaging sequences of all patients were obtained using a GE 3.0T magnetic resonance imaging scanner.Automated brain segmentation techniques were used to obtain the standardized volumes of each brain structure (the ratio of the absolute volume of the brain structure to the whole brain volume).Two-independent-samples t and Mann-Whitney U tests were used to compare the standardized volumes of different brain regions between the 2 groups.Pearson and Spearman correlation analyses were used to depict the correlations between volume data of brain areas with significant differences and Gesell Developmental Scale scores. Results:Compared with those in the TD group, the volumes of the left grey matter[25.45%(0.70%) vs.25.16%(1.05%)], the right grey matter [(25.89±0.71)% vs.(25.51±0.73)%], the right lateral orbitofrontal cortex [(0.62±0.03)% vs.(0.59±0.05)%], the right medial orbitofrontal cortex[(0.48±0.04)% vs.(0.46±0.04)%], the right pars triangularis [(0.38±0.07)% vs.(0.35±0.05)%], the left hippocampus [0.22%(0.04%) vs.0.20%(0.02%)], the right hippocampus [0.23%(0.04%) vs.0.22%(0.02%)], the left parahippocampal gyrus [0.15%(0.03%) vs.0.14%(0.02%)], the right parahippocampal gyrus [(0.15±0.02)% vs.(0.14±0.02)%], the left fusiform gyrus [(0.82±0.08)% vs.(0.78±0.08)%], the right superior temporal gyrus [(0.96±0.10)% vs.(0.90±0.09)%], the left insular lobe [(0.54±0.03)% vs.(0.53±0.04)%], the right insular lobe [(0.55±0.03)% vs.(0.53±0.04)%], the right inferior parietal cortex [(1.40±0.16)% vs.(1.33±0.12)%], the right precuneus cortex [(0.99±0.09)% vs.(0.94±0.09)%], the right putamen [(0.37±0.04)% vs.(0.35±0.03)%], the left pallidum [(0.14±0.01)% vs.(0.13±0.01)%], the right pallidum [0.14%(0.02%) vs.0.13%(0.01%)], and the right thalamus [(0.51±0.04)% vs.(0.49±0.03)%] were significantly increased in the ASD group (all P<0.05).Nonetheless, the volumes of the left pericalcarine cortex [(0.19±0.04)% vs.(0.20±0.04)%] and the corpus callosum posterior region [0.05%(0.01%) vs.0.06%(0.01%)] in the ASD group were considerably smaller than those in the TD group (all P<0.05).Correlation analysis showed that the right thalamus volume was negatively correlated with the Gesell-adaptation development quotient in children with ASD ( r=-0.276, P=0.048).The volumes of the left fusiform gyrus and left pericalcarine cortex were negatively correlated with the Gesell-fine motor development quotient in children with ASD ( r=-0.290, P=0.037; r=-0.368, P=0.007). The right precuneus cortex volume was negatively correlated with the Gesell-personal and social competence development quotient in children with ASD ( r=-0.396, P=0.007). Conclusions:Children with ASD show abnormalities in the volumes of multiple brain regions, and some brain regions are related to the degree of brain development.Automatic brain segmentation technology based on artificial intelligence can rapidly and directly measure and display the volume of brain structures in both ASD and TD children.

Objective:To construct an evidence-based practice program for dietary management of patients with non-dialysis chronic kidney disease (CKD) based on best evidence and to evaluate the effectiveness of its application.Methods:The best evidence for dietary management of non-dialysis CKD patients was summarized. From September to October 2022, following the evidence clinical transformation model of the Fudan University Centre for Evidence-based Nursing, the best evidence was screened and evidence-based practice program were developed, taking into account patients' wishes, expert opinions, and clinical contexts. From November 2022 through March 2023, baseline reviews, analysis of barriers and facilitators were implemented. Between April 2023 and April 2024, evidence-based practice was carried out in the Department of Nephrology of the Second Affiliated Hospital of Guangzhou Medical University to compare the implementation rate of review indicators at the system, practitioner, and patient levels, and practitioners' knowledge before and after the application of evidence.Results:A total of 14 review indicators were developed. The implementation rate of the 12 review indicators and the practitioners' knowledge of the CKD diet were elevated after the evidence-based practice ( P<0.05) . Conclusions:Evidence-based practice program for dietary management of patients with non-dialysis CKD has a positive effect on improving practitioners' knowledge of non-dialysis CKD diets, implementation rate of dietary management behaviors, and patients' dietary behaviors.

Objective:To characterize the brain structure of Chinese children with autism spectrum disorder (ASD) using artificial intelligence automatic brain segmentation technique, and to analyze the correlation between the characteristics of the brain structure and the degree of brain development.Methods:A case-control study.The data of 52 children who were diagnosed with ASD according to the diagnostic criteria for ASD in the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition of the United States at the Department of Psychology of Qingdao University Affiliated Women and Children′s Hospital from January 2023 to April 2024 were prospectively analyzed.Meanwhile, 48 gender- and age-matched typically developing (TD) children in Qingdao were also included.The three-dimensional T1 weighted imaging sequences of all patients were obtained using a GE 3.0T magnetic resonance imaging scanner.Automated brain segmentation techniques were used to obtain the standardized volumes of each brain structure (the ratio of the absolute volume of the brain structure to the whole brain volume).Two-independent-samples t and Mann-Whitney U tests were used to compare the standardized volumes of different brain regions between the 2 groups.Pearson and Spearman correlation analyses were used to depict the correlations between volume data of brain areas with significant differences and Gesell Developmental Scale scores. Results:Compared with those in the TD group, the volumes of the left grey matter[25.45%(0.70%) vs.25.16%(1.05%)], the right grey matter [(25.89±0.71)% vs.(25.51±0.73)%], the right lateral orbitofrontal cortex [(0.62±0.03)% vs.(0.59±0.05)%], the right medial orbitofrontal cortex[(0.48±0.04)% vs.(0.46±0.04)%], the right pars triangularis [(0.38±0.07)% vs.(0.35±0.05)%], the left hippocampus [0.22%(0.04%) vs.0.20%(0.02%)], the right hippocampus [0.23%(0.04%) vs.0.22%(0.02%)], the left parahippocampal gyrus [0.15%(0.03%) vs.0.14%(0.02%)], the right parahippocampal gyrus [(0.15±0.02)% vs.(0.14±0.02)%], the left fusiform gyrus [(0.82±0.08)% vs.(0.78±0.08)%], the right superior temporal gyrus [(0.96±0.10)% vs.(0.90±0.09)%], the left insular lobe [(0.54±0.03)% vs.(0.53±0.04)%], the right insular lobe [(0.55±0.03)% vs.(0.53±0.04)%], the right inferior parietal cortex [(1.40±0.16)% vs.(1.33±0.12)%], the right precuneus cortex [(0.99±0.09)% vs.(0.94±0.09)%], the right putamen [(0.37±0.04)% vs.(0.35±0.03)%], the left pallidum [(0.14±0.01)% vs.(0.13±0.01)%], the right pallidum [0.14%(0.02%) vs.0.13%(0.01%)], and the right thalamus [(0.51±0.04)% vs.(0.49±0.03)%] were significantly increased in the ASD group (all P<0.05).Nonetheless, the volumes of the left pericalcarine cortex [(0.19±0.04)% vs.(0.20±0.04)%] and the corpus callosum posterior region [0.05%(0.01%) vs.0.06%(0.01%)] in the ASD group were considerably smaller than those in the TD group (all P<0.05).Correlation analysis showed that the right thalamus volume was negatively correlated with the Gesell-adaptation development quotient in children with ASD ( r=-0.276, P=0.048).The volumes of the left fusiform gyrus and left pericalcarine cortex were negatively correlated with the Gesell-fine motor development quotient in children with ASD ( r=-0.290, P=0.037; r=-0.368, P=0.007). The right precuneus cortex volume was negatively correlated with the Gesell-personal and social competence development quotient in children with ASD ( r=-0.396, P=0.007). Conclusions:Children with ASD show abnormalities in the volumes of multiple brain regions, and some brain regions are related to the degree of brain development.Automatic brain segmentation technology based on artificial intelligence can rapidly and directly measure and display the volume of brain structures in both ASD and TD children.

Objective:To investigate the clinical characteristics, bleeding site distribution, and factors associated with hospitalization for surgical management in patients with refractory posterior epistaxis.Methods:This cross-sectional study retrospectively analyzed data from 3 473 patients with refractory posterior epistaxis treated at ENT department or Emergency Department of Affiliated Zhangzhou Hospital of Fujian Medical University, between January 2018 and December 2024. The demographic and clinical data of patients were collected. Univariate analyses and multivariable logistic regression were applied to identify factors associated with hospitalization for surgical intervention.Results:Among 3 473 patients (65.94%(2 290 cases) male; mean age (54±21) years), 46.96% (1 631 cases)were aged 41-69 years. Bleeding predominantly occurred at night (89.66%, 3 114 cases) and in winter (29.92%, 1 039 cases). The most frequent bleeding sites were the olfactory cleft (25.22%,876 cases) and inferior meatus vault (25.63%,890 cases), followed by the posterior regions of middle meatus (11.26%,391 cases), the foremost regions of nasal cavity (11.20%,389 cases), the nasal septum surface (11.23%,390 cases), the bottom of nasal cavity (9.42%,327 cases), and the others or uncertain sites (6.05%,210 cases). Endoscopic electrocautery was performed in 75.01% of cases. Overall, 2 715 patients required hospitalization for surgery. Univariate analysis identified older age (≥70 years), male sex, alcohol use, nighttime onset, winter season, hypertension, diabetes, and anticoagulant use as significantly associated with hospitalization ( χ2=6.51, 8.03, 5.11, -0.17, 7.53, 12.52, 6.83, 5.18, all P<0.05). Multivariable logistic regression confirmed older age ( OR=2.45, 95% CI: 1.81-7.50), winter season ( OR=9.55, 95% CI: 2.26-9.38), nighttime onset ( OR=6.78, 95% CI: 1.84-6.96), alcohol use ( OR=27.71, 95% CI: 11.97-64.14), hypertension ( OR=7.93, 95% CI: 1.64-11.84), and anticoagulant use ( OR=6.39, 95% CI: 1.06-9.47) as independent positive factors associated with hospitalization for surgical management (all P<0.05). Conclusions:Refractory posterior epistaxis most commonly affects individuals aged 41-69 years, with bleeding frequently originating from the olfactory cleft or inferior meatus vault, and exhibits seasonal (winter) and diurnal (nighttime) patterns. Independent factors significantly associated with the need for hospitalization and surgical intervention include older age, winter onset, nighttime onset, alcohol use, hypertension, and anticoagulant use. Identifying these factors may aid in risk stratification and clinical decision-making.

Public hospitals serve as important windows for the Party to lead the people and serve the people,making the exploration of Party-building-led high-quality development in public hospitals highly significant in practical terms.This study delves into the current challenges faced in guiding the high-quality development of public hospitals through party building.It presents the practical exploration and outcomes of Dongguan People's Hospital,which has taken the initiative to establish a provincial demon-stration site for the"Four Orientations"project(Leading groups work effectively,Party branches work with promising methods,Party building achieves a fame with brand,and each unit has its own model)within the public hospital party-building framework.The hospital has deepened the practical application of the"Four Endeavors"project by practicing the project.These practices offer valuable insights into and references for high-quality development in public hospitals under the guidance of Party building.

Objective To investigate the status quo of pain catastrophizing(PC)in the patients with di-abetic peripheral neuropathic pain(DPNP),and to analyze the influencing factors to provide reference for for-mulating clinical preventive intervention strategies.Methods A total of 206 patients with DPNP admitted and treated in the People's Hospital of Guangxi Zhuang Autonomous Region were selected as the research sub-jects by convenience sampling method.The general data questionnaire,Numerical Rating Scale(NRS),Pain Catastrophizing scale(PCS),Perceived Social Support Scale(PSSS)and diabetes distress scale(DDS)were used to conduct the investigation.Results The incidence rate of PC in 206 cases of DPNP patients was 44.66％(92/206),and the total score of PCS was(30.10±5.16)points.The results of multiple linear regres-sion analysis showed that the gender,duration of diabetes(≥10 years),multiple drug use,number of compli-cations(＞5),NRS score,PSSS score and scores of DDS dimensions were the main influencing factors of PC(all P＜0.05),which could explain 92.3％of the total variation of PC.Conclusion The PC incidence rate in the patients with DPNP is high.Clinical healthcare workers should pay attention to the evaluation of PC in these patients,and formulate the scientific and effective targeted intervention measures according to the main influen-cing factors to help the patients to reduce the pain burden in order to reduce the level of PC.