Objective To investigate the risk factors for ICU-acquired weakness (ICU-AW) in patients with sepsis, and to construct a nomogram prediction model. Methods A total of 360 patients with sepsis admitted from January 2020 to December 2025 were enrolled as study subjects. The risk factors for ICU-AW were identified by logistic regression analysis. A nomogram prediction model was constructed, and the model was validated. Results Multivariate logistic regression analysis indicated that age, APACHE II score, duration of mechanical ventilation, duration of immobilization, duration of sedation, and NLR were risk factors for the occurrence of ICU-AW (P<0.05), while ALB was a protective factor (P<0.05). A nomogram model was constructed based on these seven variables. After validation via Bootstrap resampling, ROC curve showed an AUC of 0.949 (0.929–0.969) and a corrected AUC of 0.942 (0.940–0.948), indicating good discrimination degree of the model. Hosmer-Lemeshow test for calibration curve revealed a chi-square value of 10.188 (P=0.252), suggesting that the predicted value of fitting was generally consistent with the actual value. Decision curve analysis demonstrated that when the threshold was in the range of 0.05–0.9, the model had a good net benefit. Conclusion The nomogram prediction model for sepsis ICU-AW based on seven indicators including age, APACHE II score, NLR, ALB, and the durations of mechanical ventilation, immobilization, and sedation exhibits good predictive efficiency and stability. This nomogram prediction model is helpful for the clinical rapid screening of ICU-AW high-risk groups in patients with sepsis, and meets clinical needs for early warning and precise prevention and control.

Enamel demineralization, the formation of white spot lesions, is a common issue in clinical orthodontic treatment. The appearance of white spot lesions not only affects the texture and health of dental hard tissues but also impacts the health and aesthetics of teeth after orthodontic treatment. The prevention, diagnosis, and treatment of white spot lesions that occur throughout the orthodontic treatment process involve multiple dental specialties. This expert consensus will focus on providing guiding opinions on the management and prevention of white spot lesions during orthodontic treatment, advocating for proactive prevention, early detection, timely treatment, scientific follow-up, and multidisciplinary management of white spot lesions throughout the orthodontic process, thereby maintaining the dental health of patients during orthodontic treatment.
Humans ; Consensus ; Dental Caries/etiology* ; Dental Enamel/pathology* ; Tooth Demineralization/etiology* ; Tooth Remineralization

Objective: To describe bullying victimization of middle school students in Dalian and associated factors, so as to provide scientific basis for campus bullying prevention. Methods: The stratified cluster sampling method was used to select 2 540 middle school students from urban and rural areas in Dalian, who were investigated with campus bullying victimization and related factors. Results: The reported rate of campus bullying victimization among middle school students in Dalian was 25.11%. The rates of physical violence (5.99%, 3.66%) and verbal violence(24.93%, 15.87%) of male students were higher than that of female students( χ 2=6.56, 27.94, P <0.05). The rates of verbal violence (22.84%, 16.25%) and emotional neglect(16.84%, 13.18%) of junior high school students were higher than those of high school students( χ 2=14.21, 5.44, P < 0.05 ). The rates of physical violence(6.07%, 3.55%), verbal violence(24.58%, 16.05%) and emotional neglect(18.88%, 12.06 %) of rural students were higher than those of urban students( χ 2=7.72, 24.81, 19.64, P <0.05). Male students, junior high school students and rural students suffered more severe campus bullying than female students, high school students and urban students( Z =3.46, 3.75, 5.89, P <0.01). The structural equation model showed that academic performance (path coefficient -0.003) and father s education (path coefficient -0.004 ) have a direct negative effect on campus bullying behavior, while mother s education (indirect action coefficient -0.000 8), height(indirect action coefficient -0.000 3), father s education (indirect action coefficient -0.000 3) and weight (indirect action coefficient 0.000 2) indirect effects on campus bullying through academic performance. Conclusion The prevalence of campus bullying victimization among middle school students in Dalian is relatively high, which worths further attention to. Rural students, junior high school students and boys are more likely to suffer campus bullying. Improving academic performance might be beneficial for campus bullying prevention.

Objective:To explore the path of standardized training and quality supervision for geriatric nursing assistants basing on the three-way linkage of "hospital, government and market".Methods:From January 2019 to December 2020, we conducted standardized training and management for geriatric nursing assistants in 24 nursing institutions for the aged in Mianyang, Sichuan Province in batches. Through the three-way linkage of "hospital, government and market", the whole-process management mode of "standardized training of geriatric nursing assistants, one-to-many tracking service for three months after the training, and service quality supervision of nursing institutions for the aged" has been established. The theoretical and operational achievements of nursing staff before and after training, the service quality of nursing home and the incidence of adverse events before and after the implementation of the project were observed and compared.Results:From 2019 to 2020, a total of 224 geriatric nursing assistants were trained in five sessions. There were statistical differences in the theoretical and operational scores before and after the training ( t=-72.494, -26.150; P<0.01) . 13 nursing institutions participating in the training in 2019 were selected to compare the service quality before and after the project implementation, the difference was statistically significant ( t=-14.575, P<0.01) , and the incidence of nursing adverse events decreased (χ 2=-7.913, P<0.01) . Conclusions:The mode of geriatric nursing assistants training and quality supervision based on the three-way linkage of "hospital, government, market" is conducive to giving full play to the administrative function of the government and the professional function of the hospital, effectively integrating resources and improving the quality of geriatric nursing service in the region.

Objective:To investigate the effect of hyperbaric oxygen on plasma endothelin-1 (ET-1) and nitric oxide (NO) in patients with intrauterine growth retardation (IUGR) as well as the clinical efficacy.Methods:A total of 90 IUGR patients, treated in the First Affiliated Hospital of Zhengzhou University from January 2018 to May 2019, were selected and divided into the observation group and the control group according to the double-blind lottery method, with 45 patients in each group. The patients in the control group were only given routine treatment, while those in the observation group were treated with hyperbaric oxygen combined with the routine treatment as same as the control group. The therapeutic effects of the two groups were observed and recorded. The level of ET-1 was analyzed by enzyme linked immunosorbent assay, and the level of NO was tested by nitrate reductase colorimetry. The values of peak-to-diastolic ratio (S/D), resistant index (RI), and pulsation index (PI) at the end of umbilical artery vasoconstriction were detected by ultrasonic doppler umbilical cord blood flow analyzer. The levels of plasma TXB2 and 6-Keto-PGF1α were detected by radioimmunoassay.Results:After 3 weeks treatment, the total effective rate of the observation group (95.56%) was significantly higher than that of the control group (77.78%) ( χ2=7.168, P<0.05); compared with those before treatment, the levels of ET-1 and NO of both groups were significantly up-regulated; the ET-1 level of the observation group after treatment was significantly lower than that of the control group, while the NO level was significantly higher ( P<0.05). After treatment, the values of S/D, RI, and PI at the end of umbilical artery vasoconstriction of both the groups after treatment were all lower than those before treatment, especially the values of S/D, RI, and PI of the observation group after treatment were significantly lower than those of the control group ( P<0.05). Compared with those before treatment, the levels of patients′ plasma TXB2 and 6-keto-PGF1α of both the groups were significantly up-regulated; the level of patients′ plasma TXB2 of the observation group after treatment was significantly lower than that of the control group, while the level of 6-keto-PGF1α was significantly increased( P<0.05 or P<0.01). Conclusion:Hyperbaric oxygen could significantly improve the clinical effect on IUGR, and improve the fetal development. This treatment, therefore, is worthy of popularization and application in clinic.

Objective:To investigate the effect of hyperbaric oxygen on plasma endothelin-1 (ET-1) and nitric oxide (NO) in patients with intrauterine growth retardation (IUGR) as well as the clinical efficacy.Methods:A total of 90 IUGR patients, treated in the First Affiliated Hospital of Zhengzhou University from January 2018 to May 2019, were selected and divided into the observation group and the control group according to the double-blind lottery method, with 45 patients in each group. The patients in the control group were only given routine treatment, while those in the observation group were treated with hyperbaric oxygen combined with the routine treatment as same as the control group. The therapeutic effects of the two groups were observed and recorded. The level of ET-1 was analyzed by enzyme linked immunosorbent assay, and the level of NO was tested by nitrate reductase colorimetry. The values of peak-to-diastolic ratio (S/D), resistant index (RI), and pulsation index (PI) at the end of umbilical artery vasoconstriction were detected by ultrasonic doppler umbilical cord blood flow analyzer. The levels of plasma TXB2 and 6-Keto-PGF1α were detected by radioimmunoassay.Results:After 3 weeks treatment, the total effective rate of the observation group (95.56%) was significantly higher than that of the control group (77.78%) ( χ2=7.168, P<0.05); compared with those before treatment, the levels of ET-1 and NO of both groups were significantly up-regulated; the ET-1 level of the observation group after treatment was significantly lower than that of the control group, while the NO level was significantly higher ( P<0.05). After treatment, the values of S/D, RI, and PI at the end of umbilical artery vasoconstriction of both the groups after treatment were all lower than those before treatment, especially the values of S/D, RI, and PI of the observation group after treatment were significantly lower than those of the control group ( P<0.05). Compared with those before treatment, the levels of patients′ plasma TXB2 and 6-keto-PGF1α of both the groups were significantly up-regulated; the level of patients′ plasma TXB2 of the observation group after treatment was significantly lower than that of the control group, while the level of 6-keto-PGF1α was significantly increased( P<0.05 or P<0.01). Conclusion:Hyperbaric oxygen could significantly improve the clinical effect on IUGR, and improve the fetal development. This treatment, therefore, is worthy of popularization and application in clinic.

In order to explore the role of acetylcholine in the pathogenesis of Parkinson's disease (PD), the changes in the concentration of acetylcholine (Ach) in the striatum, the apoptosis of substantia nigra cells, the ultrastructure and the changes of Nissl cells in rats during the morbidity of PD, and the corresponding behaviors in rats with PD were observed. Rat PD model was established by using the modified Thomas method. Eighty-one rats were randomly divided into normal control, sham operation and PD groups and their behavior features were observed at post-operative day (POD) 7, 14 and 21 as three subgroups (n=9 each). The concentration of Ach in the striatum was determined by using high-performance liquid chromatography. The apoptosis of substantia nigra cells was assayed by using TUNEL method. The ultrastructural changes in the substantia nigra were observed under the electron microscopy, and the survival of neurons in the substantia nigra area was examined by using Nissl staining. In PD group at POD 7 to 21, the damage in the substantia nigra area was gradually aggravated, the concentration of Ach, apoptosis rate and turns of rotation were gradually increased, and the number of Nissl cells was gradually reduced over the time as compared with the normal control and sham operation groups (all P<0.05). It was concluded that there exist dynamic changes in Ach concentration, ethology and apoptosis of the substantia nigra cells during the morbidity of PD, suggesting the contribution of apoptosis to the morbidity of PD, and critical role of Ach in the pathogenesis of PD.
Acetylcholine ; pharmacology ; Animals ; Corpus Striatum ; drug effects ; metabolism ; pathology ; Disease Models, Animal ; Male ; Parkinson Disease ; metabolism ; pathology ; Rats ; Rats, Wistar

In order to explore the role of acetylcholine in the pathogenesis of Parkinson's disease (PD), the changes in the concentration of acetylcholine (Ach) in the striatum, the apoptosis of substantia nigra cells, the ultrastructure and the changes of Nissl cells in rats during the morbidity of PD, and the corresponding behaviors in rats with PD were observed. Rat PD model was established by using the modified Thomas method. Eighty-one rats were randomly divided into normal control, sham operation and PD groups and their behavior features were observed at post-operative day (POD) 7, 14 and 21 as three subgroups (n=9 each). The concentration of Ach in the striatum was determined by using high-performance liquid chromatography. The apoptosis of substantia nigra cells was assayed by using TUNEL method. The ultrastructural changes in the substantia nigra were observed under the electron microscopy, and the survival of neurons in the substantia nigra area was examined by using Nissl staining. In PD group at POD 7 to 21, the damage in the substantia nigra area was gradually aggravated, the concentration of Ach, apoptosis rate and turns of rotation were gradually increased, and the number of Nissl cells was gradually reduced over the time as compared with the normal control and sham operation groups (all P<0.05). It was concluded that there exist dynamic changes in Ach concentration, ethology and apoptosis of the substantia nigra cells during the morbidity of PD, suggesting the contribution of apoptosis to the morbidity of PD, and critical role of Ach in the pathogenesis of PD.

Objective To investigate the predictive value of umbilical cord blood bilirubin for pathological jaundice in healthy term newborns. Methods Two ml navel string vein blood of baby were collected after giving birth in the normal newborn, and the hemobilirubin was detected by accidentally oxidation method. After birth, the infant's bilirubin level was tested on the forehead by the transcutaneous bilirubinometer at 8:00 -9:00 every morning until discharging from hospital. The ration of pathological jaundice of newborn and its treatment were analyzed in different levels of cord blood hemobilirubin. Results Fifty-nine cases ( 22.96% ) with pathological jaundice were diagnosed in 257 newboms.The concentration of cord blood hemobilirubin in baby with pathological jaundice [(39.68 ±8.10) μmol/L] was significantly higher than that of the normal newborn [(30.05 ±5.51) μmol/L](P＜0.01). As the concentration of cord blood hemobilirubin was increased, the incidence of pathological jaundice was raised (P＜ 0.01), and the cases that needed to intervention treatment was increased(P＜ 0.01). Conclusion The detection of the level of cord blood hemobilirubin is not only very worthy to estimate the occurrence of pathological jaundice of newborn, but also offer reliable evidence for clinical early diagnosis and treatment.

ObjectiveTo know about the correlation analysis of the physical and mental status of organ transplanted patients' family members during the patients' rehabilitation period and the long term survival of the transplanted organs.MethodsA total of 600 organ transplanted patients' family members were investigated by Zung self-rating anxiety scale (SAS) and simple coping style questionnaire.The results underwent subsequent analysis.ResultsAnxious state of organ transplanted patients' family members was more severe than that of domestic norm (P<0.01).There were some differences in terms of anxious state of family members with different genders,education backgrounds,income and the resource of medical expenditure (P<0.05).Family members most took positive coping styles,whereas fewer adopted negative coping styles (P<0.01).Positive coping styles were negatively correlated with the anxiety of family members (P<0.01) and positively correlated with long term survival of transplanted organ(P<0.05).However,negative coping styles of family members were significantly positively correlated with their anxiety (P<0.05) and were negatively correlated with long term survival of transplanted organ.ConclusionsThe anxiety generally exists in organ transplanted patients' family members.There are differences in terms of anxious state among family members of different genders,different education backgrounds,income or with the resource of medical expenditure.The more they adopt positive coping styles,the lower anxiety level they show and the longer the transplanted organ survive.Conversely,the more they adopt negative coping styles,the higher anxious level they show and the shorter the transplanted organ survive.