Objective To construct the prevention strategy of emergance agitation in orthopedic surgery patients under general anesthesia,it provides reference for clinical nursing practice.Methods Through literature review and expert correspondence,strategy to prevent agitation during the awakening period in patients undergoing orthopedic general anesthesia surgery was developed.Results Two rounds of expert correspondence were conducted.The effective recovery rates of the questionnaires were 91.3％and 95.2％respectively.Expert authority coefficients were 0.940 and 0.919 respectively.Kendall harmony coefficients were 0.153 and 0.163.In the second round of expert correspondence,the average importance of indicators at all levels ranged from 4.000 to 4.944,and coefficient of variation ranged from 0.046 to 0.213.Finally,3 first-level indicators,15 second-level indicators,and 42 third-level indicators were determined.Conclusion The preventive strategy constructed in this study covers the entire perioperative process and has good scientific validity,reliability.

Objective It aims to understand the current situation of digital development of tertiary public hospitals in Shanghai,and provide reference for further promoting the digital transformation and development of public hospitals in China.Methods By convenient sampling method,15 tertiary public hospitals in Shanghai were selected to conduct a cross-sectional survey from August to October 2024,including the basic situation of hospitals and the digital trans-formation and development of hospitals.Results The survey showed that in terms of staffing,The sample hospitals have outstanding performance in the assessment and rating related to digital transformation.The difference in the number of digitization staff between different hospital sizes was statistically significant(P＜0.05).In terms of finan-cial support,the median digitization-related budget in 2023 was 1.61％of the total budget;in terms of teaching and researching,the proportion of hospitals applying digital technology to support teaching and researching was greater than 80％,and there was statistical significance in the number of specialized disease databases in dif-ferent scale hospitals(P＜0.05);in terms of technology application,Artificial Intelligence technology is mainly ap-plied to medical services,hospital management,and hospital research among the 15 hospitals,while the applica-tion of blockchain and meta-universe technology is still relatively limited.Conclusion Tertiary public hospitals in Shang-hai have made certain progress in digital transformation,but they still need to further optimize resource allocation,further tap the application potential of digital technology,strengthen capital attention and investment,and increase the introduction and training of digital talents,so as to improve the overall level of digital development of hospitals.

Objective It aims to systematically review the concept of hospital digital maturity and its application in the digital transformation of hospitals,analyzes existing digital maturity assessment models internationally,and examine relevant research progress to provide reference and support for the digital transformation of Chinese hospitals.Methods By using the systematic review method,a systematic review was conducted by searching rele-vant literature in both Chinese and English databases,including CNKI,Wanfang Database,PubMed,Medline,and Web of Science.Keywords used for the search included digital maturity,digital capability,health,and hospital.Results Widely used international digital maturity assessment models encompass various dimensions,such as organizational management,digital technology capabilities,healthcare professional digital capabilities,data analytics,and interoperability.Some countries have applied these models in the digital transformation practices of hospitals,while attention to this field remains relatively limited in China.Conclusion Digital maturity assessment is a crucial tool for promoting the digital transformation of hospitals;however,existing evaluation frameworks are not directly appli-cable to China's public hospital system.Future research should focus on developing quantifiable assessment tools tai-lored to the characteristics of Chinese public hospitals,thereby promoting hospital digital transformation and high-quality development.

The aim of the experiment was to study the effects of Echinacea purpurea extract on the digestive ability,immune function and intestinal barrier of the Bamei ternary pigs.Forty-eight healthy pigs of 50 days old were randomly divided into four groups,each with three replicates and four pigs in each replicate.The control group(CON)was fed a basal diet,and the experimental group was divided into 5 g/kg(T1),10 g/kg(T2)and 15 g/kg(T3)of Echinacea extract in the basal diet.The pre-test period was 5 days and the main test period was 35 days with free feeding and drinking during the test period.The results showed that:There was no significant effect on the apparent digestibility of nutrients and jejunum morphology in the test group compared to the CON group(P＞0.05).Amylase and trypsin activities were significantly higher in the experimental group and lipase activities were significantly higher in T2 and T3 groups compared to CON group(P＜0.05).GSH,CAT and T-AOC activities were significantly higher in the experimental group compared to CON group(P＜0.05).In comparison with CON group,the levels of IL-1 and IL-6 were significantly lower in the experimental group(P＜0.05),and the levels of TNF-α were significantly lower in the T2 and T3 groups(P＜0.05);and the levels of IL-10 were signifi-cantly higher in the T3 group(P＜0.05).The mRNA and protein expression levels of TLR4,MyD88,TRAF6,and NF-κB were significantly lower in the experimental group(P＜0.05).The mRNA and protein expression levels of CLDN-1,OCLN and ZO-1 were significantly increased in the test group(P＜0.05).The results between the test groups showed that the protein expression levels of CLDN-1 and OCLN were significantly increased in the T3 group compared with the T1 group(P＜0.05).In conclusion,the addition of Echinacea extract to the ration can,to a certain ex-tent,improve the digestive ability,balance the immune ability,and improve the intestinal barrier function of the Bamei ternary pigs,thus promoting the intestinal health of pigs.

Objective:To evaluate value of CT perfusion in evaluating the efficacy of different vascular reconstruction methods in the treatment of adult ischemic moyamoya disease.Methods:The clinical data of 80 adult patients with moyamoya disease with ischemic blood type who received revascularization in the Affiliated Hospital of Jining Medical University from February 2019 to February 2023 were retrospectively analyzed, including 43 patients who received superficial temporal arterio-middle cerebral artery anastomosis (direct group) and 37 patients who received brain-dural arterio-artery vascularization (indirect group). The improvement of clinical symptoms, Modified Rankin Scale (mRS) Score, collateral vessels and CTP parameters were compared between the two groups.Results:The improvement of clinical symptoms in the direct group was better than that in the indirect group ( P<0.05), and the significant remission rate was significantly higher than that in the indirect group [86.0%(37/43) vs 59.5%(22/37), χ 2=7.262, P=0.007]. The postoperative mRS score in the direct group was significantly lower than that before surgery [0(0, 1) vs 1(1, 2), Z=5.550, P<0.001]. The score of mRS After surgery in the indirect group was significantly lower than that before surgery [0(0, 1) vs 1(1, 2), Z=4.281, P<0.001], but there was no statistically significant difference between the two groups ( P>0.05). There was no significant difference in digital subtraction angiography (DSA) collateral vessel formation between the two groups ( P>0.05). The CTP parameters of the two groups before and after surgery were consistent between observers and within observers [intraclass correlation coefficient (ICC) range 0.88-0.94]. In the operation area, the relative cerebral blood flow (rCBF) after surgery was significantly increased, and the relative time to peak (rTTP) and relative mean transit time (rMTT) were significantly decreased in both groups, with statistical significance ( P<0.05). In the ipsilateral basal ganglia and frontal lobe, rCBF in the direct group was significantly increased, rTTP and rMTT were significantly decreased, and the differences were statistically significant (all P<0.05), while there were no statistically significant differences in parameters in the indirect group (all P>0.05). The changes of rCBF, rTTP and rMTT in the operative area in the direct group were better than those in the indirect group, and the changes of rCBF, rTTP and rCBF in the basal ganglia and frontal lobe were better than those in the indirect group, with statistical significance (all P<0.05), while there were no statistically significant differences in the remaining parameters (all P>0.05). Conclusions:CT perfusion is of great value in evaluating the difference of clinical symptom improvement in the treatment of adult ischemic moyamoya disease with different vascular reconstruction methods.

The aim of the experiment was to study the effects of Echinacea purpurea extract on the digestive ability,immune function and intestinal barrier of the Bamei ternary pigs.Forty-eight healthy pigs of 50 days old were randomly divided into four groups,each with three replicates and four pigs in each replicate.The control group(CON)was fed a basal diet,and the experimental group was divided into 5 g/kg(T1),10 g/kg(T2)and 15 g/kg(T3)of Echinacea extract in the basal diet.The pre-test period was 5 days and the main test period was 35 days with free feeding and drinking during the test period.The results showed that:There was no significant effect on the apparent digestibility of nutrients and jejunum morphology in the test group compared to the CON group(P＞0.05).Amylase and trypsin activities were significantly higher in the experimental group and lipase activities were significantly higher in T2 and T3 groups compared to CON group(P＜0.05).GSH,CAT and T-AOC activities were significantly higher in the experimental group compared to CON group(P＜0.05).In comparison with CON group,the levels of IL-1 and IL-6 were significantly lower in the experimental group(P＜0.05),and the levels of TNF-α were significantly lower in the T2 and T3 groups(P＜0.05);and the levels of IL-10 were signifi-cantly higher in the T3 group(P＜0.05).The mRNA and protein expression levels of TLR4,MyD88,TRAF6,and NF-κB were significantly lower in the experimental group(P＜0.05).The mRNA and protein expression levels of CLDN-1,OCLN and ZO-1 were significantly increased in the test group(P＜0.05).The results between the test groups showed that the protein expression levels of CLDN-1 and OCLN were significantly increased in the T3 group compared with the T1 group(P＜0.05).In conclusion,the addition of Echinacea extract to the ration can,to a certain ex-tent,improve the digestive ability,balance the immune ability,and improve the intestinal barrier function of the Bamei ternary pigs,thus promoting the intestinal health of pigs.

Objectives:To analyze the cardiac involvement of patients with Fabry disease(FD)in Anhui region.Methods:This retrospective analysis included 48 previously and currently diagnosed FD patients(25 males)in Anhui region,overall patient and gender specific cardiac involvement was analyzed.Results:The median age of FD patients is 28.0(19.0,46.0)years.The cardiac manifestations of patients with FD were most commonly characterized by palpitations/arrhythmias(13/42 cases)and exertional dyspnea(11/42 cases),electrocardiographic changes were most commonly characterized by T-wave inversion(22/42 cases),ST-segment depression(16/42 cases),and left ventricular hypervoltage(18/42 cases),cardiac structural and functional changes were most common in papillary muscle hypertrophy(29/36 cases),bilateral sign(22/37 cases)and left ventricular hypertrophy(21/46 cases),as well as reduced left ventricular global longitudinal strain(26/39 cases).Neuropathic pain(28/43 cases)was the most common extracardiac manifestation of FD patients.FD patients of different gender differed in age at diagnosis(P=0.018),alpha galactosidase A activity(P<0.001),globotriaosylsphingosine(lyso-GL3)levels(P<0.001),enzyme replacement therapy rate(P=0.043),dyshidrosis(P<0.01),and the incidence of angiokeratoma(P=0.004).Correlation analysis showed that genotype was not correlated with enzyme activity or Lyso-GL-3 levels,whereas the Sokolow-Lyon index was positively correlated with Lyso-GL-3 levels(ρ=0.423,P=0.008),and the Sokolow-Lyon indices(septal thickness:ρ=0.562,P<0.001;left ventricle posterior wall thickness:ρ=0.569,P<0.001)and QRS duration(septal thickness:ρ=0.543,P<0.001;left ventricle posterior wall thickness:ρ=0.557,P<0.001)were positively correlated with left ventricular wall thickness.Conclusions:Cardiac involvement in patients with FD in the Anhui region is characterised by palpitations or arrhythmias,accompanied by nonspecific electrocardiographic changes.Echocardiography frequently reveals papillary muscle hypertrophy.The manifestation of cardiac involvement in patients of different genders is similar.

Objective It aims to understand the current situation of digital development of tertiary public hospitals in Shanghai,and provide reference for further promoting the digital transformation and development of public hospitals in China.Methods By convenient sampling method,15 tertiary public hospitals in Shanghai were selected to conduct a cross-sectional survey from August to October 2024,including the basic situation of hospitals and the digital trans-formation and development of hospitals.Results The survey showed that in terms of staffing,The sample hospitals have outstanding performance in the assessment and rating related to digital transformation.The difference in the number of digitization staff between different hospital sizes was statistically significant(P＜0.05).In terms of finan-cial support,the median digitization-related budget in 2023 was 1.61％of the total budget;in terms of teaching and researching,the proportion of hospitals applying digital technology to support teaching and researching was greater than 80％,and there was statistical significance in the number of specialized disease databases in dif-ferent scale hospitals(P＜0.05);in terms of technology application,Artificial Intelligence technology is mainly ap-plied to medical services,hospital management,and hospital research among the 15 hospitals,while the applica-tion of blockchain and meta-universe technology is still relatively limited.Conclusion Tertiary public hospitals in Shang-hai have made certain progress in digital transformation,but they still need to further optimize resource allocation,further tap the application potential of digital technology,strengthen capital attention and investment,and increase the introduction and training of digital talents,so as to improve the overall level of digital development of hospitals.

Objective It aims to systematically review the concept of hospital digital maturity and its application in the digital transformation of hospitals,analyzes existing digital maturity assessment models internationally,and examine relevant research progress to provide reference and support for the digital transformation of Chinese hospitals.Methods By using the systematic review method,a systematic review was conducted by searching rele-vant literature in both Chinese and English databases,including CNKI,Wanfang Database,PubMed,Medline,and Web of Science.Keywords used for the search included digital maturity,digital capability,health,and hospital.Results Widely used international digital maturity assessment models encompass various dimensions,such as organizational management,digital technology capabilities,healthcare professional digital capabilities,data analytics,and interoperability.Some countries have applied these models in the digital transformation practices of hospitals,while attention to this field remains relatively limited in China.Conclusion Digital maturity assessment is a crucial tool for promoting the digital transformation of hospitals;however,existing evaluation frameworks are not directly appli-cable to China's public hospital system.Future research should focus on developing quantifiable assessment tools tai-lored to the characteristics of Chinese public hospitals,thereby promoting hospital digital transformation and high-quality development.

Objectives:To analyze the cardiac involvement of patients with Fabry disease(FD)in Anhui region.Methods:This retrospective analysis included 48 previously and currently diagnosed FD patients(25 males)in Anhui region,overall patient and gender specific cardiac involvement was analyzed.Results:The median age of FD patients is 28.0(19.0,46.0)years.The cardiac manifestations of patients with FD were most commonly characterized by palpitations/arrhythmias(13/42 cases)and exertional dyspnea(11/42 cases),electrocardiographic changes were most commonly characterized by T-wave inversion(22/42 cases),ST-segment depression(16/42 cases),and left ventricular hypervoltage(18/42 cases),cardiac structural and functional changes were most common in papillary muscle hypertrophy(29/36 cases),bilateral sign(22/37 cases)and left ventricular hypertrophy(21/46 cases),as well as reduced left ventricular global longitudinal strain(26/39 cases).Neuropathic pain(28/43 cases)was the most common extracardiac manifestation of FD patients.FD patients of different gender differed in age at diagnosis(P=0.018),alpha galactosidase A activity(P<0.001),globotriaosylsphingosine(lyso-GL3)levels(P<0.001),enzyme replacement therapy rate(P=0.043),dyshidrosis(P<0.01),and the incidence of angiokeratoma(P=0.004).Correlation analysis showed that genotype was not correlated with enzyme activity or Lyso-GL-3 levels,whereas the Sokolow-Lyon index was positively correlated with Lyso-GL-3 levels(ρ=0.423,P=0.008),and the Sokolow-Lyon indices(septal thickness:ρ=0.562,P<0.001;left ventricle posterior wall thickness:ρ=0.569,P<0.001)and QRS duration(septal thickness:ρ=0.543,P<0.001;left ventricle posterior wall thickness:ρ=0.557,P<0.001)were positively correlated with left ventricular wall thickness.Conclusions:Cardiac involvement in patients with FD in the Anhui region is characterised by palpitations or arrhythmias,accompanied by nonspecific electrocardiographic changes.Echocardiography frequently reveals papillary muscle hypertrophy.The manifestation of cardiac involvement in patients of different genders is similar.