Eating disorders(ED) are a group of psychiatric disorders related to abnormal eating behaviors, with complex and variable symptoms, frequent crossover of diagnoses among various subtypes, high comorbidity rates, and often difficulties in medical treatment, which seriously affect the quality of life of patients. Understanding ED from a transdiagnostic perspective provides new ideas for treatment. According to the theory of cognitive behavioral therapy, psychological cognitive development is an important maintenance mechanism for the transdiagnosis of ED. Core beliefs, as the deepest level of psychological cognition, play an important role in the development and maintenance of ED. A large number of studies have found that among patients with various subtypes of ED, the core beliefs related to the self involve body shape and weight, achievement/worth, sense of control, and the core beliefs related to the world/others involve unloveability and abandonment influence both eating-related symptoms and comorbidity levels. For the first time, this paper focuses on sorting out the transdiagnostic core beliefs of patients with ED and further clarifying the relationship between transdiagnostic core beliefs and ED symptoms, in order to better understand, prevent and treat ED, then promote recovery and reduce relapse.

Objective:To construct a meridian tapping exercise program for frail elderly, so as to provide daily healthcare options for frail elderly people.Methods:Guided by the theory of meridians and collaterals, data mining was conducted on the database of ancient Chinese medical literature to select acupoints and meridians for tapping. Through literature research, the exercise prescription was improved. A preliminary exercise prescription was formulated through literature review and revised through two rounds of expert consultation in December 2023.Results:The effective response rate for both rounds of expert consultation questionnaires was 7/7. The expert authority coefficients were 0.83 and 0.87, respectively, and the overall Kendall′s coefficient of concordance was 0.301 and 0.302 (both P<0.05). The final meridian tapping exercise for frail elderly comprised 2 primary indicators, 8 secondary indicators, and 23 tertiary indicators. Conclusions:The meridian tapping exercise for the frail elderly is scientific, reliable and practical, which can provide a choice for the frail elderly to carry out targeted traditional Chinese medicine exercises.

Eating disorders(ED) are a group of psychiatric disorders related to abnormal eating behaviors, with complex and variable symptoms, frequent crossover of diagnoses among various subtypes, high comorbidity rates, and often difficulties in medical treatment, which seriously affect the quality of life of patients. Understanding ED from a transdiagnostic perspective provides new ideas for treatment. According to the theory of cognitive behavioral therapy, psychological cognitive development is an important maintenance mechanism for the transdiagnosis of ED. Core beliefs, as the deepest level of psychological cognition, play an important role in the development and maintenance of ED. A large number of studies have found that among patients with various subtypes of ED, the core beliefs related to the self involve body shape and weight, achievement/worth, sense of control, and the core beliefs related to the world/others involve unloveability and abandonment influence both eating-related symptoms and comorbidity levels. For the first time, this paper focuses on sorting out the transdiagnostic core beliefs of patients with ED and further clarifying the relationship between transdiagnostic core beliefs and ED symptoms, in order to better understand, prevent and treat ED, then promote recovery and reduce relapse.

This study analyzed the clinical and laboratory data of 3 children diagnosed with mitochondrial disease-associated primary adrenal insufficiency (PAI) at the Guangzhou Women and Children′s Medical Center, Guangzhou Medical University from October 2018 to November 2023.All patients were normal at birth but gradually developed symptoms and were diagnosed with PAI between the ages of 1 year and 1 month and 7 years and 3 months.The children presented typical clinical symptoms of PAI, including skin and mucosal hyperpigmentation (3 cases), electrolyte disturbances (3 cases), and hypoglycemia (2 cases), as well as multisystem abnormalities related to mitochondrial disease, including recurrent infections, growth retardation, cachexia, and hyperlactatemia.Genetic testing revealed significant single deletions in mitochondrial DNA in all patients: Patient 1: m.11219_15954del, Patient 2: m.8483_13459del, and Patient 3: m.8649_16084del.Treatment with Hydrocortisone acetate replacement therapy improved the electrolyte disturbances and hypoglycemia, but issues with recurrent infections, growth retardation, and cachexia persisted.This study suggests that in clinical practice, the possibility of mitochondrial disease should be highly suspected when PAI patients present with multisystem abnormalities, especially in conjunction with hyperlactatemia.

Objective:To construct a meridian tapping exercise program for frail elderly, so as to provide daily healthcare options for frail elderly people.Methods:Guided by the theory of meridians and collaterals, data mining was conducted on the database of ancient Chinese medical literature to select acupoints and meridians for tapping. Through literature research, the exercise prescription was improved. A preliminary exercise prescription was formulated through literature review and revised through two rounds of expert consultation in December 2023.Results:The effective response rate for both rounds of expert consultation questionnaires was 7/7. The expert authority coefficients were 0.83 and 0.87, respectively, and the overall Kendall′s coefficient of concordance was 0.301 and 0.302 (both P<0.05). The final meridian tapping exercise for frail elderly comprised 2 primary indicators, 8 secondary indicators, and 23 tertiary indicators. Conclusions:The meridian tapping exercise for the frail elderly is scientific, reliable and practical, which can provide a choice for the frail elderly to carry out targeted traditional Chinese medicine exercises.

This study analyzed the clinical and laboratory data of 3 children diagnosed with mitochondrial disease-associated primary adrenal insufficiency (PAI) at the Guangzhou Women and Children′s Medical Center, Guangzhou Medical University from October 2018 to November 2023.All patients were normal at birth but gradually developed symptoms and were diagnosed with PAI between the ages of 1 year and 1 month and 7 years and 3 months.The children presented typical clinical symptoms of PAI, including skin and mucosal hyperpigmentation (3 cases), electrolyte disturbances (3 cases), and hypoglycemia (2 cases), as well as multisystem abnormalities related to mitochondrial disease, including recurrent infections, growth retardation, cachexia, and hyperlactatemia.Genetic testing revealed significant single deletions in mitochondrial DNA in all patients: Patient 1: m.11219_15954del, Patient 2: m.8483_13459del, and Patient 3: m.8649_16084del.Treatment with Hydrocortisone acetate replacement therapy improved the electrolyte disturbances and hypoglycemia, but issues with recurrent infections, growth retardation, and cachexia persisted.This study suggests that in clinical practice, the possibility of mitochondrial disease should be highly suspected when PAI patients present with multisystem abnormalities, especially in conjunction with hyperlactatemia.

Talent is the foundation of hospital development.Since the independent operation of a third grade children's hospital,it is faced with some difficulties such as imperfect construction of talent echelon,large gap of talent demand,insufficient funds for talent introduction and weak talent training.The Party committee of the hospital adheres to the party management of tal-ents,and on the basis of improving the talent introduction,training and incentive mechanism,builds a"1+1＞2 ecosystem"of Party management talents in view of the difficulties and blind spots in the construction of talent teams,focuses on the introduction and training of talents,quantity and quality,and production capacity input and output,and promotes the"induction and reten-tion"of talent construction to achieve actual results.Lay a talent foundation for the high-quality development of the hospital.

Objective: To explore the clinical application value of neural network technology,and to screen the clinical early warning indicators of severe hand-foot-mouth disease(HFMD) by constructing a back propagation neural network(BPNN) model. Methods: The clinical data of children with HFMD admitted to the Department of Infectious Diseases and Pediatrics of the First Affiliated Hospital of Xinxiang Medical University from January2019 to January 2023 were collected.The data were divided into 70% training samples and 30 % test samples using SPSS Modeler 18.0.The BPNN model and Logistic model were constructed to compare and evaluate the prediction accuracy and screening effect of the model. Results: The clinical data of 589 children were collected and analyzed,including 324 cases in the mild group and 265 cases in the severe group.The prediction accuracy of the test set(n=178) of BP neural network model and Logistic regression model was 82.02% and 84.83%,respectively.The area under the ROC curve(95% CI) was 0.791(0.749-0.834) and 0.625(0.577-0.674),respectively.Among the predictive variables output by the BPNN model,the top five factors that had the greatest impact on the grouping were highest body temperature,duration of fever,glutamyl transpeptidase,aspartate aminotransferase,and globulin.There were 3 of the top 10 overlaps in the importance of the predictive variables output by the two models,which were the highest body temperature,duration of fever and limb shaking. Conclusion The BPNN model and Logistic regression model perform well in screening and verifying the risk factors of severe hand-foot-mouth disease,but the comprehensive prediction performance of BP neural network model is better.The top five influencing factors of severe HFMD screened by the BPNN model are the highest body temperature,duration of fever,glutamyl transpeptidase,aspartate aminotransferase and globulin.

Objective:To investigate the correlation between serum PCT and CRP levels and clinical outcome in patients with acute brucellosis.Methods:From June 2014 to June 2020, 73 patients with acute brucellosis diagnosed in Anji County People's Hospital, Huzhou City were selected as acute brucellosis group and 68 patients with chronic brucellosis as chronic brucellosis group; another 60 healthy people were selected as control group. The levels of serum PCT and CRP of each group were measured by chemiluminescence assay and immunoturbidimetric assay. Patients with acute brucellosis were treated with rifampicin, doxycycline and rifapentine capsules for 9 weeks. The levels of serum PCT and CRP in three groups and patients with acute brucellosis with different therapeutic effects were compared. Univariate and multivariate Cox regression analysis were used to analyze the related factors affecting the efficacy of patients with acute brucellosis. The area under curve (AUC) and cut-off value of receiver operating characteristic (ROC) curve of PCT and CRP were used to evaluate the diagnosis of acute brucellosis.Results:The levels of serum PCT and CRP in acute brucellosis group [(3.25±0.49) ng/ml, (31.28±6.56) mg/L] were higher than those in chronic brucellosis group [(0.12±0.05) ng/ml, (5.21±0.89) mg/L] and control group [(0.03±0.01) ng/ml, (2.63±0.37) mg/L], and those in chronic brucellosis group were higher than those in control group ( P < 0.05). In acute brucellosis patients, 56 cases were effective and 17 cases were ineffective. The levels of serum PCT and CRP in ineffective patients were higher than those in effective patients ( P < 0.05). Univariate Cox regression analysis showed that there were significant differences in leukocyte count, neutrophil count, PCT and CRP levels among acute brucellosis patients with different therapeutic effects ( P < 0.05). Multivariate Cox regression analysis showed that leukocyte count, neutrophil count, PCT and CRP levels were the risk factors for therapeutic effect ( P < 0.05). The diagnostic evaluation showed that the sensitivity and specificity of PCT in the diagnosis of acute brucellosis were 95.24% and 80.00%, respectively; and the sensitivity and specificity of CRP in the diagnosis of acute brucellosis were 93.10% and 80.00%, respectively. Conclusion:The levels of serum PCT and CRP in patients with acute brucellosis are significantly increased, and they are risk factors for therapeutic effect, which should be used as reference indexes for diagnosis and treatment of acute brucellosis.

Objective To explore the effects of healthcare failure mode and effects analysis (HFMEA) on needlestick injuries prevention in nurses. Methods A total of 1 082 nurses were selected from January to December 2015 in a grade three hospital and 1 105 nurses from January to December 2016. From January to December 2016, the needle withdrawal process when finishing infusion was managed with HFMEA. The potential failure mode of needlestick injuries was found by "brainstorming method". The risk priority number (RPN) was assessed according to the harm score matrix. A total of 9 failure modes (RPN≥ 8) were reformed and carried with quality control. The score of RPN and the incidence of needle puncture standardization were compared before and after HFMEA. Results After applying HFMEA, the RPN of failure modes of needlestick injuries during needle withdrawal process all dropped to targeted value (under 8). The total RPN decreased from (81.08±26.68) to (48.46±12.48) (t'=2.854, P<0.05). Except for centrally separating needle head, RPN of other failure modes all significantly reduced (P<0.05). The RPN involving poor technique, rescue and emergency needle withdrawal, nonstandard medical wastes classification, low adaptability degree of patients, push-back needle head in infusion bag, needle cap sheathed by both hands all declined more obvious. The standardized incidence of needlestick injuries in total flow decreased from 0.062 cases per FTE year before implementing HFMEA to 0.038 cases per FTE year (χ2=6.698, P<0.01). Conclusions Application of HFMEA in management of needle withdrawal process in nurses can prospectively control nonstandard operative behavior and optimize process so as to effectively reduce the risk of needlestick injuries.