Purpose: The aim of this study was to investigate the feasibility of an intelligent handheld ultrasound (US) device for assisting non-expert general practitioners (GPs) in detecting carotid plaques (CPs) in community populations. Methods: This prospective parallel controlled trial recruited 111 consecutive community residents. All of them underwent examinations by non-expert GPs and specialist doctors using handheld US devices (setting A, setting B, and setting C). The results of setting C with specialist doctors were considered the gold standard. Carotid intima-media thickness (CIMT) and the features of CPs were measured and recorded. The diagnostic performance of GPs in distinguishing CPs was evaluated using a receiver operating characteristic curve. Inter-observer agreement was compared using the intragroup correlation coefficient (ICC). Questionnaires were completed to evaluate clinical benefits. Results: Among the 111 community residents, 80, 96, and 112 CPs were detected in settings A, B, and C, respectively. Setting B exhibited better diagnostic performance than setting A for detecting CPs (area under the curve, 0.856 vs. 0.749; P<0.01). Setting B had better consistency with setting C than setting A in CIMT measurement and the assessment of CPs (ICC, 0.731 to 0.923). Moreover, measurements in setting B required less time than the other two settings (44.59 seconds vs. 108.87 seconds vs. 126.13 seconds, both P<0.01). Conclusion Using an intelligent handheld US device, GPs can perform CP screening and achieve a diagnostic capability comparable to that of specialist doctors.

Purpose: The aim of this study was to investigate the feasibility of an intelligent handheld ultrasound (US) device for assisting non-expert general practitioners (GPs) in detecting carotid plaques (CPs) in community populations. Methods: This prospective parallel controlled trial recruited 111 consecutive community residents. All of them underwent examinations by non-expert GPs and specialist doctors using handheld US devices (setting A, setting B, and setting C). The results of setting C with specialist doctors were considered the gold standard. Carotid intima-media thickness (CIMT) and the features of CPs were measured and recorded. The diagnostic performance of GPs in distinguishing CPs was evaluated using a receiver operating characteristic curve. Inter-observer agreement was compared using the intragroup correlation coefficient (ICC). Questionnaires were completed to evaluate clinical benefits. Results: Among the 111 community residents, 80, 96, and 112 CPs were detected in settings A, B, and C, respectively. Setting B exhibited better diagnostic performance than setting A for detecting CPs (area under the curve, 0.856 vs. 0.749; P<0.01). Setting B had better consistency with setting C than setting A in CIMT measurement and the assessment of CPs (ICC, 0.731 to 0.923). Moreover, measurements in setting B required less time than the other two settings (44.59 seconds vs. 108.87 seconds vs. 126.13 seconds, both P<0.01). Conclusion Using an intelligent handheld US device, GPs can perform CP screening and achieve a diagnostic capability comparable to that of specialist doctors.

Purpose: The aim of this study was to investigate the feasibility of an intelligent handheld ultrasound (US) device for assisting non-expert general practitioners (GPs) in detecting carotid plaques (CPs) in community populations. Methods: This prospective parallel controlled trial recruited 111 consecutive community residents. All of them underwent examinations by non-expert GPs and specialist doctors using handheld US devices (setting A, setting B, and setting C). The results of setting C with specialist doctors were considered the gold standard. Carotid intima-media thickness (CIMT) and the features of CPs were measured and recorded. The diagnostic performance of GPs in distinguishing CPs was evaluated using a receiver operating characteristic curve. Inter-observer agreement was compared using the intragroup correlation coefficient (ICC). Questionnaires were completed to evaluate clinical benefits. Results: Among the 111 community residents, 80, 96, and 112 CPs were detected in settings A, B, and C, respectively. Setting B exhibited better diagnostic performance than setting A for detecting CPs (area under the curve, 0.856 vs. 0.749; P<0.01). Setting B had better consistency with setting C than setting A in CIMT measurement and the assessment of CPs (ICC, 0.731 to 0.923). Moreover, measurements in setting B required less time than the other two settings (44.59 seconds vs. 108.87 seconds vs. 126.13 seconds, both P<0.01). Conclusion Using an intelligent handheld US device, GPs can perform CP screening and achieve a diagnostic capability comparable to that of specialist doctors.

Objective To investigate the current situation of ethical system construction in the publication of medical science and technology journals in universities,to explore the problems in the construction of ethical system in the publication of medical science and technology journals in universities,and propose corresponding suggestions.Methods A total of 55 medical university journals included in the 2023 edition of the China Science and Technology Journal Citation Reports(Core Edition)Natural Science Volume were selected as the research subjects,and their publishing ethics system construction was investigated through the journal's official website.Results Only 18 journals have clear publishing ethics sections on their official websites,covering publishing ethics systems related to authors,reviewers,editors,and publishers,while other journals only mention publishing ethics systems related to authors,reviewers,editors,and publishers in their submission guidelines,peer reviews,and related statements published on their respective official websites,and the coverage is incomplete and the publishing process is opaque.Conclusion Ethical systems and strengthen the prevention and handling of academic misconduct,to strengthen the promotion of publishing ethics system and enhance the integrity awareness of authors,to promote transparency in the publishing process and strengthen supervision and to early warning of various publishing processes.

Objective:To analyze and summarize the clinical features and short-medium term follow-up results of children with multisystem inflammatory syndrome（MIS-C）following coronavirus infection.Methods:The data of six children with MIS-C admitted to the Intensive Care Unit of Shanghai Children's Medical Center from January to March 2023 were retrospectively analyzed.Results:All six cases were in shock，requiring vasoactive drugs，and one case required invasive mechanical ventilation.All the six patients had multiple organ function injury and increased inflammation indicators.After admission，they received organ support，glucocorticoids and gamma globulin treatment.Two patients were treated with biological agents.Both organ function and inflammation indicators showed significantly improvement after therapy.Six patients had mild coronary artery widening.All patients had good prognosis following short-medium term follow-up.Conclusion:Children with severe MIS-C may suffer life-threatening hemodynamic instability.Timely assessment，active anti-inflammatory and organ support therapy can obtain favorable prognosis.

Purpose To explore the value of machine learning models based on synthetic MRI,dynamic contrast-enhanced MRI(DCE-MRI)and diffusion weighted imaging(DWI)parameters in identifying molecular subtypes of breast cancer.Materials and Methods A retrospective analysis was conducted on the data of 292 patients who underwent synthetic MRI,DCE-MRI and DWI examinations from September 2020 to September 2024 in Ningxia Medical University General Hospital before surgery and were pathologically confirmed to have breast cancer postoperatively.Patients were randomly divided into training and test sets using a ratio of 7:3.Multiple parameters were obtained from the synthetic MRI,DCE-MRI and DWI images.Variance analysis were used to screen the characteristic parameters among molecular subtype groups.Five machine learning models were established based on the selected characteristic parameters,and receiver operating characteristic curves were plotted to calculate the area under the curve among the molecular subtype groups.Results The support vector machine model exhibited the highest overall performance,with an area under the curve of 0.972,accuracy of 82.5％,specificity of 94.76％and sensitivity of 82.14％in the test set.This model's area under the curve values for differentiating luminal A,luminal B,human epidermal growth factor receptor-2 overexpression,and triple-negative groups in the training set were 0.979,0.925,0.971 and 0.982,respectively;in the test set,the area under the curve values were 0.973,0.873,0.956 and 0.955,respectively.Conclusion Machine learning models based on multimodal MRI parameters can assist clinicians in preoperatively determining the molecular subtypes of breast cancer and the support vector machine model shows relatively high comprehensive performance.

Objective:To investigate the mediating effect of work engagement on the relationship between nurses′ perception of authentic leadership and their innovative behavior, providing insights for enhancing nurses′ innovative practices.Methods:A convenience sampling method was employed to recruit registered nurses from 37 hospitals in Anhui Province between January and March 2022. The Authentic Leadership Questionnaire, Utrecht Work Engagement Scale and Nurse Innovative Behavior Scale were utilized to conduct a cross-sectional survey. SPSS 25.0 was used to analyze the correlations among nurses′ perception of authentic leadership, work engagement, and innovative behavior, while AMOS 26.0 was employed to assess the mediating effect of work engagement between nurses′ perception of authentic leadership and innovative behavior.Results:A total of 3 200 questionnaires were distributed, and 2 994 valid questionnaires were collected. Among the 2 994 participating nurses, 2 907 (97.1%) were female and 87 (2.9%) were male, 1 002 (33.5%) aged 22-25 years, 1 374 (45.9%) aged 26-39 years, 467 (15.6%) aged 40-49 years, and 151 (5.0%) aged 50 years or older. The total scores of the Authentic Leadership Questionnaire, Utrecht Work Engagement Scale and Nurse Innovative Behavior Scale were (68.23 ± 13.15), (51.49 ± 11.65) and (38.28 ± 8.35) points, respectively. Pearson correlation analysis revealed significant positive correlations between nurses′ perception of authentic leadership and work engagement ( r=0.473, P<0.01), between nurses′ perception of authentic leadership and innovative behavior ( r=0.530, P<0.01), and between work engagement and innovative behavior ( r=0.553, P<0.01). The mediating effect analysis indicated that work engagement partially mediates the relationship between nurses′ perception of authentic leadership and innovative behavior ( β=0.18, P<0.01), with a mediation effect ratio of 34.62%. Conclusions:Nurses′ perception of authentic leadership can indirectly influence their innovative behavior through work engagement. It is recommended that nursing managers prioritize the enhancement of authentic leadership and foster work engagement among nurses to stimulate their innovative behavior.

Objective:To analyze the relevant factors affecting treatment compliance in infertile patients with mycoplasma infection, construct a nomogram prediction model and validate it.Methods:In this case-control study, we retrospectively analyzed the clinical data of 400 infertile patients who attended the Department of Reproduction of Ganzhou Maternal and Child Health Hospital, Jiangxi Province from April 2022 to March 2024. They were divided into modeling group ( n=280) and validation group ( n=120) according to the 7∶3 principle with random number method, and further divided into complete compliance subgroup and unstable compliance subgroup based on different levels of compliance. Multiple logistic regression model was used to analyze the risk factors affecting treatment adherence in infertile patients with mycoplasma infection, variance inflation factor was used to assess the collinearity of the independent variables and to construct a columnar plot prediction model, and the validation and predictive efficacy of the columnar plot model were assessed by calibration curves and decision curves, respectively. The validation and predictive efficacy of the column chart model were evaluated by calibration curve and decision curve respectively. Results:In the modeling group, there was no significant statistical difference between the fully compliant group and the unstable compliant group in terms of body mass index, place of residence, occupation, settlement form, and attitude of medical staff (all P>0.05). Age in the unstable adherence subgroup [(33.22±3.20) years], proportion of junior high school and below in education [36.81% (67/182)], proportion of average monthly disposable amount ≤2 000 yuan [36.81% (67/182)], proportion of poor disease awareness [62.09% (113/182)], and infertility related stress scale (IRSS) scores (45.60±17.14) were higher than those in the full adherence subgroup [(31.36±3.24) years, P<0.001; 19.39% (19/98), P=0.003; 16.33% (16/98), P<0.001; 28.57% (28/98), P<0.001; 37.64±16.69, P<0.001]. The receiver operating characteristc curve analysis results showed that the optimal cutoff values for age and IRSS score were 32 years old and 42 points, respectively. The results of logistic multiple regression model showed that: age ( OR=1.453, 95% CI: 1.260-1.794, P=0.002), education level ( OR=1.386, 95% CI: 1.185-1.564, P<0.001), average monthly disposable amount ( OR=1.081, 95% CI: 1.002-1.246, P=0.023), disease awareness level ( OR=1.827, 95% CI: 1.390-2.359, P<0.001), and average monthly disposable amount ( OR=1.081, 95% CI: 1.002-1.246, P=0.023), disease awareness ( OR=1.827, 95% CI:1.390-2.359, P<0.001), and IRSS score ( OR=1.590, 95% CI: 1.255-1.902, P=0.006) were independent risk factors affecting treatment adherence in infertile patients with mycoplasma infection. The modeling group C-index was 0.872 (0.816-0.927), the intercept (-0.004) and slope (0.995) of the calibration curve were close to the desirable values of 0 and 1, the Brier score was 0.017, and thresholds between 0.37 and 0.96 provided a net clinical benefit. The C-index of the test model set was 0.816 (0.736-0.896), the intercept (-0.007) and slope (1.015) of the calibration curve were close to the ideal values of 0 and 1, the Brier score was 0.013, and the threshold value provided a net clinical benefit when the threshold value ranged from 0.21 to 0.98, and the H-L goodness-of-fit test showed that χ 2=7.36, P=0.499, and the constructed predictive model for the column line graphs had good discrimination and consistency. Conclusion:Age, educational level, monthly average disposable income, disease awareness, and IRSS score are the relevant factors affecting treatment compliance in infertile patients with mycoplasma infection. The nomogram prediction model constructed in this study based on those relevant factors has a good predictive value for treatment compliance in infertile patients with mycoplasma infection, and can provide certain reference for clinical intervention measures.

Objective:To investigate the levels of brain natriuretic peptide(BNP),angiotensin Ⅱ(AngⅡ)and Apelin in hypertensive patients with heart failure and their correlation with cardiac function.Methods:A total of 110 pa-tients with hypertension and heart failure(observation group),110 hypertensive patients(hypertension control group)and 100 healthy subjects undergoing physical examination simultaneously(healthy control group)admitted to Chongming Hospital Affiliated to Shanghai University of Medicine & Health Sciences between January 2021 and Oc-tober 2022 were enrolled.BNP,AngⅡ and Apelin levels were compared among above-mentioned groups.Pearson correlation analysis was employed to analyze association of above indexes with cardiac function.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of BNP,AngⅡ and Apelin combination for hy-pertension combined heart failure.Results:Compared with participants in healthy control group and hypertension control group,those in observation group had significant higher BNP,AngⅡ,Apelin and left ventricular end-dias-tolic diameter(LVEDd),and significant lower left ventricular ejection fraction(LVEF)(P＜0.001 all).Pearson correlation analysis showed that BNP,AngⅡ,Apelin were negatively correlated with LVEF(r=-0.607,-0.517,-0.549,P＜0.001 all),while they were positively correlated with LVEDd(r=0.695,0.676,0.677,P＜0.001 all).Compared with patients in class Ⅱ and class Ⅲ groups,those in class Ⅳ group had significant higher BNP[(501.42±65.58)pg/ml vs.(382.59±49.69)pg/ml vs.(409.58±53.58)pg/ml],AngⅡ[(3.24±0.84)ng/ml vs.(0.85±0.24)ng/ml vs.(1.06±0.41)ng/ml],Apelin[(6.53±0.71)pg/ml vs.(3.55±0.29)pg/ml vs.(4.98±0.56)pg/ml](P＜0.001 all).ROC curve indicated that the AUC of the combined diagnosis of BNP,AngⅡ and Apelin for hypertensive patients with heart failure of class Ⅲ～Ⅳ was 0.943(95％CI 0.882～0.978),which was significantly higher than that of single index(Z=2.960,6.099,4.653,P＜0.01 all).Conclusion:BNP,AngⅡ and Apelin combination has good performance in diagnosing hypertension complicated heart failure.

Objective:To summarize the domestic and international research progress on adverse reactions to contrast-enhanced CT examinations, and forecast research themes, future hotspots, and trends.Methods:Using CiteSpace bibliometric methodology, retrieve Chinese and English literature on adverse reactions in patients undergoing contrast-enhanced CT examinations from China National Knowledge Infrastructure(CNKI), Wanfang Data Knowledge Service Platform, VIP Chinese Science and Technology Periodical Database, and Web of Science. The search period covers database inception to December 31, 2023. After deduplication, CiteSpace and other software are employed to conduct statistics and analyses on publication volume, publishing countries, institutions, and keywords for both Chinese and English literature separately.Results:A total of 3 749 articles were included, comprising 3 044 Chinese-language articles and 705 English-language publications. Visual analysis revealed that the annual number of publications on CT contrast-enhanced examination-related adverse reactions exhibited fluctuating growth from 1994 to 2023. The United States emerged as the leading contributor in this research domain, while China demonstrated rapid growth in recent years. Network analysis of research institutions revealed insufficient collaboration and communication among domestic institutions. Thematic clustering identified 22 clusters and 25 emerging keywords in Chinese literature, compared to 20 clusters and 7 burst keywords in English publications. Domestic research priorities focused predominantly on adverse reactions to contrast agents, nursing interventions, and nursing prevention strategies. International research trends emphasized safety, risk factor identification for adverse reactions, contrast-induced acute kidney injury (CI-AKI) prevention, and the prevention of adverse reactions using contrast-agent nanomaterials.Conclusions:Both domestic and international research in this field exhibits distinct emphases but universally underscores the importance of nursing. It is imperative to strengthen multidisciplinary collaboration among domestic institutions in the future. By focusing on research hotspots and cutting-edge frontiers, expanding the depth and breadth of China's research in this domain, and continuously optimizing nursing strategies, we can effectively enhance nursing quality for CT contrast-enhanced examination patients, optimize patient experience, and contribute to the high-quality development of nursing practice in this field.