Objective To investigate the prognostic value of serum thrombospondin-1(THBS-1)combined with Alberta Stroke Program Early CT Score(ASPECTS)in patients with acute cerebral infarction with large vessel occlusion(ACI-LVO).Methods A total of 198 ACI-LVO patients admitted to the hospital from January 2022 to October 2024 were prospectively enrolled(ACI-LVO group).Patients were categorized into mild,moderate,and severe subgroups based on National Institutes of Health Stroke Scale(NIHSS)scores,and into good or poor prognosis groups based on 90-day outcomes.Serum THBS-1 levels were measured using ELISA,and ASPECTS scores were calculated.Spearman correlation analysis was used to assess the relationship between THBS-1,ASPECTS,and NIHSS scores.Prognostic factors and predictive values of THBS-1 and ASPECTS were also analyzed.Results Among the 198 patients,58 had mild,67 had moderate,and 73 had severe ACI-LVO.Serum THBS-1 levels increased,and ASPECTS scores decreased progressively with worsening disease severity(P<0.05).NIHSS scores were positively correlated with serum THBS-1 and negatively correlated with ASPECTS scores(P<0.05).The 90-day poor outcome rate was 37.37％(74/198).Independent risk factors for poor prognosis included older age,modified thrombolysis in cerebral infarction score of 0～2a,higher NIHSS score,larger infarct volume,hemorrhagic transformation,and elevated THBS-1.A higher ASPECTS score was an independent protective factor(P<0.05).The area under the curve(AUC)for predicting prognosis was 0.794 for THBS-1,0.831 for ASPECTS,and 0.903 for their combination,with the combined model showing superior predictive value(P<0.05).Conclusions Elevated serum THBS-1 and decreased ASPECTS scores are associated with increased disease severity and poorer prognosis in ACI-LVO patients.The combination of serum THBS-1 and ASPECTS score provides high predictive value for assessing prognosis in ACI-LVO patients.

Objective:To discuss the clinical and genetic characteristics of neurodevelopmental disorder with or without early-onset generalized epilepsy (NEDEGE) caused by NBEA gene variation. Methods:The clinical and genetic records of a patient who was diagnosed with NEDEGE caused by NBEA gene variation at the Department of Neurology, Guangzhou Women and Children′s Medical Center in April 2024 were collected retrospectively. Using " NBEA or neurobeachin" "Autism spectrum disorders or ASD" "Epilepsy" "Neurodevelopmental disorders" as the keywords, relevant articles were searched at CNKI, Wanfang and PubMed databases from establishment of these databases to December 2024. Clinical and genetic features of NEDEGE were summarized in the combination of this case. Results:The proband, a 3 years old boy, was backward in development since childhood. He had autism spectrum disorder-like manifestations such as stereotyped behavior and poor eye contact. At the age of 2, he developed generalized seizures. The whole exome sequencing showed a de novo heterozygous variation of c.244CT(p.Gln82 *) in the NBEA gene (NM-001385012.1), and he was diagnosed with NEDEGE. A total of 10 articles (all in English) were retrieved, reporting 36 cases of NBEA gene related NEDEGE (including this case), 4 of whom coming from China. Twenty-four individuals suffered from mild to severe intellectual disability, and most were moderate.Twenty-eight patients had language delay, including 4 cases of complete loss of language function, and 24 patients had seizures, and 19 patients had autism or autima-like behavior problems. Conclusions:This case enriches the mutation spectrum of the NBEA gene, and the c.244CT is the first reported related variation in the Chinese population. The clinical symptoms of NEDEGE related to NBEA gene mutations are most pronounced in neurodevelopmental disorders, followed by seizures and autistic behavior.

Objective To investigate the prognostic value of serum thrombospondin-1(THBS-1)combined with Alberta Stroke Program Early CT Score(ASPECTS)in patients with acute cerebral infarction with large vessel occlusion(ACI-LVO).Methods A total of 198 ACI-LVO patients admitted to the hospital from January 2022 to October 2024 were prospectively enrolled(ACI-LVO group).Patients were categorized into mild,moderate,and severe subgroups based on National Institutes of Health Stroke Scale(NIHSS)scores,and into good or poor prognosis groups based on 90-day outcomes.Serum THBS-1 levels were measured using ELISA,and ASPECTS scores were calculated.Spearman correlation analysis was used to assess the relationship between THBS-1,ASPECTS,and NIHSS scores.Prognostic factors and predictive values of THBS-1 and ASPECTS were also analyzed.Results Among the 198 patients,58 had mild,67 had moderate,and 73 had severe ACI-LVO.Serum THBS-1 levels increased,and ASPECTS scores decreased progressively with worsening disease severity(P<0.05).NIHSS scores were positively correlated with serum THBS-1 and negatively correlated with ASPECTS scores(P<0.05).The 90-day poor outcome rate was 37.37％(74/198).Independent risk factors for poor prognosis included older age,modified thrombolysis in cerebral infarction score of 0～2a,higher NIHSS score,larger infarct volume,hemorrhagic transformation,and elevated THBS-1.A higher ASPECTS score was an independent protective factor(P<0.05).The area under the curve(AUC)for predicting prognosis was 0.794 for THBS-1,0.831 for ASPECTS,and 0.903 for their combination,with the combined model showing superior predictive value(P<0.05).Conclusions Elevated serum THBS-1 and decreased ASPECTS scores are associated with increased disease severity and poorer prognosis in ACI-LVO patients.The combination of serum THBS-1 and ASPECTS score provides high predictive value for assessing prognosis in ACI-LVO patients.

Objective:To investigate the improvement in nutritional indicators, clinical complications, and respiratory infections among children with cerebral palsy (CP) and malnutrition who meet the indications for tube feeding under oral feeding and tube feeding interventions.Methods:In this retrospective cohort study, 82 children with CP and malnutrition that met the indications for tube feeding from the Children′s Rehabilitation Hospital of the Third Affiliated Hospital of Zhengzhou University from January 2022 to April 2024 were included.These patients were divided into an oral feeding group and a tube feeding group.The t-test, Mann-Whitney U test, or Kruskal-Wallis test was used to analyze nutritional indices such as weight-for-age Z-score (WAZ), height/length-for-age Z-score (HAZ), and weight-for-height/length Z-score (WHZ) before and after intervention in both groups.The improvement in clinical complications and respiratory infections was also analyzed. Results:After 3-month nutritional intervention, there were 60 cases in the oral feeding group and 22 cases in the tube feeding group.The tube feeding group showed better improvement in WHZ [-0.23(-1.79, 0.88) vs.-1.62(-2.02, -0.91) ] than the oral feeding group ( P<0.05).After 6-month nutritional intervention, there were 50 cases in the oral feeding group and 16 cases in the tube feeding group.The tube feeding group showed better improvement in WAZ [-0.80(-1.92, -0.42) vs. -2.26(-2.88, -1.84)], HAZ (-1.31±1.23 vs. -2.32±1.19), and WHZ (-0.74±1.39 vs. -1.58±1.03) than the oral feeding group (all P<0.05).After 12-month nutritional intervention, there were 30 cases in the oral feeding group and 10 cases in the tube feeding group.The tube feeding group showed better improvement in WAZ [-1.06(-1.77, -0.88) vs.-2.25(-3.06, -1.47) ] and HAZ (-1.22±1.63 vs. -2.54±1.50) than the oral feeding group (all P<0.05).Clinical complications improved better in the tube feeding group than those in the oral feeding group.In the tube feeding group, significant differences in choking ( χ2=16.29, P=0.001) and vomiting ( χ2=6.81, P=0.013) were observed before and after nutritional intervention.There was a statistically significant difference in frequency of lower respiratory infections 3 and 6 months after nutritional intervention between the 2 groups (all P<0.05). Conclusions:Compared with oral feeding, tube feeding can effectively improve the clinical nutritional indicators and reduce the clinical complications and the risk of respiratory infections in CP children that meet the indications for tube feeding.

Objective:To investigate the improvement in nutritional indicators, clinical complications, and respiratory infections among children with cerebral palsy (CP) and malnutrition who meet the indications for tube feeding under oral feeding and tube feeding interventions.Methods:In this retrospective cohort study, 82 children with CP and malnutrition that met the indications for tube feeding from the Children′s Rehabilitation Hospital of the Third Affiliated Hospital of Zhengzhou University from January 2022 to April 2024 were included.These patients were divided into an oral feeding group and a tube feeding group.The t-test, Mann-Whitney U test, or Kruskal-Wallis test was used to analyze nutritional indices such as weight-for-age Z-score (WAZ), height/length-for-age Z-score (HAZ), and weight-for-height/length Z-score (WHZ) before and after intervention in both groups.The improvement in clinical complications and respiratory infections was also analyzed. Results:After 3-month nutritional intervention, there were 60 cases in the oral feeding group and 22 cases in the tube feeding group.The tube feeding group showed better improvement in WHZ [-0.23(-1.79, 0.88) vs.-1.62(-2.02, -0.91) ] than the oral feeding group ( P<0.05).After 6-month nutritional intervention, there were 50 cases in the oral feeding group and 16 cases in the tube feeding group.The tube feeding group showed better improvement in WAZ [-0.80(-1.92, -0.42) vs. -2.26(-2.88, -1.84)], HAZ (-1.31±1.23 vs. -2.32±1.19), and WHZ (-0.74±1.39 vs. -1.58±1.03) than the oral feeding group (all P<0.05).After 12-month nutritional intervention, there were 30 cases in the oral feeding group and 10 cases in the tube feeding group.The tube feeding group showed better improvement in WAZ [-1.06(-1.77, -0.88) vs.-2.25(-3.06, -1.47) ] and HAZ (-1.22±1.63 vs. -2.54±1.50) than the oral feeding group (all P<0.05).Clinical complications improved better in the tube feeding group than those in the oral feeding group.In the tube feeding group, significant differences in choking ( χ2=16.29, P=0.001) and vomiting ( χ2=6.81, P=0.013) were observed before and after nutritional intervention.There was a statistically significant difference in frequency of lower respiratory infections 3 and 6 months after nutritional intervention between the 2 groups (all P<0.05). Conclusions:Compared with oral feeding, tube feeding can effectively improve the clinical nutritional indicators and reduce the clinical complications and the risk of respiratory infections in CP children that meet the indications for tube feeding.

Objective:To discuss the clinical and genetic characteristics of neurodevelopmental disorder with or without early-onset generalized epilepsy (NEDEGE) caused by NBEA gene variation. Methods:The clinical and genetic records of a patient who was diagnosed with NEDEGE caused by NBEA gene variation at the Department of Neurology, Guangzhou Women and Children′s Medical Center in April 2024 were collected retrospectively. Using " NBEA or neurobeachin" "Autism spectrum disorders or ASD" "Epilepsy" "Neurodevelopmental disorders" as the keywords, relevant articles were searched at CNKI, Wanfang and PubMed databases from establishment of these databases to December 2024. Clinical and genetic features of NEDEGE were summarized in the combination of this case. Results:The proband, a 3 years old boy, was backward in development since childhood. He had autism spectrum disorder-like manifestations such as stereotyped behavior and poor eye contact. At the age of 2, he developed generalized seizures. The whole exome sequencing showed a de novo heterozygous variation of c.244CT(p.Gln82 *) in the NBEA gene (NM-001385012.1), and he was diagnosed with NEDEGE. A total of 10 articles (all in English) were retrieved, reporting 36 cases of NBEA gene related NEDEGE (including this case), 4 of whom coming from China. Twenty-four individuals suffered from mild to severe intellectual disability, and most were moderate.Twenty-eight patients had language delay, including 4 cases of complete loss of language function, and 24 patients had seizures, and 19 patients had autism or autima-like behavior problems. Conclusions:This case enriches the mutation spectrum of the NBEA gene, and the c.244CT is the first reported related variation in the Chinese population. The clinical symptoms of NEDEGE related to NBEA gene mutations are most pronounced in neurodevelopmental disorders, followed by seizures and autistic behavior.

Objective:To evaluate the effect of ultrasound-guided subserratus anterior plane block on postoperative analgesia in patients un-dergoing laparoscopic radical gastrectomy.Methods:Sixty patients who underwent elective laparoscopic radical gastrectomy were enrolled between May 2022 and October 2023 at Tianjin Medical University Cancer Institute&Hospital.Patients were assigned into two groups us-ing a random number table method:the control(group C)and the ultrasound-guided serratus anterior plane block(SAPB)(group S).Patient-controlled intravenous analgesia(PCIA)was administered at the end of the surgery.After surgery,visual analogue scale(VAS)of static pain scores was evaluated at 1,6,12,24,and 48 hours.PCIA pump was started at the VAS pain score≥4 after surgery,and sufentanil 0.1μg/kg was intravenously injected when the efficacy was inadequate.The requirement for PCIA use,time to first postoperative anal exhaust,first postoperative out-of-bed activity,first oral intake,and the duration of hospitalization stay were recorded for the two groups.Results:VAS scores were significantly lower at postoperative 1,6,and 12 h in group S than in group C(P<0.05).Additionally,the number of effective uses of PCIA,and rescue analgesia were significantly lower in group S[(6.1±0.4)(2)]than in group C[(18.6±1.4)(17)](P<0.001).The time to first postoperative anal exhaust,first postoperative out-of-bed activity,first oral intake,and duration of hospital stay were shortened in group S than in group C(P<0.05).There were no significant differences in other parameters between these two groups.Conclusion:Ultrasound-guided SAPB can reduce postoperative pain and facilitate fast recovery in laparoscopic radical gastrectomy patients.

Objective:To evaluate the effect of ultrasound-guided internal branch of superior laryngeal nerve(ibSLN) block on the quality of anesthesia recovery in the patients undergoing intracranial tumor surgery.Methods:The data from patients of either gender, aged 18-65 yr, with a body mass index of 18-28 kg/m 2, who underwent intracranial tumor surgery from December 2022 to October 2023, were retrospectively collected. Patients were divided into control group (group C) and ultrasound-guided ibSLN block group (group U). Bilateral ibSLN block was performed with 0.375% ropivacaine hydrochloride 2 ml.The tracheal extubation time, emergence time, development of cardiovascular events within 15 min after extubation, emergence agitation, Ramsay sedation score, Steward recovery score, visual analogue scale scores at 10 min after extubation and development of postoperative sore throat and hoarseness in postanesthesia care unit were recorded. Results:Compared with group C, the incidence of emergence agitation, Ramsay sedation score, visual analogue scale scores and sore throat were significantly decreased, the incidence of hoarseness was increased ( P<0.05), and no significant change was found in the extubation time, emergence time and Steward recovery score in group U( P>0.05). No hypertension, hypotension, tachachycardia and bradycardia were found in two groups. Conclusions:Ultrasound-guided ibSLN block can improve the quality of anesthesia recovery in the patients undergoing intracranial tumor surgery.

ObjectiveTo analyze the epidemic intensity and characteristics of influenza in Changzhou City， Jiangsu Province from 2019 to 2023， and to provide scientific evidence for the formulation of influenza prevention and control strategies. MethodsThe surveillance data of influenza surveillance sentinel hospitals in Changzhou City from April 2019 to March 2023 were collected through the China influenza surveillance information system. Influenza-like illness （ILI） cases before and after the pandemic of COVID-19 in Changzhou City were analyzed， and the differences among qualitative data were compared by using χ^² test. ResultsFrom April 2019 to March 2023 the percentages of ILI cases’ medical visits in the four-influenza surveillance year were 2.57%， 1.84%， 5.38%， and 3.66%， respectively， and the positive detection rates of influenza virus were 25.71%， 0.44%， 22.78%， and 24.32%， respectively. The number of influenza outbreaks was 61， 1， 23， and 128， respectively. ILI cases were mainly among adolescent children aged 5‒14 years. The percentage of ILI cases in 2020‒2021 after the pandemic of COVID-19 was significantly lower than that in 2019‒2020 （χ²=737.342， P<0.001）， and the percentage of ILI cases in 2021‒2023 was higher than that in 2019‒2020. Influenza viruses in 2019‒2021 were dominated by type B Victoria， and influenza A virus was the dominant strain in positive influenza virus detections in 2022‒2023. The number of influenza outbreaks in 2021‒2023 was significantly lower than that in 2019‒2020 （χ²=185.662， P<0.001）. ConclusionThe epidemiological characteristics of influenza are different in different stages of COVID-19 prevention and control during 2019‒2023. In the dynamic clearance phase of COVID-19， ILI case’s medical visits showed low-level fluctuations without obvious seasonal fluctuations， and influenza virus was dominated by type B. In the high-intensity phase of the pandemic， the level of ILI case’s medical visits has reached the peak of the calendar year， and the positive detection of influenza virus was dominated by type A H3N2. In the "Category B B control" phase， the level of ILI case’s medical visits increased after a rapid decline， and the positive detection of influenza virus was dominated by type A H1N1. It is necessary to further strengthen the monitoring of influenza cases， pay close attention to the changes in influenza strains， actively promote influenza vaccination for key population group， and promote health behavior changes for the whole population.

Objective:To explore the application of analogical thinking combined with situational teaching method to create a happy learning situation in ophthalmic nursing practice teaching.Methods:A total of 90 nursing students who had practice in Department of Ophthalmology, Xijing Hospital, Air Force Medical University, from October 2020 to January 2022 were selected as the research objects. According to different teaching methods, they were divided into control group and observation group. The control group ( n=45) adopted conventional teaching, while the observation group ( n=45) adopted analogical thinking combined with situational teaching method. The two groups of nursing students were evaluated by comprehensive examination results, teaching effect questionnaire and students' overall satisfaction with their teachers. SPSS 22.0 was used for t-test and Chi-square test. Results:The test scores of theoretical knowledge [(85.39±1.57) vs. (84.41±1.34)] and nursing skills [(87.52±0.04) vs. (82.64±0.05)] of observation group were both higher than those of control group. In the observation group, the students' awareness of medication safety, professional interest and independent learning, cooperation and organization ability, independent thinking and independent learning ability, the purpose of multi-disciplinary knowledge integration, information and knowledge range improvement, clinical thinking communication ability enhancement, flexible application of theoretical knowledge, practical operation ability enhancement, and the cultivation of innovation consciousness were all improved. And all the scores were better than those of the control group. The satisfaction of teachers in the observation group on students' learning attitude, language expression, calling communication ability and independent problem-solving ability was higher than that in the control group ( P < 0.05). Conclusion:The combination of analogical thinking and the situational teaching method to create a happy learning situation can improve the average scores of nursing students and nursing skills, and significantly improve the satisfaction of students to the teachers.