Objective To organize a nationwide interlaboratory comparison for measurement of gross α and gross β radioactivity in water, and improve the laboratory analysis of gross α and gross β radioactivity in water. Methods A unified comparison protocol was developed by the organizers. The groundwater with high natural radioactivity was used as water sample and distributed randomly to the participating laboratories. The participating laboratories used routine analytical methods to measure the samples and provided information such as analytical results, original records, and test reports. The results were evaluated using z-score. Results A total of 76 laboratories participated in the comparison, all employing the evaporation concentration-α/β counting method. Among them, 69 laboratories achieved |z| ≤ 2 for both gross α and gross β radioactivity measurements, and 32 laboratories achieved |z| ≤ 0.50 for both gross α and gross β radioactivity measurements. There were 69 laboratories with qualified results and 30 laboratories with excellent results, yielding a qualified rate of 90.8% and an excellent rate of 39.5%. Seven laboratories showed unqualified results and the unqualified rate was 9.2%. Conclusion Most laboratories have the ability to analyze gross α and gross β radioactivity in water. The main reasons for the deviation in comparison results are calibration efficiency, errors in the total residue mass caused by improper water sample processing operations. By analyzing the main technical problems existed in unqualified laboratories, their ability for measurement of gross α and gross β radioactivity in water has been improved.

Objective:To explore the prognostic value of the age-adjusted Charlson comorbidity index (ACCI) in patients with stage IIB cervical squamous cell carcinoma (CSCC) who received radical concurrent chemoradiotherapy (rCCRT).Methods:Clinical data of 115 patients with stage IIB CSCC who underwent rCCRT at the First Affiliated Hospital of Xinxiang Medical University from January 2017 to January 2023 were retrospectively analyzed. Fourteen clinical factors, including ACCI, were assessed. Univariate and multivariate Cox regression analyses were performed to identify the independent prognostic factors for progression-free survival (PFS) and overall survival (OS). The optimal cut-off value for ACCI was determined using the receiver operating characteristic (ROC) curve analysis, and patients were divided into the high ACCI (ACCI > 3) and low ACCI (ACCI ≤ 3) groups. Survival differences between two groups were evaluated using Kaplan-Meier curves and compared by log-rank tests.Results:Multivariate Cox regression analysis revealed that ACCI was an independent prognostic factor for both PFS and OS ( HR=3.405, 95% CI: 1.108-10.467, P=0.032; HR=4.732, 95% CI: 1.363-16.425, P=0.014). Significant differences were observed in PFS and OS between the high and low ACCI groups ( P=0.023 and 0.003, respectively). The median PFS was 44 months in the high ACCI group and 56 months in the low ACCI group. The 2-year and 3-year PFS rates were 81.9% and 80.1% in the high ACCI group, and 94.4% and 94.4% in the low ACCI group, respectively. The median OS was 46 months in the high ACCI group and 56 months in the low ACCI group. The 2-year and 3-year OS rates were 88.3% and 84.7% in the high ACCI group, and 94.4% and 94.4% in the low ACCI group, respectively. Conclusions:For patients with stage IIB CSCC receiving rCCRT, ACCI is an independent and significant prognostic factor, with patients in the high ACCI group exhibiting worse prognosis.

Objective To explore the clinical application of needle-embedding therapy for preventing and treating postoperative constipation in the patients with thoracolumbar vertebral fractures based on the theory of"preventing illness".Methods Eighty patients meeting the criteria for postoperative constipation af-ter thoracolumbar vertebral surgery in a tertiary hospital of Hangzhou City from January 2023 to February 2024 were selected as the study subjects.The patients were divided into the control group and experimental group by using the random number table method,40 cases in each group.The control group adopted the treat-ment of orally taking lactulose oral solution and the nursing such as routine postoperative food and drink and bed defecation training.The experimental group was given the needle-embedding therapy on the basis of rou-tine care.The gastrointestinal syndrome rating scale(GSRS)score,intra-abdominal pressure(IAP),abdomi-nal circumference,defecation and exhausting situation before and after intervention were performed the statis-tics and compared between the two groups.Results At 36,72 h after oeperation,the GSRS score,IAP and ab-dominal circumference in the both groups were significantly declined or decreased compared with those imme-diately after the operation,the above indicators in the experimental group were superior to those in the control group,and the differences were statistically significant(P＜0.01).The first exhausting and defecation time of the experimental group was earlier than that of the control group,and the difference was statistically signifi-cant(P＜0.01).Conclusion Under the basis of"preventing illness",the needing-embedding therapy has signif-icant therapeutic effects in preventing and treating postoperative constipation in thoracolumbar fractures,could effec-tively reduce IAP,alleviate the symptoms of constipation in the patients and improve their quality of life.

Objective:To explore the prognostic value of the age-adjusted Charlson comorbidity index (ACCI) in patients with stage IIB cervical squamous cell carcinoma (CSCC) who received radical concurrent chemoradiotherapy (rCCRT).Methods:Clinical data of 115 patients with stage IIB CSCC who underwent rCCRT at the First Affiliated Hospital of Xinxiang Medical University from January 2017 to January 2023 were retrospectively analyzed. Fourteen clinical factors, including ACCI, were assessed. Univariate and multivariate Cox regression analyses were performed to identify the independent prognostic factors for progression-free survival (PFS) and overall survival (OS). The optimal cut-off value for ACCI was determined using the receiver operating characteristic (ROC) curve analysis, and patients were divided into the high ACCI (ACCI > 3) and low ACCI (ACCI ≤ 3) groups. Survival differences between two groups were evaluated using Kaplan-Meier curves and compared by log-rank tests.Results:Multivariate Cox regression analysis revealed that ACCI was an independent prognostic factor for both PFS and OS ( HR=3.405, 95% CI: 1.108-10.467, P=0.032; HR=4.732, 95% CI: 1.363-16.425, P=0.014). Significant differences were observed in PFS and OS between the high and low ACCI groups ( P=0.023 and 0.003, respectively). The median PFS was 44 months in the high ACCI group and 56 months in the low ACCI group. The 2-year and 3-year PFS rates were 81.9% and 80.1% in the high ACCI group, and 94.4% and 94.4% in the low ACCI group, respectively. The median OS was 46 months in the high ACCI group and 56 months in the low ACCI group. The 2-year and 3-year OS rates were 88.3% and 84.7% in the high ACCI group, and 94.4% and 94.4% in the low ACCI group, respectively. Conclusions:For patients with stage IIB CSCC receiving rCCRT, ACCI is an independent and significant prognostic factor, with patients in the high ACCI group exhibiting worse prognosis.

To evaluate the safety and efficacy of oral double-balloon enteroscopy for small intestinal bezoars with obstruction, the clinical, endoscopic, imaging, pathological and surgical data of patients with small intestinal bezoars and obstruction treated in Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from December 2021 to March 2023 were retrospectively analyzed. A total of 5 patients, all female, aged 52-83 years, were included. The clinical manifestation was mainly digestive tract obstruction. The diameter of bezoars was 30-50 mm. Three were located in the jejunum, one in the proximal ileum, and one at the jejuno-ileal junction. Three cases were diagnosed as having small intestinal bezoars by imaging examination before operation. All 5 patients achieved technical success. Four patients achieved clinical success, the symptoms of obstruction were completely relieved, and 1 patient was partially relieved due to malignant obstruction. No obvious complication occurred in 5 patients after operation. The follow-up time was 15-790 days, and there was no recurrence. The results showed that oral double-balloon enteroscopy for small intestinal bezoars was safe and effective, providing a new treatment for patients with small intestinal bezoars except for surgery.

Objective To investigate the curative effect of traditional Chinese medicine fumigation com-bined with meibomain gland massage in the middle-aged and elderly patients with meibomain gland dysfunc-tion(MGD)dry eye syndrome.Methods Ninety patients with MGD visiting in the ophthalmology depart-ment of this hospital from November 1,2021 to October 31,2023 were selected as the study subjects and di-vided into the routine group,control group and observation group according to the random number table meth-od,30 cases in each group.The routine group used 0.3％Sodium Hyaluronate Eye Drops and simple mei-bomain gland massage.The control group was given the simple vapor fumigation combined with meibomain gland massage on the basis of the routine group.The observation group was given the Chinese medicine fumi-gation and washing combined with meibomain gland massage on the basis of the control group.The changes of OSDI score,tear secretion test(SIt),breakup time of tear film(BUT)and fluorescein eye surface staining be-fore treatment and in 1,4 weeks after treatment were compared among the three groups.Results The OSDI score,eyelid margin morphology score and scores of SIt,BUT and FL had the interaction in different groups and treatment time(P＜0.01),moreover the main effect was remarkable.Compared with before treatment,the OSDI score,eyelid margin morphology score and FL score in 1,4 weeks after treatment in the three groups were decreased,moreover the observation group was the lowest,while the SIt level and BUT were increased,moreover the observation group was the highest,and the differences were statistically significant(P＜0.05).Compared with the routine group,the effective rate in the control group and observation group was higher(83.33％vs.96.67％vs.76.67％),moreover the observation group was higher than the control group,and the differences were statistically significant(P＜0.05).Conclusion The traditional Chinese medicine fumiga-tion combined with meibomian gland massage could significantly improve the ocular symptoms and improve-ment of tear secretion level in the patients with MGD dry eye.

Objective To investigate the effects of Shengjiyuhong ointment on coagulation system,endothelial progenitor cells(EPCs)differentiation and Rho kinase activity in rats with thromboangiitis obliterans by inhibiting autophagy.Methods The rat model of thromboangiitis obliterans was established by injecting sodium laurate solution into the left lower limb artery.40 SD rats were randomly divided into sham operation group,model group,compound sodium aescinate gel group and Shengjiyuhong ointment group,10 per group.The pathological morphology of vascular tissue was detected by HE staining.The expression of autophagy related proteins was detected by Western blot,coagulation system parameters were detected by coagulation detector,EPCs differentiation was detected by flow cytometry,and Rho kinase activity was detected by immunohistochemistry.Results The expression of autophagy marker protein LC3Ⅱ/I,Beclin1,Rho kinase protein,the positive expression rate of CD34 in fibrinogen and EPCs of Shengjiyuhong ointment group were decreased,and the positive expression rate of serum prothrombin time,international normalized ratio,von Willebrand factor in EPCs and the expression of P62 in vascular tissue were increased(P＜0.05).The in vitro experiment showed that Shengjiyuhong ointment could reduce the expression of LC3Ⅱ/I and Beclin1,and increase the expression of P62 protein in injured endothelial cells(P＜0.05).Conclusion Shengjiyuhong ointment can effectively improve the coagulation function,promote the differentiation of EPCs and reduce the activity of Rho kinase in rats with thromboangIItis obliterans.The mechanism may be related to inhibition of autophagy.

Surgical position is very important in upper urinary calculi surgery.The correct surgical position can provide a good surgical field of view,shorten the operation time,reduce the incidence of complications,and ensure the safety of patients'airway and comfort.Endoscopic surgery is the preferred treatment for kidney and ureteral stones.As the traditional position causes higher recurrence rate and more complications,more positions have been experimented.This article reviews the application and therapeutic effects of different surgical positions in percutaneous nephrolithotomy(PCNL),retrograde intrarenal flexible ureteroscopic lithotripsy(RIRS)as well as their combined use,and summarizes the advantages and disadvantages for clinical reference.

Objective: To investigate the status of insomnia, Internet addiction, and depressive symptoms among medical students and to analyze the effect of Internet addiction on insomnia and the mediating role of depressive symptoms, in order to provide a basis for the development of targeted interventions and measurements for medical students. Methods: A stratified whole group sampling method was used to select full-time college students from three medical universities in Anhui Province. The Chinese version of Insomnia Severity Index (ISI), Internet Addiction Test (IAT) scale and 9-item Patient Health Questionnaire (PHQ-9) were used to evaluate the symptoms of insomnia, Internet addiction and depressive in students. A multivariate Logistic regression analysis was used to explore the factors influencing insomnia among medical students and to analyze the relationship between insomnia with Internet addiction and depressive symptoms, respectively. Results: The overall rate of Internet addiction was 49.5%, depressive symptoms was 39.5%, insomnia was 18.6%. High academic stress, and the presence of surrounding people diagnosed with COVID-19 were associated with a higher risk of insomnia ( P <0.05). The higher the level of Internet addiction (mild, OR =2.60; moderate/severe, OR =4.21) and depression. (mild, OR =6.35; moderate/severe, OR =19.32), the higher the risk of insomnia. Mediated effect analysis showed that Internet addiction had a direct predictive effect ( β =0.02, P <0.05) on insomnia and also indirectly affected insomnia through depression (indirect effect=0.07，95% CI =0.06-0.08). Conclusion The detected rates of insomnia, Internet addiction and depressive symptoms are high among medical students in Anhui Province, and Internet addiction and depressive symptoms are risk factors for insomnia, which should be given more attention and appropriate interventions when necessary to improve their physical and mental health.

Clinical data of 26 patients with proton pump inhibitor dependent gastroesophageal reflux disease (GERD) who underwent anti-reflux mucosectomy (ARMS) in Nanjing Drum Tower Hospital from July 2017 to December 2020 were reviewed, and the GERD questionnaire (GERD-Q) score, the short-form reflux-qual (RQS) score, esophageal motility and 24 h esophageal pH parameters before and after ARMS were compared. With a median follow-up period of 18.4 months (6-27 months), 23 (88.5%) patients reported symptomatic improvement and 15 (57.7%) patients discontinued the use of proton pump inhibitors. After ARMS, the mean scores of GERD-Q (6.23 VS 13.19, P=0.004) and RQS (26.67 VS 10.98, P<0.001) were significantly improved, the mean DeMeester score (10.69 VS 53.15, P<0.001), the mean acid exposure time percentage (3.56% VS 9.92%, P<0.001) and the mean number of acid reflux episodes (36.9 VS 139.9, P=0.001) were lower, and the mean rest pressure at lower esophageal sphincter (LES) (25.19 mmHg VS 13.63 mmHg, P<0.001) and the mean distal contractile integral (1 819.15 mmHg·s·cm VS 1 007.67 mmHg·s·cm, P<0.001) were significantly increased compared with those before surgery. ARMS has significant short-term efficacy in the treatment of proton pump inhibitor dependent GERD, which can effectively improve reflux symptoms and life quality of patients, and strengthen the rest pressure of LES and peristalsis of the esophageal body.