Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.

Inflammatory bowel disease(IBD)is a non-specific chronic inflammatory bowel condition.Crohn's disease(CD)and ulcerative colitis(UC)are the 2 main types of IBD.IBD is prone to recurrent attacks,which is associated with many factors,such as immune dysfunction,intestinal microenvironment homeostasis imbalance,and environmental and genetic factors;however,its specific pathogenesis is still unclear.Zebrafish has recently emerged as an emerging animal model and have been used extensively for mechanistic research into IBD,model construction,activity evaluation,and screening of anti-IBD agents,due to their unique biological advantages.Based on the latest research progress using zebrafish in the field of IBD,this review systematically introduces the intestinal development characteristics,tissue structure,intestinal immunity,IBD model,and the application of drug screening in zebrafish,to demonstrate the value of zebrafish in the study of IBD.

Inflammatory bowel disease(IBD)is a non-specific chronic inflammatory bowel condition.Crohn's disease(CD)and ulcerative colitis(UC)are the 2 main types of IBD.IBD is prone to recurrent attacks,which is associated with many factors,such as immune dysfunction,intestinal microenvironment homeostasis imbalance,and environmental and genetic factors;however,its specific pathogenesis is still unclear.Zebrafish has recently emerged as an emerging animal model and have been used extensively for mechanistic research into IBD,model construction,activity evaluation,and screening of anti-IBD agents,due to their unique biological advantages.Based on the latest research progress using zebrafish in the field of IBD,this review systematically introduces the intestinal development characteristics,tissue structure,intestinal immunity,IBD model,and the application of drug screening in zebrafish,to demonstrate the value of zebrafish in the study of IBD.

Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.

Objective To compare the efficacy of three different methods in the prevention of adhesion after the HEOS system for different degrees of intrauterine adhesions.Methods 284 patients with mild,moderate and severe intrauterine adhesions,who were treated with the HEOS system,were divided into three groups,the intrauterine device with sodium hyaluronate gel was placed in Group A,Foley water capsule tube with sodium hyaluronate gel was placed in Group B,and sodium hyaluronate gel was placed in Group C only.The recovery of uterine adhesion,improvement of menstruation,endometrial thickness,and adverse reactions were compared among the three groups.Results The mild intrauterine adhesions group showed statistical differences among the three groups(P<0.05).Group A had a higher menstrual improvement rate than Group C(P<0.017),and there was no significant difference in other therapeutic indicators(P>0.017).However,the adverse reaction rate in Group A was also higher than that in Group C(P<0.017).In the moderate intrauterine group,there was a significant difference in the improvement rate of intrauterine adhesions between Group B and the other two groups(P<0.017).Group A and B were higher than Group C in terms of menstrual status,endometrial thickness,and adverse reactions(P<0.017).In severe intrauterine adhesions,Group A had higher efficacy indicators than other groups(P<0.017).Conclusions The curative effect index and adverse reaction rate were analyzed,after operation.For the light,moderate,and severe intrauterine adhesions,sodium hyaluronate gel,Foley water capsule tube with sodium hyaluronate gel,and intrauterine device with sodium hyaluronate gel were the best choice for adhesion.Individual and hierarchical management can achieve good clinical effects,which is worth popularizing.

Objective:To analyze the correlation between homocysteine (Hcy), ferritin and gestational anemia in advanced age pregnant women, and the effect on adverse pregnancy outcomes.Methods:The clinical data of 344 advanced age pregnant women in Handan City Maternal and Child Health Hospital from March 2021 to June 2022 were retrospectively analyzed. The adverse pregnancy outcomes were followed up and recorded. The pregnant women were divided into anemia group (114 cases) and control group (230 cases) according to the diagnostic criteria for anemia. The levels of Hcy and ferritin, etc. were compared between two groups, different degrees of anemia and different pregnancy outcomes. Pearson method was used to analyze the correlation between Hcy, ferritin and hemoglobin. Multivariate Logistic regression was used to analyze the independent risk factors of adverse pregnancy outcomes in advanced age pregnant women with gestational anemia.Results:The Hcy in anemia group was significantly higher than that in control group: (31.39 ± 3.34) mol/L vs. (9.28 ± 1.44) mol/L, the ferritin was significantly lower than that in control group: (69.81 ± 5.08) μg/L vs. (96.43 ± 7.52) μg/L, and there were statistical differences ( P<0.01). Among 114 advanced age pregnant women with gestational anemia, 64 cases were mild anemia (mild anemia group), 35 cases were moderate anemia (moderate anemia group), and 15 cases were severe anemia (severe anemia group). The levels of Hcy in the control group, mild anemia group, moderate anemia group and severe anemia group were gradually increased: (9.28 ± 1.44), (24.79 ± 3.25), (37.63 ± 5.51) and (45.01 ± 7.23) mol/L, the levels of ferritin were gradually decreased: (96.43 ± 7.52), (81.19 ± 5.14), (64.82 ± 4.47) and (32.96 ± 2.01) μg/L, and the difference between pairwise comparisons were statistically significant ( P<0.05). Pearson correlation analysis result showed that Hcy was negatively correlated with hemoglobin ( r = - 0.596, P<0.01), and ferritin was positively correlated with hemoglobin ( r = 0.685, P<0.01). Among 114 advanced age pregnant women with gestational anemia, 35 cases had adverse pregnancy outcomes, and 79 cases had normal pregnancy outcomes. The age, gestational reproductive tract infection rate and Hcy in advanced age pregnant women with adverse pregnancy outcomes were significantly higher than those in advanced age pregnant women with normal pregnancy outcomes: (41.17 ± 3.74) years old vs. (38.25 ± 4.28) years old, 28.57% (10/35) vs. 10.13% (8/79) and (49.56 ± 4.12) mol/L vs. (23.34 ± 2.63) mol/L, the ferritin was significantly lower than that in advanced age pregnant women with normal pregnancy outcomes: (38.36 ± 3.08) μg/L vs. (83.74 ± 6.25) μg/L, and the degree of gestational anemia was more serious than that in advanced age pregnant women with normal pregnancy outcomes, and there were statistical differences ( P<0.01 or <0.05). Multivariate Logistic regression analysis result showed that age, gestational reproductive tract infection, Hcy, ferritin and the degree of gestational anemia were the independent risk factors of adverse pregnancy outcomes in advanced age pregnant women with gestational anemia ( OR = 1.570, 1.758, 1.865, 1.556 and 1.652; 95% CI 1.154 to 2.136, 1.181 to 2.617, 1.223 to 2.842, 1.100 to 2.201 and 1.175 to 2.323; P<0.01). Conclusions:The level of Hcy in advanced age pregnant women with gestational anemia is relatively higher, and the level of ferritin is relatively lower. The ferritin and Hcy levels are risk factors for adverse pregnancy outcomes in advanced age pregnant women with gestational anemia, and may be involved in the occurrence and development of gestational anemia in advanced age pregnant women.

Objective:To investigate the clinical characteristics of patients with keratoconus, and to explore the factors influencing keratoconus severity.Methods:A cross-sectional study was performed.A total of 908 patients (1 476 eyes) with primary keratoconus were enrolled in Henan Eye Hospital from January 2019 to December 2021.The medical history data of patients were collected by face-to-face questionnaire survey.Refractive parameters were measured by subjective optometry.Intraocular pressure (IOP) was measured by a non-contact tonometer, and corrected IOP was calculated by Dresden formula.Corneal topography parameters was obtained using Pentacam HR.The subgroup analysis of clinical characteristics of all patients was performed by age (<21 years, 21~<31 years, ≥31 years) and gender.Disease severity was graded based on steep keratometry (Ks), namely mild (Ks<48 D), moderate (48 D≤Ks<55 D) and severe (Ks≥55 D). The influencing factors of disease severity in keratoconus were analyzed by ordered Logistic regression.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Henan Eye Hospital (No.HNEECKY-2019[5]). All subjects or guardians were informed of the purpose and significance of the study and written informed consent was obtained.Results:Of the 908 patients, 622 were with bilateral keratoconus and 286 were with unilateral keratoconus.The median age of onset was 20(17, 26) years, and the median age of diagnosis was 21(18, 27) years.The ratio of males to females was 3.05∶1.There were 9.80%(89/908) of the patients having a history of allergy, 25.55%(232/908) having a history of other systemic diseases, and 1.98%(18/908) having a family history of keratoconus.Of the 1 476 affected eyes, 27.57%(407/1 476) were diagnosed as severe keratoconus, and 61.94%(568/917) had a history of eye rubbing.The medians of sphericity, cylindricity, IOP, corrected IOP, Ks, thinnest corneal thickness (TCT), anterior corneal surface elevation (AE) and posterior corneal surface elevation (PE) were -4.00(-7.00, -1.75)D, -3.50(-6.00, -1.50)D, 12.00(10.30, 13.80)mmHg, 15.40(13.60, 17.00)mmHg, 49.85(46.40, 54.90)D, 460.00(425.00, 490.00)μm, 21.00(13.00, 34.75)μm, 51.00(33.00, 75.00)μm, respectively.The spherical refraction, IOP and corrected IOP were lower and the cylindrical refraction was higher in patients at age <21 years than in patients at age 21~<31 years, and the TCT of patients at age <21 years was higher than that at age ≥31 years, and the differences were statistically significant (all at P<0.05). Compared with female patients, male patients had younger onset age, lower spherical refraction, IOP and corrected IOP, as well as higher cylindrical refraction, AE and PE, showing statistically significant differences (all at P<0.05). The spherical refraction and IOP of male patients were lower than those of female patients at age <21 years, and the cylindrical refraction was higher in males than in females among the patients at age 21~<31 years, and the differences were statistically significant (both at P<0.05). Among the patients with onset age <21 years and diagnosis age <21 years, the ratio of males to females in patients with severe keratoconus was higher than those with mild and moderate disease, and the difference was statistically significant (both at P<0.05). Older age of onset was a protective factor for disease severity in keratoconus (odds ratio=0.981, 95% confidence interval: 0.963~0.999). Conclusions:The younger the onset age of keratoconus patients, the more severe the disease.Among the patients with severe keratoconus, there were more male patients, and males have a younger onset age and severer conditions.It is suggested that early screening of keratoconus in children and adolescents should be strengthened in clinical work, and more active prevention and treatment measures should be taken for younger patients, especially males.

Objective::To build a reference fetal growth chart for the Chinese population based on fetal ultrasound measurements.Methods::This was a multicenter, population-based retrospective cohort study. Longitudinal ultrasound measurement data were collected from 24 hospitals in 18 provinces of China from 1 st September through 31 st October of 2019. The estimated fetal weight (EFW) was calculated based on head circumference, abdominal circumference, and femur length using Hadlock formula 3. Fetal growth curves were estimated using a two-level linear regression model with cubic splines. All participants were divided into two groups: the northern group ( n = 5829) and the southern group ( n = 3246) based on the geographical division of China and male fetus group ( n = 4775) and female fetus group ( n = 4300) based on fetal gender. The EFW was compared by fetal gender and geographical group. All statistical models were adjusted for maternal sociodemographic characteristics. Results::A total of 9075 participants with 31,700 ultrasound measurement records were included in this study. Male fetuses demonstrated significantly larger EFW compared to female ones starting at 16 weeks of gestation and extending to delivery (global test P < 0.01). The overall geographic difference in EFW was significant (global test P = 0.03), and week-specific comparisons showed that the northern group had a greater EFW starting at 15 weeks of gestation and extending to 29 weeks of gestation, although this difference did not extend to the time of delivery. The Z-score of EFW confirmed that our Chinese fetal growth charts differed from previously published standards. Conclusion::This study provides EFW and ultrasound biometric reference measurements for Chinese fetuses and reveals differences from other fetal growth charts. The chart is worth promoting in more regions of China but should be tested prudently before use.

Objective::To build a reference fetal growth chart for the Chinese population based on fetal ultrasound measurements.Methods::This was a multicenter, population-based retrospective cohort study. Longitudinal ultrasound measurement data were collected from 24 hospitals in 18 provinces of China from 1 st September through 31 st October of 2019. The estimated fetal weight (EFW) was calculated based on head circumference, abdominal circumference, and femur length using Hadlock formula 3. Fetal growth curves were estimated using a two-level linear regression model with cubic splines. All participants were divided into two groups: the northern group ( n = 5829) and the southern group ( n = 3246) based on the geographical division of China and male fetus group ( n = 4775) and female fetus group ( n = 4300) based on fetal gender. The EFW was compared by fetal gender and geographical group. All statistical models were adjusted for maternal sociodemographic characteristics. Results::A total of 9075 participants with 31,700 ultrasound measurement records were included in this study. Male fetuses demonstrated significantly larger EFW compared to female ones starting at 16 weeks of gestation and extending to delivery (global test P < 0.01). The overall geographic difference in EFW was significant (global test P = 0.03), and week-specific comparisons showed that the northern group had a greater EFW starting at 15 weeks of gestation and extending to 29 weeks of gestation, although this difference did not extend to the time of delivery. The Z-score of EFW confirmed that our Chinese fetal growth charts differed from previously published standards. Conclusion::This study provides EFW and ultrasound biometric reference measurements for Chinese fetuses and reveals differences from other fetal growth charts. The chart is worth promoting in more regions of China but should be tested prudently before use.

Premature infants are multisystem immature and more prone to extravasation injury of intravenous drugs than mature neonates. Extravasation injury will not only increase the pain of children, prolong hospital stay, increase medical expenses, but also cause limb dysfunction in children, and even leave them disabled. In view of the lack of professional guidelines and consensus on the treatment of extravasation injury in premature infants by intravenous treatment, clinical nurses have certain difficulties in the prevention and treatment of extravasation injury in premature infants. This article reviews the evaluation of risk factors, assessment and management for extravasation injury in premature infants, aiming to provide a practical basis for clinical practice and provide a reference for further development of prevention and treatment strategies.