Objective To assess the stability of the molluscicidal activity of the fermentation broth supernatant of Bacillus indicus F19, so as to provide insights into development of novel molluscicides derived from this isolate. Methods Healthy Oncomelania hupensis snails free from Schistosoma japonicum infections and acclimated in the laboratory for 7 days were selected. The fermentation broth supernatant of B. indicus F19 was prepared. For each treatment condition, four experimental groups and one control group were established, with 10 mL of the fermentation broth supernatant each group. O. hupensis snails were exposed to different pH values (3, 6, 9 and 12), temperatures (40, 60, 80 °C and 100 °C), and ultraviolet (UV) exposure durations (1, 2, 3 h and 4 h). Then, the supernatant was diluted with dechlorinated water to concentrations of 50%, 10%, and 5% (v/v), and 10 mL of each dilution solution was added to three separate tubes, with an equal volume of dechlorinated water as a blank control. Twenty O. hupensis snails were transferred to each tube, immersed for 48 h and 72 h, and collected for viability assessment using the shell-tapping method. The mortality of O. hupensis snails was calculated and compared among dilution groups and the blank control group to evaluate the molluscicidal activity of the fermentation broth supernatant of B. indicus F19. Results There was a significant difference in the mortality of O. hupensis snails immersed in 5% fermentation broth supernatants of B. indicus F19 for 48 h at various pH levels (χ² = 11.556, P < 0.05), and the mortality reduced to 13.33% (8/60) in the experimental groups at a pH value of 12, which was significantly lower than in the blank control group [33.33% (20/60)] (χ² = 6.708, P < 0.05). There was a significant difference in the mortality of O. hupensis snails immersed in 10% fermentation broth supernatants of B. indicus F19 for 72 h at various pH levels (χ² = 31.691, P < 0.001), and the mortality reduced to 71.67% (43/60) and 65.00% (39/60) in the experimental group at pH values of 9 and 12, which was significantly lower than in the blank control group [100.00% (60/60)] (χ² = 8.571 and 12.110, both P values < 0.01). The mortality of O. hupensis snails both reduced to 23.33% (14/60) following immersion in 5% fermentation broth supernatants of B. indicus F19 heated in a water bath at 80 °C and 100 °C for 48 h, which was lower than that of unheated O. hupensis snails [33.33% (20/60)] and snails heated in a water bath at 40 °C [35.00% (21/60)] and 60 °C [33.33% (20/60)], and there was no significant difference in the mortality of O. hupensis snails among groups (χ² = 3.898, P > 0.05). The mortality of O. hupensis snails was 68.33% (41/60), 66.67% (40/60), 65.00% (39/60), and 68.33% (41/60) following immersion in fermentation broth supernatants heated in a water bath at 40, 60, 80 °C and 100 °C for 72 h, which was all lower than that of snails in the control group [71.70% (43/60)]; however, there was no significant difference seen in the snail mortality among groups (χ² = 0.674, P > 0.05). The mortality of O. hupensis snails was 73.33% (44/60), 71.67% (43/60), 71.67% (43/60), and 75.00% (45/60) following 48 h immersion in 10% fermentation broth supernatants of B. indicus F19 irradiated by UV for 1, 2, 3 h and 4 h, 33.33% (20/60), 31.67% (19/60), 35.00% (21/60), and 33.33% (20/60) following 48 h immersion in 10% fermentation broth supernatants of B. indicus F19 irradiated by UV for 1, 2, 3 h and 4 h, and 71.67% (43/60) and 33.33% (20/60) following 48 h immersion in 10% fermentation broth supernatants of B. indicus F19 without UV irradiation, and no significant differences were found among groups (χ² = 0.229 and 0.150, both P values > 0.05). In addition, the mortality of O. hupensis snails was 76.67% (46/60), 71.67% (43/60), 70.00% (42/60), and 76.67% (46/60) following 72 h immersion in 5% fermentation broth supernatants of B. indicus F19 irradiated by UV for 1, 2, 3 h and 4 h, and 71.67% (43/60) in the control group, and there was no significant difference in the snail mortality among groups (χ² = 1.193, P > 0.05). Conclusion The molluscicidal action of the fermentation broth supernatants of B. indicus F19 is tolerant to high temperature and UV irradiation; however, the activity is attenuated under alkaline conditions.

Objective To make a comprehensive review about transitional care practice for patients receiving percutaneous transhepatic biliary drainage(PTBD)and to analyze the current transitional care contents and evaluation indexes so as to provide guidance for improving the quality of transitional care services for discharged patients carrying a PTBD tube.Methods A scoping review study design was used to conduct a computerized retrieval of academic papers concerning the transitional care practice for discharged patients carrying a PTBD tube from the databases of PubMed,WOS Core Collection,CINAHL,Embase,Cochrane Library,CNKI,VIP,Wanfang med online,and Sinomed.The retrieval time period was from the establishment of the database to August 20,2024.Two investigators independently screened the literature to determine the studies to be included and the relevant information to be extracted.Results A total of 18 papers were enrolled in this study.The transitional care ways included telephone follow-up,home visit,online platform follow-up,and outpatient clinic follow-up.The intervention contents extended from in-hospital to out-of-hospital for up to 6 months.The evaluation indexes focused on the patient's knowledge about PTBD tube,the incidence of tube-related complications,the satisfaction with care,self-care ability,etc.Conclusion At present,the transitional care for discharged patients carrying a PTBD tube has a variety of content elements,which can improve the self-care ability and quality of life of the discharged patients carrying a PTBD tube to a certain extent,although more individualized transitional care modes need to be further explored.The evaluation indexes are mainly the outcome assessment of PTBD tube care.It is necessary to strengthen the quality supervision of organizational structure and nursing process.

Clinical practice guideline adaptation(hereinafter referred to as"guideline adaptation")is the consolidation and revision of existing high-quality guidelines so that the recommendations are better suited to the specific needs of different regions,thereby guiding optimal clinical practice.Currently,the guideline adap-tations is increasing in number internationally,but their reporting quality still needs to be improved.In 2022,the RIGHT-Ad@pt guideline adaptation reporting checklist was released.It provides a detailed description of the guideline adaptation process and reporting content,which will significantly enhance the rigor,transparency,and standardization of guideline adaptations.This paper interprets and analyzes the 34 items on the checklist,with the aim of providing reference for guideline adapters to standardize the reporting process.

Clinical practice guideline adaptation (hereinafter referred to as "guideline adaptation") is the consolidation and revision of existing high-quality guidelines so that the recommendations are better suited to the specific needs of different regions, thereby guiding optimal clinical practice. Currently, the guideline adaptations is increasing in number internationally, but their reporting quality still needs to be improved. In 2022, the RIGHT-Ad@pt guideline adaptation reporting checklist was released. It provides a detailed description of the guideline adaptation process and reporting content, which will significantly enhance the rigor, transparency, and standardization of guideline adaptations. This paper interprets and analyzes the 34 items on the checklist, with the aim of providing reference for guideline adapters to standardize the reporting process.

Liver transplantation, the only effective treatment for end stage liver disease, is characterized by complicated surgery, long surgery time, and high trauma. Patients may experience a variety of difficulties following surgery, including infection, abdominal bleeding and rejection, all of which directly affect the quality of rehabilitation. Enhanced Recovery After Surgery (ERAS), a novel perioperative management strategy, can effectively promote postoperative recovery of patients and has been extensively implemented in various fields of surgery. However, there are no scientific and universal ERAS protocols in the fields of liver transplantation in China. The first Consensus Recommendations of Enhanced Recovery for Liver Transplantation was issued by the International Liver Transplantation Society in December 2022, offering recommendations about ERAS strategies for liver transplantation recipients who receive deceased and living organ donations, and for living donors of liver transplantation. This paper provides a detailed interpretation of the key points to offer a practical reference for domestic liver transplantation perioperative ERAS management.

Objective:To describe the prevalence of food allergy among children aged 0-5 years in China and to explore related influencing factors.Methods:Multistage stratified random sampling method was used to collect data from 275 surveillance sites of the China National Nutrition and Health Survey of Chinese children and lactating mothers programs in 31 provinces (autonomous regions and municipalities) of China in 2016-2017. A total of 70 107 participants aged 0-5 years were included in this study. The study collected information of participants' demographic characteristics and food allergies by face-to-face questionnaire. The prevalence of food allergy was analyzed, using the complex data weighting method. The logistic regression models were used to analyze the influencing factors related to food allergy.Results:The overall prevalence of self-reported food allergy among children aged 0-5 years was 4.81%. Prevalence rates in infants aged 0-5 months, and 6-23 months and preschool children aged 2-5 years were 0.81%, 4.68% and 5.26%, respectively. The results of logistic analysis showed that there was a significantly positive correlation between factors including children from 6 months to 5 years old, urban area, southwest area, first-born, mothers with college education or above, and the prevalence of food allergy in children. Shrimp, poultry eggs, crab shellfish, fruit, milk and fish appeared the common allergic foods in children aged 0-5 years, with prevalence rates of self-reported food allergy as 1.55%, 1.25%, 0.99%, 0.97%, 0.87% and 0.86%, respectively. The proportion of single food allergy in children with allergies was 69.85%.Conclusions:Among children aged 0-5 years, the prevalence of self-reported food allergy increases with age, in China. Foods that is prone to allergies include fish, shrimp, crab, shellfish, poultry eggs, milk and fruits, etc. Most allergies were only caused by single food in children, under observation.

Objective To explore the value of serum stearoyl sphingosine(C18∶1-Cer)and 1-stearoyl-sn-glycero-3-phospho-choline(LPC 18∶0)levels in pregnant women's serum samples during pregnancy in predicting gestational diabetes mellitus(GDM).Methods The clinical data and laboratory indicators of 126 pregnant women were retrospectively analyzed.The sub-jects were divided into GDM group(n=66)and control group(n=60)according to the GDM diagnosis results.Mass spec-trometry was used to detect the serum C18∶1-Cer and LPC18∶0 levels of the subjects in early and mid pregnancy.Logistic re-gression analysis was used to screen out the risk factors for GDM.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of C18∶1-Cer,LPC18∶0 and their combination for GDM.Results Compared with the control group,the serum C18∶1-Cer and LPC18∶0 levels of the subjects in the GDM group were significantly increased in early(18.92±2.77ng/ml vs 23.47±4.18ng/ml,41.32±17.55ng/ml vs 88.08±16.02ng/ml)and mid pregnancy(23.14±4.10ng/ml vs 18.76±4.05ng/ml,84.60±14.53ng/ml vs 40.50±17.79ng/ml),and the differences were statistically significant(t=7.127,15.637;-5.984,2.174,all P＜0.05)C18∶1-Cer was positively correlated with fasting plasma glucose(FPG),fasting plasma insulin(FPI),homeostasis model assessment of insulin resistance(HOMA-IR),glycated hemoglobin(HbA1c)and triglyceride(TG)(r=0.458,0.209,0.317,0.223,0.219,all P<0.05).LPC18.0 was positively correlated with FPG,FPI,HOMA-IR,HbA1c,total cholesterol(TC)and TG(r= 0.715,0.426,0.580,0.465,0.232,0.372,all P<0.05).Logistic regression analysis results showed that C18∶1-Cer[OR(95%CI):1.522(1.136～2.039),P<0.05]and LPC18:0[OR(95%CI):1.198(1.102～1.302),P<0.001]were independent risk factors for GDM.ROC curve analysis results showed that the area under the curve(AUC)of serum C18∶1-Cer,LPC18∶0 and the combination of the two indicators were 0.819,0.971 and 0.986,respectively.The predictive performance of the combination of the two indicators was better than that of the single detection.Conclusion Serum C18∶1-Cer and LPC18∶0 in early pregnancy were closely related to the occurrence of GDM.C18∶1-Cer combined with LPC 18∶0 has a certain predictive value for the early diagnosis of GDM.

Objective To detect the expression of long non-coding RNA (lncRNA) CCAT1 in human papillary thyroid cancer, and to observe the effect of CCAT1 down-regulation on the invasion and migration of human papillary thyroid cancer.Methods The expression of CCAT1 was detected in human normal thyroid Nthy-ori 3-1 cells and human papillary thyroid cancer TPC-1 cells.CCAT1 siRNA plasmid was transfected into TPC-1 cells.The effect of CCAT1 down-regulation on cell invasion and migration was observed by Transwell chamber assay and scratch test, and the expressions of BRAF, MUC15 and RKIP proteins were detected by Western blot.Results The level of CCAT1 in human papillary thyroid cancer TPC-1 cells was significantly higher than that in human normal thyroid Nthy-ori 3-1 cells.CCAT1 down-regulation significantly inhibited the invasion and migration of TPC-1 cells.The Transwell invasion assay revealed that the number of migrated TPC-1 cells in the CCAT1 down-regulation group was significantly lower than that in the control group.The scratch test showed an increased distance between cells in the CCAT1 down-regulation group compared to the control group, suggesting a reduced cell motility.The expressions of BRAF and MUC15 proteins were decreased in the CCAT1 down-regulation group, while that of RKIP protein was increased.Conclusions The expression of CCAT1 in papillary thyroid cancer cells is significantly higher than that in normal human thyroid cells.Down-regulation of CCAT1 in papillary thyroid cancer cells may inhibit the cell invasion and migration by regulating the expression of BRAF, MUC15 and RKIP proteins.

One of the effective methods to resolve the conflict between the ever-increasing medical demands and relatively limited medical resources is to improve the work efficiency of the medical institutions as well as to effectively control their operating cost through continuous reforms and improvements of the management modes in the medical industry.The Lean Management and Six Sigma Management theories which have been applied in manufacturing industry and service industry are now gradually being introduced to clinical medicine.This article systematically describes the Lean Management and Six Sigma Management theories and illustrates some examples of its application in health management renovation and the effects achieved.

Objective To evaluated the safety and clinical efficacy of CT-guided percutaneous radioactive 125I seeds implantation in treatment of spinal metastatic tumors.Methods Totally 20 cases (23 lesions) of spinal metastatic tumors with spinal compression and severe back pain were treated by CT-guided percutaneous 125I seeds implantation.Intractable pain and nerve function before and after therapy were evaluated.And the postoperative cumulative local tumors control rates and cumulative survival rates were calculated.Results The median follow-up period was 14 months (range 7-32months).There was no patient lost follow-up.And no severe complication occurred.Intractable pain significantly relieved one month after therapy.The neural retention rate of 12 patients with nerve function impairment was 85.00％ (17/20) and the neural function recovery rate was 30.00％ (6/20) three months after 125 I seeds'implantation.The local tumors control rates in 3-,6-,and 12-month were 100％,100％ and 90％,respectively.The survival rates in 6-and 12-month was 100％and 78.81％,respectively.Conclusion CT-guided percutaneous radioactive 125I seeds implantation for spinal metastatic tumors is safe and feasible.It can relief pain and improve neural function effectively.