Objective:To analyze the effects of low-molecular-weight heparin combined with insulin (LMWH+INS) and double filtration plasmapheresis (DFPP) on lipid profiles and clinical outcomes in patients with hypertriglyceridemic acute pancreatitis (HTG-AP) based on propensity score matching.Methods:The clinical data of 126 patients with HTG-AP from October 2022 to February 2024 in The Third Affiliated Hospital of Nanjing Medical University, Changzhou Traditional Chinese Medicine Hospital Affiliated to Nanjing Traditional Chinese Medicine University and Changzhou First People's Hospital were retrospectively included. Patients were divided into LMWH+INS group ( n=87) and DFPP group ( n=39) according to the treatment. Propensity score matching was applied at a 1∶1 ratio. The repeated measures analysis of variance was conducted to assess dynamic changes of blood lipids within the 5 days of admission between the LMWH+INS and DFPP groups after matching. Clinical symptoms and outcomes were compared between the two matched groups following matching. Results:29 patients were included in both LMWH+INS group and DFPP group after propensity score matching. No statistically significant differences were observed in triglycerides (TG), acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) score, or bedside index for the severity of acute pancreatitis (BISAP) between the two groups (all P value >0.05), indicating comparability. Repeated measures analysis of variance revealed that TG and TC levels in the DFPP group were significantly lower than those in the LMWH+INS group at 2-5 days after admission [TG 2 d: (5.26±2.59) mmol/L vs (10.79±3.81) mmol/L, 3 d: (3.35±1.01) mmol/L vs (7.72±3.64) mmol/L, 4 d: (3.45±0.77) mmol/L vs (6.57±3.17) mmol/L, 5 d: (3.73±1.26) mmol/L vs (5.61±3.07) mmol/L; TC 2 d: (4.83±2.29) mmol/L vs (8.2±2.82) mmol/L, 3 d: (4.23±2.17) mmol/L vs (7.71±2.68) mmol/L, 4 d: (4.28±1.59) mmol/L vs (7.55±2.41) mmol/L, 5 d: (4.1±1.21) mmol/L vs (7.84±2.6) mmol/L], with a more rapid decrease. LDL levels in the LMWH+INS and DFPP groups showed similar trends, with significant decreases at 2 day after admission [(5.41±3.24) mmol/L vs (2.96±1.47) mmol/L, (4.99±3.51) mmol/L vs (2.47±1.53) mmol/L]. The differences mentioned above are all statistically significant (all P value <0.001). No significant changes were observed in HDL levels in either LMWH+INS and DFPP groups at 2-5 days after admission. After matching, the DFPP group had a significantly longer time of resuming feeding [3(2, 3) days vs 4(3, 6) days] and higher hospital cost [12113.87 (9055.31, 14401.84) yuan vs 28025.34 (25388.11, 36335.48) yuan] compared with the LMWH+INS group, with statistically significant differences. Conclusions:DFPP could reduce TG and TC levels more rapidly and effectively than LMWH combined with INS, but does not show an advantage in improving clinical outcomes and reducing hospitalization costs.

To formulate an expert consensus on the principles of preoperative hair removal and provide scientific guidance for standardized removal of hair before surgical procedures so as to reduce the incidence of surgical site infections.METHODS Led by the Hospital Management Institute of National Health Commission of the People's Republic of China,this consensus was reached with the joint efforts from the expects of relevant fields such as surgeries,interventional therapies,nursing,and infection prevention and control.The consensus facilitates the classification and evaluation of literatures by following the evidence grade formulated by Oxford Evidence-based Medicine Center and focuses on the association of preoperative hair removal with surgical site infection,it reaches the evidence grade of expert consensus and recommendation intensity by integrating with discussions on meetings and clinical experience of the expects from relevant fields.RESULTS A total of 6 items of consensus were reached by summarizing the latest evidence on the aspects including the indications for preoperative hair removal,tools,range,timing and places.CONCLUSION The consensus,to some extent,make supplements to and complete the exiting regulations and standards.It provides guidance for the medical institutions to carry out the preoperative hair removal.

To formulate an expert consensus on the principles of preoperative hair removal and provide scientific guidance for standardized removal of hair before surgical procedures so as to reduce the incidence of surgical site infections.METHODS Led by the Hospital Management Institute of National Health Commission of the People's Republic of China,this consensus was reached with the joint efforts from the expects of relevant fields such as surgeries,interventional therapies,nursing,and infection prevention and control.The consensus facilitates the classification and evaluation of literatures by following the evidence grade formulated by Oxford Evidence-based Medicine Center and focuses on the association of preoperative hair removal with surgical site infection,it reaches the evidence grade of expert consensus and recommendation intensity by integrating with discussions on meetings and clinical experience of the expects from relevant fields.RESULTS A total of 6 items of consensus were reached by summarizing the latest evidence on the aspects including the indications for preoperative hair removal,tools,range,timing and places.CONCLUSION The consensus,to some extent,make supplements to and complete the exiting regulations and standards.It provides guidance for the medical institutions to carry out the preoperative hair removal.

Objective:To analyze the effects of low-molecular-weight heparin combined with insulin (LMWH+INS) and double filtration plasmapheresis (DFPP) on lipid profiles and clinical outcomes in patients with hypertriglyceridemic acute pancreatitis (HTG-AP) based on propensity score matching.Methods:The clinical data of 126 patients with HTG-AP from October 2022 to February 2024 in The Third Affiliated Hospital of Nanjing Medical University, Changzhou Traditional Chinese Medicine Hospital Affiliated to Nanjing Traditional Chinese Medicine University and Changzhou First People's Hospital were retrospectively included. Patients were divided into LMWH+INS group ( n=87) and DFPP group ( n=39) according to the treatment. Propensity score matching was applied at a 1∶1 ratio. The repeated measures analysis of variance was conducted to assess dynamic changes of blood lipids within the 5 days of admission between the LMWH+INS and DFPP groups after matching. Clinical symptoms and outcomes were compared between the two matched groups following matching. Results:29 patients were included in both LMWH+INS group and DFPP group after propensity score matching. No statistically significant differences were observed in triglycerides (TG), acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) score, or bedside index for the severity of acute pancreatitis (BISAP) between the two groups (all P value >0.05), indicating comparability. Repeated measures analysis of variance revealed that TG and TC levels in the DFPP group were significantly lower than those in the LMWH+INS group at 2-5 days after admission [TG 2 d: (5.26±2.59) mmol/L vs (10.79±3.81) mmol/L, 3 d: (3.35±1.01) mmol/L vs (7.72±3.64) mmol/L, 4 d: (3.45±0.77) mmol/L vs (6.57±3.17) mmol/L, 5 d: (3.73±1.26) mmol/L vs (5.61±3.07) mmol/L; TC 2 d: (4.83±2.29) mmol/L vs (8.2±2.82) mmol/L, 3 d: (4.23±2.17) mmol/L vs (7.71±2.68) mmol/L, 4 d: (4.28±1.59) mmol/L vs (7.55±2.41) mmol/L, 5 d: (4.1±1.21) mmol/L vs (7.84±2.6) mmol/L], with a more rapid decrease. LDL levels in the LMWH+INS and DFPP groups showed similar trends, with significant decreases at 2 day after admission [(5.41±3.24) mmol/L vs (2.96±1.47) mmol/L, (4.99±3.51) mmol/L vs (2.47±1.53) mmol/L]. The differences mentioned above are all statistically significant (all P value <0.001). No significant changes were observed in HDL levels in either LMWH+INS and DFPP groups at 2-5 days after admission. After matching, the DFPP group had a significantly longer time of resuming feeding [3(2, 3) days vs 4(3, 6) days] and higher hospital cost [12113.87 (9055.31, 14401.84) yuan vs 28025.34 (25388.11, 36335.48) yuan] compared with the LMWH+INS group, with statistically significant differences. Conclusions:DFPP could reduce TG and TC levels more rapidly and effectively than LMWH combined with INS, but does not show an advantage in improving clinical outcomes and reducing hospitalization costs.

Objective:To investigate the teaching activity based on an online radiological teaching case library that integrates various teaching models including problem-based learning (PBL), case-based learning (CBL), flipped classroom, and microclass, as well as its application effect in standardized residency training in department of radiology.Methods:A total of 65 physicians who completed standardized residency training in Department of Radiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, from 2016 to 2022 were enrolled as subjects and were divided into control group with 32 physicians and experimental group with 33 physicians. The physicians in the control group received traditional teaching, and those in the experimental group received blended teaching with PBL, CBL, flipped classroom, and microclass based on a teaching case library. The two groups were compared in terms of the test scores of clinical thinking and decision making at the end of the course and their assessment and feedback for the teaching method. SPSS 22.0 was used to perform the t-test and the chi-square test. Results:For the assessment of clinical thinking and decision making, compared with the control group, the experimental group had significantly higher score of objective essay questions (49.83±1.27 vs. 48.74±1.64, P<0.05), score of subjective essay questions (39.57±1.75 vs. 36.02±1.81, P<0.05), and total score (89.40±1.54 vs. 84.76±1.93, P<0.05). The experimental group had significantly better assessment and feedback for the teaching method than the control group ( P<0.05). Conclusions:For physicians participating in standardized residency training, the blended teaching model based on teaching case library that integrates PBL, CBL, flipped classroom, and microclass can effectively improve the test scores of clinical thinking and decision making, stimulate their learning initiative and participation enthusiasm in medical imaging, and enhance their comprehensive ability for clinical diagnosis.

Objective:To design an intelligent measurement program of detection parameters of quality control of imaging system of multi-slice spiral computed tomography (MSCT) based on MATLAB software platform,so as to achieve intelligent detection for quality control of MSCT imaging system. Methods:We designed an intelligent measurement program for the detection parameters of quality control of MSCT imaging system (referred to as the intelligent measurement program) bases on the function of graphical user interfaces (GUI) of MATLAB software. A series of algorithms such as image reading,binarization,and circular detection based on the Hough transform were employed to conduct automatic measurement and calculation for CT values (water),noise and uniformity of the parameters of MSCT quality control. The Intraclass Correlation Coefficient (ICC) was adopted to analyze the consistency of the detection results between the manual measurement method and the designed intelligent detection program. Results:The designed intelligent measurement program in this study can automatically assess the detection parameters of quality control of the MSCT imaging system,which included CT values (water),noise and uniformity. There was favorable consistency in the detection results between the manual measurement method and the intelligent measurement program (range of ICC values was from 0.881 to 0.985). Conclusion:The intelligent measurement program of detection parameters of quality control of MSCT imaging system can simplify the process of calculating detection parameters of quality control of MSCT imaging system,and provide a reliable detection tool for quality control of MSCT imaging equipment,which can effectively improve the detection efficiency of quality control.

Objective:To design an intelligent measurement program of detection parameters of quality control of imaging system of multi-slice spiral computed tomography (MSCT) based on MATLAB software platform,so as to achieve intelligent detection for quality control of MSCT imaging system. Methods:We designed an intelligent measurement program for the detection parameters of quality control of MSCT imaging system (referred to as the intelligent measurement program) bases on the function of graphical user interfaces (GUI) of MATLAB software. A series of algorithms such as image reading,binarization,and circular detection based on the Hough transform were employed to conduct automatic measurement and calculation for CT values (water),noise and uniformity of the parameters of MSCT quality control. The Intraclass Correlation Coefficient (ICC) was adopted to analyze the consistency of the detection results between the manual measurement method and the designed intelligent detection program. Results:The designed intelligent measurement program in this study can automatically assess the detection parameters of quality control of the MSCT imaging system,which included CT values (water),noise and uniformity. There was favorable consistency in the detection results between the manual measurement method and the intelligent measurement program (range of ICC values was from 0.881 to 0.985). Conclusion:The intelligent measurement program of detection parameters of quality control of MSCT imaging system can simplify the process of calculating detection parameters of quality control of MSCT imaging system,and provide a reliable detection tool for quality control of MSCT imaging equipment,which can effectively improve the detection efficiency of quality control.

Abstract As a common public health problem in society, it can seriously affect sleep, and lead to sleep structure disorder, sleep pattern changes, and sleep disturbance. Poor sleep can adversely affect the normal development of physiological, psychological, cognitive, and behavioral functions, and reduce quality of life. On the basis of summarizing the definition, classification, and epidemic status of child abuse, this paper summarizes the sleep characteristics and influencing factors of childhood abuse victims. It aims to provide a scientific basis for developing prevention and intervention measures to address sleep problems among childhood abuse victims, so as to improve sleep quality, and promote their physical and mental health.

Adverse childhood experience (ACE) is potentially negative experience that occurs between 0 and 18 years old. The ACE adolescents have prominent mental health problems such as emotional regulation disorder, unstable interpersonal relationship, poor coping ability, and cognitive dysfunction. Until now, the factors affecting the mental health of ACE adolescents are not clear, but it is certain that the ecosystem in which ACE adolescents life affects their mental health. Specifically, the parent-child relationship, the school environment, the peer relationship in the micro-system, and the interaction between the parent-child relationship and other interpersonal relationship in the meso-system have been confirmed to be significantly related to the mental health of ACE adolescents. In the appearance system, the neighborhood cohesion, the level of family income, the educational level of parents and the different social and cultural background in the macro-system all have different degrees of impact on the development of ACE adolescents' psychological behaviors. In the diachronic system, the time and frequency of suffering from ACE have different effects on the mental health regarding the ACE adolescents.
Adolescent ; Adverse Childhood Experiences ; Child ; Child, Preschool ; Ecosystem ; Health Status ; Humans ; Infant ; Infant, Newborn ; Mental Health ; Parents

Our previous studies found that mitochondrial uncouplers CCCP and niclosamide inhibited artery constriction and the mechanism involved AMPK activation in vascular smooth muscle cells. BAM15 is a novel type of mitochondrial uncoupler. The aim of the present study is to identify the vasoactivity of BAM15 and characterize the BAM15-induced AMPK activation in vascular smooth muscle cells (A10 cells). BAM15 relaxed phenylephrine (PE)-induced constricted rat mesenteric arteries with intact and denuded endothelium. Pretreatment with BAM15 inhibited PE-induced constriction of rat mesenteric arteries with intact and denuded endothelium. BAM15, CCCP, and niclosamide had the comparable IC value of vasorelaxation in PE-induced constriction of rat mesenteric arteries. BAM15 was less cytotoxic in A10 cells compared with CCCP and niclosamide. BAM15 depolarized mitochondrial membrane potential, induced mitochondrial fission, increased mitochondrial ROS production, and increased mitochondrial oxygen consumption rate in A10 cells. BAM15 potently activated AMPK in A10 cells and the efficacy of BAM15 was stronger than that of CCCP, niclosamide, and AMPK positive activators metformin and AICAR. In conclusion, BAM15 activates AMPK in vascular smooth muscle cells with higher potency than that of CCCP, niclosamide and the known AMPK activators metformin and AICAR. The present work indicates that BAM15 is a potent AMPK activator.