Objective To develop an assessment scale for post-intensive care syndrome in pediatrics(PICS-p)and evaluate its reliability and validity,aiming to provide a scientifically sound and feasible tool for clinical assessment.Methods Based on the PICS-p conceptual framework,combined with literature review,semi-structured interviews,and Delphi expert consultation,a preliminary scale was developed.From June to December 2023,a survey was conducted among 330 pediatric patients who were discharged from a tertiary children's hospital in Hangzhou,followed by a two-week retest with 30 children to assess the reliability and validity of the scale.Results Finally 304 children completed the survey.The Post-Intensive Care Syndrome Scale for Children consists of 4 dimensions of physical dysfunction,cognitive dysfunction,psychological dysfunction and social dysfunction,with a total of 29 entries,with a cumulative variance contribution of 61.705％.The content validity index for individual items ranged from 0.800 to 1.000,and the content validity index for the scale as a whole was 0.98.The dimensions of the scale showed positive correlations with the Functional Status Scale(r=0.438-0.581,P＜0.001).The overall Cronbach's α coefficient of the scale was 0.847;the split-half reliability was 0.868;the test-retest reliability was 0.832.Conclusion The scale demonstrates good reliability and validity,and it is suitable for assessing the severity of PICS-p in pediatric patients discharged from the PICU.

Objective: The impact of prophylactic salpingectomy on the prevention of epithelial ovarian cancer (EOC) remains unclear, particularly in Asian populations where data is lacking. In this systematic review and meta-analysis study, we sought to assess whether prophylactic salpingectomy could reduce the incidence of ovarian cancer in the general population of multiple ethnicities. Methods: A systematic review and meta-analysis were conducted using PubMed/MEDLINE, EMBASE, the Cochrane Library, and Web of Science to assess the effectiveness of salpingectomy, bilateral salpingectomy (BS), and unilateral salpingectomy (US) in reducing the risk of EOC and evaluating postoperative outcomes. Results: The final analyses included 6 eligible trials (5,747,056 patients), including 1 cohort study and 5 case-control studies. The analyses of these studies demonstrated that women who underwent salpingectomy had a significantly reduced risk of EOC compared to those who did not receive salpingectomy (odds ratio [OR]=0.63; 95% confidence interval [CI]=0.45–0.89; p=0.007). Five studies (5,746,469 patients) indicated a significant reduction in EOC risk among patients who underwent BS (OR=0.48; 95% CI=0.33–0.69; p<0.001).On the other hand, in the analysis of 4 studies (5,745,887 patients) that examined US, the association with EOC risk was not significant despite the protective trend (OR=0.82; 95% CI=0.64–1.06; p=0.12). Conclusion Our results indicate BS is an effective strategy for reducing the risk of sporadic EOC, but the results did not lead to the same conclusion for patients who underwent US. When a candidate or patient is undergoing a hysterectomy or has other benign diseases, prophylactic BS may be a safe surgical procedure that carries future benefits in terms of EOC risk.

Objective: The impact of prophylactic salpingectomy on the prevention of epithelial ovarian cancer (EOC) remains unclear, particularly in Asian populations where data is lacking. In this systematic review and meta-analysis study, we sought to assess whether prophylactic salpingectomy could reduce the incidence of ovarian cancer in the general population of multiple ethnicities. Methods: A systematic review and meta-analysis were conducted using PubMed/MEDLINE, EMBASE, the Cochrane Library, and Web of Science to assess the effectiveness of salpingectomy, bilateral salpingectomy (BS), and unilateral salpingectomy (US) in reducing the risk of EOC and evaluating postoperative outcomes. Results: The final analyses included 6 eligible trials (5,747,056 patients), including 1 cohort study and 5 case-control studies. The analyses of these studies demonstrated that women who underwent salpingectomy had a significantly reduced risk of EOC compared to those who did not receive salpingectomy (odds ratio [OR]=0.63; 95% confidence interval [CI]=0.45–0.89; p=0.007). Five studies (5,746,469 patients) indicated a significant reduction in EOC risk among patients who underwent BS (OR=0.48; 95% CI=0.33–0.69; p<0.001).On the other hand, in the analysis of 4 studies (5,745,887 patients) that examined US, the association with EOC risk was not significant despite the protective trend (OR=0.82; 95% CI=0.64–1.06; p=0.12). Conclusion Our results indicate BS is an effective strategy for reducing the risk of sporadic EOC, but the results did not lead to the same conclusion for patients who underwent US. When a candidate or patient is undergoing a hysterectomy or has other benign diseases, prophylactic BS may be a safe surgical procedure that carries future benefits in terms of EOC risk.

Objective: The impact of prophylactic salpingectomy on the prevention of epithelial ovarian cancer (EOC) remains unclear, particularly in Asian populations where data is lacking. In this systematic review and meta-analysis study, we sought to assess whether prophylactic salpingectomy could reduce the incidence of ovarian cancer in the general population of multiple ethnicities. Methods: A systematic review and meta-analysis were conducted using PubMed/MEDLINE, EMBASE, the Cochrane Library, and Web of Science to assess the effectiveness of salpingectomy, bilateral salpingectomy (BS), and unilateral salpingectomy (US) in reducing the risk of EOC and evaluating postoperative outcomes. Results: The final analyses included 6 eligible trials (5,747,056 patients), including 1 cohort study and 5 case-control studies. The analyses of these studies demonstrated that women who underwent salpingectomy had a significantly reduced risk of EOC compared to those who did not receive salpingectomy (odds ratio [OR]=0.63; 95% confidence interval [CI]=0.45–0.89; p=0.007). Five studies (5,746,469 patients) indicated a significant reduction in EOC risk among patients who underwent BS (OR=0.48; 95% CI=0.33–0.69; p<0.001).On the other hand, in the analysis of 4 studies (5,745,887 patients) that examined US, the association with EOC risk was not significant despite the protective trend (OR=0.82; 95% CI=0.64–1.06; p=0.12). Conclusion Our results indicate BS is an effective strategy for reducing the risk of sporadic EOC, but the results did not lead to the same conclusion for patients who underwent US. When a candidate or patient is undergoing a hysterectomy or has other benign diseases, prophylactic BS may be a safe surgical procedure that carries future benefits in terms of EOC risk.

Objective To develop an assessment scale for post-intensive care syndrome in pediatrics(PICS-p)and evaluate its reliability and validity,aiming to provide a scientifically sound and feasible tool for clinical assessment.Methods Based on the PICS-p conceptual framework,combined with literature review,semi-structured interviews,and Delphi expert consultation,a preliminary scale was developed.From June to December 2023,a survey was conducted among 330 pediatric patients who were discharged from a tertiary children's hospital in Hangzhou,followed by a two-week retest with 30 children to assess the reliability and validity of the scale.Results Finally 304 children completed the survey.The Post-Intensive Care Syndrome Scale for Children consists of 4 dimensions of physical dysfunction,cognitive dysfunction,psychological dysfunction and social dysfunction,with a total of 29 entries,with a cumulative variance contribution of 61.705％.The content validity index for individual items ranged from 0.800 to 1.000,and the content validity index for the scale as a whole was 0.98.The dimensions of the scale showed positive correlations with the Functional Status Scale(r=0.438-0.581,P＜0.001).The overall Cronbach's α coefficient of the scale was 0.847;the split-half reliability was 0.868;the test-retest reliability was 0.832.Conclusion The scale demonstrates good reliability and validity,and it is suitable for assessing the severity of PICS-p in pediatric patients discharged from the PICU.

Objective:To assess the effects of intervention measures on the quality control of health examination institutions in Dalian City.Methods:This cross-sectional study encompassed a comprehensive evaluation of 40 physical examination institutions in Dalian City. Interrupted time series analysis was employed to examine the changes in level and slope of processing rates for significant abnormal health examination results, chief inspection physician qualification rates, and completion rates of basic health examination items before (January 2020 to July 2021) and after (August 2021 to July 2022) intervention. An interrupted time series analysis diagram was generated.Results:After the implementation of intervention measures, the processing rate of significant abnormal results in public physical examination institutions reached 93.52%, while the qualification rate of chief inspection physicians was as high as 98.86%. And completion rate of basic health examination items was 93.86%. The rates of handling important abnormal results in health check-ups at private healthcare institutions before intervention, 1 month after intervention, and long-term intervention showed an upward trend of 1.374%, 0.229%, and 0.664%, respectively ( t=8.61, 12.21, and 108.61, all P<0.05). The qualification rate of chief inspection physicians in public physical examination institutions exhibited an increase of 0.227% and 0.155% before and after the intervention respectively ( t=6.74 and 617.67, all P<0.05). The completion rates of basic health check-up items in public healthcare institutions showed an upward trend before intervention, 1 month after intervention, and long-term intervention, with a rate of 0.446%, 0.067%, and 0.745%, respectively ( t=24.95, 3.25, 138.80, all P<0.05). Conclusions:The implementation of quality control intervention measures for health check-ups has significantly improved the quality control of health examination institutions in Dalian City.

Objective: To observe the efficacy of acupuncture combined with naloxone hydrochloride in the treatment of coma after surgery for cerebral hemorrhage and to explore its possible mechanism of action. Methods: Seventy-two patients were divided into a control group and an observation group according to the random number table method, with 36 cases in each group. The control group was treated with intravenous naloxone hydrochloride, and the observation group received additional acupuncture treatment. After 1 month of treatment, the awakening rate, Glasgow coma scale (GCS) score, cerebral edema volume, mean velocity (Vm) of the middle cerebral artery, and cerebrospinal fluid Caspase-3, and macrophage migration inhibitory factor (MIF) levels were compared between the two groups. Results: During the study, there were 2 cases of shedding in the control group and 34 remaining valid cases; 1 case of shedding in the observation group and 35 remaining valid cases. After treatment, the awakening rate was higher in the observation group than in the control group (P<0.05); the GCS score increased in both groups compared with that before treatment (P<0.05), and was higher in the observation group than in the control group (P<0.05); the volume of cerebral edema decreased in both groups (P<0.05), and was smaller in the observation group than in the control group (P<0.05); the middle cerebral artery Vm increased in both groups (P<0.05), and was higher in the observation group than in the control group (P<0.05); the cerebrospinal fluid Caspase-3 and MIF levels decreased significantly in both groups (P<0.05) and were lower in the observation group than in the control group (P<0.05). Conclusion: Acupuncture combined with naloxone hydrochloride for the treatment of coma after surgery for cerebral hemorrhage can promote patients' awakening, improve the degree of coma, reduce the volume of cerebral edema, and enhance cerebral blood flow velocity, producing a better effect than naloxone hydrochloride used alone; it may be related to its reduction of cerebrospinal fluid Caspase-3 and MIF levels.

Objective:This study was performed to investigate the feasibility of preservation of internal branch of superior laryngeal nerve(ibSLN) during transoral endoscopic surgery for hypopharyngeal squamous cancer(HSCC) and the influence on patient′s swallowing function after operation.Methods:From May 2020 to June 2021, the data of 29 HSCC patients who required for transoral endoscopic surgery in the Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital of Central South University were prospectively included, and the included patients were divided into two groups randomly by lottery. According to whether ibSLN was actively dissected during operation, they were divided into ibSLN preservation group ( n=15) and control group ( n=14, without ibSLN preservation). Operation time, intraoperative hemorrhage, intraoperative neck dissection, postoperative radiotherapy, postoperative recurrence within 1 year, retention and swallowing function, the recovery of oral soft diet and the quality of life were compared between two groups. SPSS 25.0 software was used for statistical analysis. Results:The study included 29 eligible patients, including 25 males and 4 females.The age ranged from 42 to 67 (56.07±5.93) years. There were no significant differences( P>0.05) between 2 groups in the following data,including age( t=-0.56), gender( χ2=0.01), TNM stage(T stage χ2=0.29, N stage χ2=0.02), pathological diagnosis( χ2=0.03), preoperative swallowing function( χ2=0.00) and M. D. Anderson Dysphagia Inventory(MDADI) score(global t=0.55, emotional t=0.16, functional t=0.60, physical t=0.64), operation time( t=1.62) and intraoperative hemorrhage( t=-1.46), intraoperative neck dissection( χ2=0.01), postoperative radiotherapy( χ2=0.32), postoperative recurrence within 1 year( P>0.050). The swallowing function was evaluated by water swallowing test after operation. The swallowing function of ibSLN preservation group was better than control group, and the difference between two groups was statistically significant on the 1st ( χ2=4.44, P=0.035), 5th ( χ2=4.24, P=0.039) and 7th ( χ2=4.55, P=0.033) day after operation. On the 14th day after operation, the MDADI scores of patients in the ibSLN preservation group were higher than those in the control group in global ( t=2.45, P=0.021), functional ( t=2.54, P=0.017) and physical ( t=2.24, P=0.034) dimensions, except for emotional dimension ( t=1.89, P=0.070). The median time of oral soft diet( U=23.00, P<0.001), normal oral diet( U=21.00, P<0.001) and the nasogastric tube removal time ( U=18.50, P<0.001) in ibSLN preservation group was 2 days, 5 days and 6 days respectively, earlier than that in control group, which had statistically significant difference. Conclusion:Our results show that it is feasible to preserve the ibSLN during HSCC transoral endoscopic surgery, which can achieve rapid recovery of postoperative swallowing function.

Objective: To investigate blood pressure and vascular remodeling of OSAS by establishing the chronic-intermittent hypoxia model in rat. Methods: Experiments were performed on 35 adult male Sprague-Dawley rats. Animals were randomly divided into four groups: unhandled control group (with 5 rats in it), CIH group at 9/6/3 weeks (with 10 ratsin each group). Rats in CIH group went through 8-hour intermittent hypoxia everyday, and those in control group were raising normally. After 9-week experiment, blood pressure was measured. The changes of the following indexes were observed: pathological changes of aorta and the middle aorta thickness (HE staining), the collagen of aorta wall (Masson staining). The experimental data were analyzed by SPSS 24.0 statistical software. The variance was analyzed by one-way analysis of variance, and the irregularity was selected using the calibration t test. Results: The systolic and diastolic blood pressures of the CIH9, 6, and 3 weeks groups and the control group were: (127±13) and (79±9), (124±11) and (81±7), (101±11) and (75±9), (91±10) and (65±9) mmHg (1 mmHg=0.133 kPa). The systolic blood pressure and diastolic blood pressure of the rats in the week of CIH 9 and 6 weeks were significantly higher than the control group (F=14.64, P=0.000; F=6.81, P=0.000). There was no significant difference in the mean blood pressure between the three groups of CIH and the control group. Membrane thickness in CIH9, 6 and 3 weeks and control group were: (20±2), (19±2), (14±2), (13±3) μm. Compared with the control group, the aortic pathology and thickness of the middle layer of the CIH9 and 6 weeks group were significantly thicker (F=20.24, P=0.000), but there was no significant difference between the CIH3 week group and the control group; the collagen deposition was unchanged compared with the control group. Conclusion Intermittent hypoxia for 6 weeks or more in rats resulted in the increasement of blood pressure, morphological changes of aorta and vascular remodeling in thickened media.

Objective To explore the characteristics of social behaviors in toddlers with high-risk of autism spectrum disorder (HR-ASD),and the correlation to the severity of ASD symptoms.Method 32 high-risk ASD toddlers,aged from 12 months to 24 months,and 34 typical developmental (TD) infants/toddlers,aged from 6 months to 24 months,were recruited.Behavioral video of the Still-Face Paradigm (SFP) was used to measure the frequencies and duration of social behaviors,including non-social smiling,protest,eye contact,social smiling and social positive engagement,during the mother-infant interaction and the still face.Autism Diagnostic Observation Scale was used to evaluate severity of clinical symptoms in high-risk ASD toddler.Gesell Development Scale was used to assess the developmental level of the two groups.Independent-sample t test was used to compare the differences of social behaviors between two groups.Pearson correlation analysis was used to analyze the correlation between the social behaviors of high-risk ASD and the age,the developmental level and the severity of ASD symptoms.Binary logistic regression was used to analyze the power of discrimination of social behaviors between HR-ASD and TD.Results During mother-infant interaction,compared with TD group,HR-ASD had significantly shorter duration ((19.8±23.4) s vs.(61.5±34.0) s,t=-5.75,P＜0.01;(6.5±9.3) s vs.(29.0±25.2) s,t=-4.73,P＜0.01;(3.0±8.8) s vs.(13.2±23.1) s,t=-2.34,P=0.02) and lower frequencies (t=-6.62、-3.03、-2.74,all P＜0.01) of eye contact,social smiling and social positive engagement.During the still face,compared with TD group,HR-ASD had significantly shorter duration (t=-3.32,P＜0.01;t=-2.59,P=0.01) and lower frequencies (t=-6.13、-3.48,all P＜0.01) of eye contact and social positive engagement.According to Pearson correlation analysis,during the still face,in HR-ASD group,the duration of eye contact and social positive engagement had significantly negative influence on the score of the language and communication in ADOS (r=-0.49、-0.52,all P＜0.01);The duration and frequencies of eye contact and social positive engagement had significantly negative influence on the score of mutually social interaction in ADOS (r=-0.57,P＜0.01;r=-0.49,P＜0.01;r=-0.74,P＜0.01;r=-0.44,P=0.01);The duration of eye contact and social positive engagement had significantly negative influence on the score of the playing in ADOS (r=-0.43,P=0.01;r=-0.45,P=0.01).According to binary logistic regression,the duration of social smiling during the still face and the frequencies of eye contact during mother-infant interaction could distinguish between HR-ASD and TD (OR=1.36,95％CI:1.08-1.71,P=0.01;OR=5.99,95％CI:1.15-31.14,P=0.03).Conclusion HR-ASD hasthe lower levels of eye contact,social smiling and social positive engagement,which may suggestthe severity of ASD core symptoms.The duration of social smiling during the still face and the frequencies of eye contact during mother-infant interaction may possiblyfigure out theHR-ASD and could be further developed as a predictablebehavioral maker.