Objective To investigate the feasibility,efficacy and safety of cold snare polypectomy(CSP)and endoscopic mucosal resection(EMR)in treatment of colonic adenoma in proximity to the orifice of appendix.Methods Clinical data of 41 cases of colonic adenoma in the orifice of appendix treated with CSP(CSP group)and 15 cases treated with EMR(EMR group)from January 2018 to January 2023 were collected.The clinicopathological features and outcomes were analyzed.The main outcome was postoperative complications,including bleeding,perforation and postoperative appendicitis,while the secondary outcome was the total resection rate,block resection rate and local recurrence rate.Results The operation time and treatment cost of CSP group were shorter than EMR group,and the differences were statistically significant(P<0.05).The diameter of applicable lesions in CSP group was smaller than that in EMR group,and the proportion of lesions with tubular adenoma was significantly higher than that in EMR group.There were no significant differences in the time of admission,intestinal preparation score,length of stay,lesion morphology and lesion type between the two groups(P>0.05).Perforation and postoperative appendicitis were not observed in both groups,and delayed postoperative hemorrhage occurred in 1 case in the CSP group,but it could heal itself after surgery without endoscopic intervention.The complete resection rate was 100.0%in both groups.The total removal rate of CSP group was 100.0%,which was significantly higher than that of EMR group(86.7%),and the difference was statistically significant(P<0.05).The local recurrence rate was 2.4%(1/41)in CSP group,and no local recurrence was observed in EMR group(0/15),with no statistical significance(P>0.05).Conclusion CSP and EMR are safe and effective in the treatment of colonic adenoma in proximity to the orifice of appendix,and they are trustworthy.Compared with EMR,CSP is more applied to small diameter tubular adenomas,which has the characteristics of economy and time saving,but at the same time there is the risk of recurrence.EMR obviously has a wider application range,but there is a disadvantage in price and time,and individual cases need to be segmented resection.

Objective:To explore the latent categories of nurses' perception of high-performance work systems (HPWS) through latent profile analysis and analyze the differences in characteristics and influencing factors among different categories.Methods:A convenience sampling method was used to select 3 450 clinical nurses from ClassⅡ、Ⅲ hospitals in 12 regions of China between June and July 2024. General information questionnaires, the Perceived High-Performance Work System Scale, and the Nurse Voice Behavior Scale were used for data collection. Latent profile analysis was conducted to analyze nurses' perception of HPWS, and multi-class logistic regression was used to examine the influencing factors for different categories.Results:A total of 3 450 questionnaires were collected, with 3 385 valid responses, yielding an effective response rate of 98.12%. Nurses' perception of HPWS had an average score of (70.46±12.21), which could be divided into three latent categories: low perception (17%, 559/3 385), moderate perception (42%, 1 433/3 385), and high perception (41%, 1 393/3 385). The multi-class logistic regression analysis showed that job nature, title, position, years of service, monthly income, health impact on work, work duration, and monthly night shifts were significant factors influencing nurses' perception of HPWS ( P<0.05) . Conclusions:There is heterogeneity in the nurses' perception of HPWS. Nursing managers should focus on nurses with low perception of HPWS and provide interventions and support based on the characteristics and influencing factors of each category to improve nurses' voice behaviors.

Objective To explore the clinical efficacy of different mucosal incision methods in endoscopic submucosal dissection(ESD)for the treatment of gastric submucosal tumors.Methods A retrospective analysis was conducted on the clinical data of 30 patients with gastric submucosal tumors treated with ESD from July 2022 to March 2024.They were divided into a circular group(n=15)and a longitudinal group(n=15)based on different mucosal incision methods.Then compare the pathological data,clinical efficacy,surgical outcomes,and complications between the two groups.Results There were no statistically significant differences between the two groups in length of hospital stay,hospitalization costs,lesion diameter,lesion location and lesion nature(P＞0.05).The surgical time of the longitudinal group was significantly shorter than that of the circular group,and the difference was statistically significant(P＜0.05);There was no statistical significant in the incidence of intraoperative complications in the longitudinal group and the circular group(P＞0.05);The complete resection rate of the longitudinal group was lower than that of the circular group,but the difference was not statistically significant(P＞0.05).Conclusion ESD treatment for gastric submucosal tumors is safe and effective,and the longitudinal incision can shorten the surgical time compared to the circular incision.Both methods have the characteristics of low incidence of complications and high complete resection rate,and are worthy of clinical application.

Objective:To explore the latent categories of nurses' perception of high-performance work systems (HPWS) through latent profile analysis and analyze the differences in characteristics and influencing factors among different categories.Methods:A convenience sampling method was used to select 3 450 clinical nurses from ClassⅡ、Ⅲ hospitals in 12 regions of China between June and July 2024. General information questionnaires, the Perceived High-Performance Work System Scale, and the Nurse Voice Behavior Scale were used for data collection. Latent profile analysis was conducted to analyze nurses' perception of HPWS, and multi-class logistic regression was used to examine the influencing factors for different categories.Results:A total of 3 450 questionnaires were collected, with 3 385 valid responses, yielding an effective response rate of 98.12%. Nurses' perception of HPWS had an average score of (70.46±12.21), which could be divided into three latent categories: low perception (17%, 559/3 385), moderate perception (42%, 1 433/3 385), and high perception (41%, 1 393/3 385). The multi-class logistic regression analysis showed that job nature, title, position, years of service, monthly income, health impact on work, work duration, and monthly night shifts were significant factors influencing nurses' perception of HPWS ( P<0.05) . Conclusions:There is heterogeneity in the nurses' perception of HPWS. Nursing managers should focus on nurses with low perception of HPWS and provide interventions and support based on the characteristics and influencing factors of each category to improve nurses' voice behaviors.

Objective To investigate the feasibility,efficacy and safety of cold snare polypectomy(CSP)and endoscopic mucosal resection(EMR)in treatment of colonic adenoma in proximity to the orifice of appendix.Methods Clinical data of 41 cases of colonic adenoma in the orifice of appendix treated with CSP(CSP group)and 15 cases treated with EMR(EMR group)from January 2018 to January 2023 were collected.The clinicopathological features and outcomes were analyzed.The main outcome was postoperative complications,including bleeding,perforation and postoperative appendicitis,while the secondary outcome was the total resection rate,block resection rate and local recurrence rate.Results The operation time and treatment cost of CSP group were shorter than EMR group,and the differences were statistically significant(P<0.05).The diameter of applicable lesions in CSP group was smaller than that in EMR group,and the proportion of lesions with tubular adenoma was significantly higher than that in EMR group.There were no significant differences in the time of admission,intestinal preparation score,length of stay,lesion morphology and lesion type between the two groups(P>0.05).Perforation and postoperative appendicitis were not observed in both groups,and delayed postoperative hemorrhage occurred in 1 case in the CSP group,but it could heal itself after surgery without endoscopic intervention.The complete resection rate was 100.0%in both groups.The total removal rate of CSP group was 100.0%,which was significantly higher than that of EMR group(86.7%),and the difference was statistically significant(P<0.05).The local recurrence rate was 2.4%(1/41)in CSP group,and no local recurrence was observed in EMR group(0/15),with no statistical significance(P>0.05).Conclusion CSP and EMR are safe and effective in the treatment of colonic adenoma in proximity to the orifice of appendix,and they are trustworthy.Compared with EMR,CSP is more applied to small diameter tubular adenomas,which has the characteristics of economy and time saving,but at the same time there is the risk of recurrence.EMR obviously has a wider application range,but there is a disadvantage in price and time,and individual cases need to be segmented resection.

Objective To explore the clinical efficacy of different mucosal incision methods in endoscopic submucosal dissection(ESD)for the treatment of gastric submucosal tumors.Methods A retrospective analysis was conducted on the clinical data of 30 patients with gastric submucosal tumors treated with ESD from July 2022 to March 2024.They were divided into a circular group(n=15)and a longitudinal group(n=15)based on different mucosal incision methods.Then compare the pathological data,clinical efficacy,surgical outcomes,and complications between the two groups.Results There were no statistically significant differences between the two groups in length of hospital stay,hospitalization costs,lesion diameter,lesion location and lesion nature(P＞0.05).The surgical time of the longitudinal group was significantly shorter than that of the circular group,and the difference was statistically significant(P＜0.05);There was no statistical significant in the incidence of intraoperative complications in the longitudinal group and the circular group(P＞0.05);The complete resection rate of the longitudinal group was lower than that of the circular group,but the difference was not statistically significant(P＞0.05).Conclusion ESD treatment for gastric submucosal tumors is safe and effective,and the longitudinal incision can shorten the surgical time compared to the circular incision.Both methods have the characteristics of low incidence of complications and high complete resection rate,and are worthy of clinical application.

Background:When colonic adenoma involves diverticulum,inflammation in the diverticulum will increase the risk of adenomatous dysplasia.Therefore,patients with colonic diverticulum adenoma are at a higher risk of colon cancer,and the adenoma needs to be resected to avoid poor outcome and improve prognosis.Aims:To explore the efficacy and safety of endoscopic mucosal resection(EMR)in treatment of colonic diverticulum adenoma.Methods:Fourteen consecutive cases of colonic adenoma near or involving a diverticulum treated by EMR from Jun.2018 to Jan.2022 at the First People's Hospital of Hangzhou Lin'an District were collected,and their clinical characteristics and outcomes were analyzed.The primary outcome was complications,including bleeding,perforation,and electrocoagulation syndrome,while the secondary outcomes were the en bloc resection rate,complete resection rate and local recurrence rate.Results:Among the 14 patients with colonic diverticulum adenoma,13 were type A(near a diverticulum)while 1 was type B(involving a diverticulum).The diameter of the lesion was(0.76±0.25)cm,and the operation time was(19.67±5.33)minutes.The main histological type was tubular adenoma,and the pathological results was intraepithelial neoplasia in most of the cases.Delayed hemorrhage was observed in 1 patient(7.1%),and electrocoagulation syndrome in 1 patient(7.1%).No perforation event occurred.The en bloc resection rate and complete resection rate were 100%.Ten patients accepted reexamination of colonoscopy within 1 year after surgery,and no local recurrence was found.Conclusions:EMR is safe and effective for treatment of colonic diverticulum adenoma.However,patients using antiplatelet drugs and adenoma involving both appendiceal orifice and diverticulum should be alert to postoperative complications.

Objective To investigate the prevalence of Helicobacter pylori(H.pylori)positivity in the urban areas of Chongqing and its relationship with age,season,and gender.Methods A total of 4,836 patients who underwent 14C-UBT testing at our hospital from April 2023 to March 2024 were selected.The detection rate of H.pylori and the infection status of H.pylori in different age groups,genders,and seasons were analyzed.Logistic regression analysis was performed on factors related to H.pylori infection identified in the univariate analysis.Results The positive detection rate of H.pylori in the 4,836 subjects was 29.3％,with a higher rate in males than in females,showing a statistically significant difference(P＜0.05).The highest positive detection rate of H.pylori was in the summer season,and the peak positivity rate for H.pylori was observed in the 30-39 age group.There was a statistically significant difference in the positive detection rate of H.pylori across seasons and among different age groups(P＜0.05).Multivariate logistic regression analysis indicated that gender,age,and season were all influential factors in the outcome of H.pylori infection(P＜0.05).Conclusion The prevalence of H.pylori infection in the urban areas of Chongqing is relatively low,and gender,age,and season are all influential factors for H.pylori infection.

Objective To investigate the effects of intrauterine perfusion with granulocyte colony-stimulating factor(G-CSF)on the endometrial thickness,volume,and blood flow parameters of patients with thin endometrium and their clinical outcomes.Methods We designed a prospective non-randomized synchronous controlled trial and recruited patients with thin endometrium who underwent frozen-thawed embryo transfer(FET)at Mianyang Central Hospital between September 1,2021 and September 1,2023.They were divided into two groups,an experimental group of patients who received the experimental treatment of intrauterine perfusion with G-CSF and a control group of patients who did not receive the experimental treatment.The general data and the clinical outcomes of the two groups were analyzed and compared.The endometrial thickness,volume and blood flow parameters of patients in the experimental group before and after intrauterine perfusion with G-CSF were analyzed.Results The clinical data of 83 patients were included in the study.The experimental group included 51 cases,while the control group included 31 cases.There were no significant differences in the baseline data between the two groups.The clinical pregnancy rate of the experimental group(56.86% )was higher than that of the control group(50.00% )and the rate of spontaneous abortion in the experimental group(27.59% )was lower than that in the control group(37.50% ),but the differences were not statistically significant(P>0.05).In the experimental group,the postperfusion endometrial thickness([0.67±0.1]cm)was greater than the preperfusion endometrial thickness([0.59±0.09]cm),the postperfusion([1.84±0.81]cm3)was greater than the preperfusion endometrial volume([1.54±0.69]cm3),and the postperfusion vascularization flow index(VFI)(1.97±2.82)was greater than the preperfusion VFI(0.99±1.04),with all the differences being statistically significant(P<0.05).Conclusion Intrauterine perfusion with G-CSF can enhance the endometrial thickness,volume,and some blood flow parameters in patients with thin endometrium.

Objective:To study the multi-locus sequence typing (MLST) gene characteristics of Brucella isolates in Guizhou Province. Methods:Brucella strains, which were isolated from 2017 to 2021 in Guizhou Province (preserved in the Bacterial and Viral Seed Bank of Guizhou Center for Disease Control and Prevention) were identified Brucella and species/types by BCSP31-PCR and AMOS-PCR methods, respectively. MLST method was used for genotyping, and Biometrics 8.0 software was used for cluster analysis of the typing results. Results:A total of 32 strains of Brucella were isolated in Guizhou Province and identified as Brucella melitensis ( B.melitensis) by BCSP31-PCR and AMOS-PCR methods. These strains were classified into 2 ST types (ST8 and ST39) by MLST method, with 28 strains of ST8 type(87.5%) and 4 strains of ST39 type (12.5%). The 28 strains of ST8 type were distributed in 7 cities (prefectures) of Guizhou Province, while the 4 strains of ST39 type were only found in Qianxinan Buyi and Miao Autonomous Prefecture. The cluster analysis results showed that ST8 and ST39 types strains were clustered in a group with the reference strain of B.melitensis, and there was only one nucleotide site difference between ST39 and ST8 types in the glk gene, indicating a close genetic relationship. Conclusions:B.melitensis is the main pathogen of the brucellosis epidemic in Guizhou Province in recent years. ST8 is the dominant MLST genotype in Guizhou Province.