Humanistic caring for patients in the operating room refers to providing the whole process of caring medical services for patients in the operating room. In order to standardize humanistic caring services for patients in the operating room of medical institutions, improve the comprehensive service level of the operating room, and enhance the surgical experience of patients, the Chinese Association for Life Care released the group standard " Humanistic Caring Management Standards for Patients in the Operating Room" in December 2023. This article interpreted the basic requirements for humanistic caring of patients in the operating room, the environment and facilities for humanistic caring, the procedures and measures for humanistic caring, and the quality management framework, aiming to assist administrators and clinical practitioners across various levels of medical institutions in accurately understanding and effectively implementing the standard, and to provide essential textual reference and practical guidance for promoting the application of the standard.

Objective:To investigate the application of 18F-FDG PET/MR and its derived parameters in the diagnosis and staging of bladder cancer. Methods:Forty patients (32 males, 8 females; age (66.8±11.2) years) with suspected bladder cancer between December 2019 and March 2022 were retrospectively included and underwent 18F-FDG PET/MR in Nanjing First Hospital. Parameters including SUV max, SUV mean, maximum tumor diameter and mean of apparent diffusion coefficient (ADC mean) were obtained, and bladder cancer muscle invasiveness and lymph node involvement were determined. The efficacy of 18F-FDG PET/MR and its derived parameters for tumor diagnosis and staging was analyzed using transurethral resection of bladder tumor (TUR-BT) or radical cystectomy (RC) and extended pelvic lymph node dissection (ePLND) histopathology as the " gold standard". Independent-sample t test, Mann-Whitney U test or χ2 test was used to analyze the data, and Delong test was used to compare different AUCs. Results:Of 40 patients, 8 were non-muscle invasive bladder cancer (NMIBC), 32 were muscle invasive bladder cancer (MIBC), and 5 were pathologically confirmed to have lymph node metastasis. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of 18F-FDG PET/MR for identifying MIBC were 96.9%(31/32), 7/8, 96.9%(31/32), 7/8, 95.0%(38/40), respectively, and those for lymph node metastasis were 4/5, 90.0%(18/20), 4/6, 18/19, 88.0%(22/25), respectively. For pathological tumor (pT) staging, significant differences were observed between pT2-3 and pT1 groups in maximum tumor diameter ( t=-2.37, P=0.024), SUV mean( Z=-2.11, P=0.035), and ADC mean( t=2.91, P=0.006). The AUCs of maximum tumor diameter, SUV mean and ADC mean in distinguishing MIBC were 0.781, 0.746, and 0.825, respectively. The sensitivity, specificity, PPV, NPV, and accuracy of MRI alone in identifying MIBC were 87.5%(28/32), 1/8, 80.0%(28/35), 1/5 and 72.5%(29/40), respectively, with the AUC of 0.500. The AUC of 18F-FDG PET/MR in identifying MIBC was 0.796, which was better than MRI alone ( Z=5.54, P<0.001), and the accuracy of PET/MR was also higher than MRI alone ( χ2=7.44, P=0.006). Conclusion:Compared with MRI alone, 18F-FDG PET/MR significantly improves the diagnostic efficacy of bladder cancer and the accuracy of pT staging.

Objective T o explore the correlation between adult chest CT quantitative parameters and traditional Chinese medicine(TCM)constitution classification in adult persons with different body mass index(BMI).Methods The basic information of 205 adult subjects in the hospital was collected,including gender,age,height,weight,BMI,etc.They were divided into the low body mass group(BMI＜18.5 kg/mi2),normal body mass group(BMI 18.5-＜24.0 kg/m2)and overweight/obese group(BMI≥24.0 kg/m2)according to BMI.All subjects underwent the TCM constitution classification.The distribution of TCM constitutions a-mong the three groups with different BMI was analyzed.The quantitative chest CT parameters were collected,including fat content,muscle content,area of the middle slice of the transverse section image,transverse diam-eter,anteroposterior diameter,scan length,etc.The differences were compared among different TCM constitu-tions,individual basic information and chest CT quantitative parameters.Results In the low BMI group,the Qi-stagnation constitution was the highest;in the BMI normal group,the gentler constitution was the highest,while in the overweight/obese group,the phlegm-damp constitution was the highest.The gender,age,height,weight and BMI had significant correlation with the TCM constitution(P＜0.05).The fat content,fat vol-ume,muscle volume,area of transverse section ROI(AROI),transverse diameter,anteroposterior diameter and scan length/transverse diameter had significant correlation with the TCM constitution(P＜0.05).The differ-ences in BMI and fat content had statistical difference among the phlegm-damp constitution,Qi-stagnation constitution and the other Chinese medicine constitutions(P＜0.01).The fat content,fat volume and muscle volume had significant correlation with BMI(P＜0.01).The muscle content had no significant correlation with BMI(P＞0.05).The muscle content,scan length and transverse diameter/anteroposterior diameter had no significant correlation with the TCM constitution(P＞0.05).Conclusion The distribution difference of TCM constitution in adult persons with different BMI has the statistical significance.The chest CT quantita-tive parameters are closely correlated with TCM constitution classification.

Objective To investigate the thyroid diseases in soldiers(aged 30 years and above)stationed on a certain island,and to clarify the value of ultrasonic diagnosis.Methods Thyroid ultrasonography was performed in 270 soldiers(aged≥30 years)stationed on an island by the high-frequency probe of the Mindray Z6 portable B-mode ultrasound diagnostic instrument.According to the C-TIRADS classification,the proportion of soldiers with thyroid nodules was calculated.Results Thyroid nodules were found in 50 soldiers(18.52%),including 29 cases(10.74%,cystic nodules)of C-TIRADS type 2,15 cases(5.56%,solid or cystic nodules)of C-TIRADS type 3,5 cases(1.85%,solid or cystic nodules)of C-TIRADS type 4a,and 1 case(0.37%,solid nodule)of C-TIRADS type 4b.Conclusion Thyroid ultrasound helps to analyze the causes of thyroid diseases,make grading assessment,and provide suggestions for soldiers stationed on islands.Not only does it clarify the necessity of thyroid ultrasonography in the physical examination,but also provides suggestions to improve the medical environment on islands.

Objective To evaluate the application of evidence-based perioperative patient-controlled analgesia(PCA)management in patients with liver cancer receiving transcatheter arterial chemoembolization(TACE)treatment.Methods By using the application model of clinical evidence-based practice,the review indicators were formulated based on the best evidence.The baseline assessment was conducted,the barrier factors were analyzed,the best clinical decision was made,the implementation steps of PCA management,including training,monitoring,education,etc.were refined,and two rounds of clinical review were carried out.The knowledge-belief-practice level and the implementation of review indicators in 50 medical and nursing staff engaged in PCA management,as well as the changes in pain scores,the incidence of adverse reactions due to PCA management,and the patient's satisfaction in 159 patients after the application of evidence were compared with their corresponding values determined before the application of evidence.Results After implementing the evidence-based practice plan and applying the evidence,at multiple time points the pain scores and the incidences of adverse reactions were decreased significantly(P＜0.05),the patient's satisfaction increased remarkably(P＜0.01),the execution rate of medical and nursing staff for the review indicators were strikingly increased(P＜0.01),and the knowledge-belief-practice level concerning PCA management was prominently improved(P＜0.01).Conclusion The implementation of perioperative PCA management in patients with liver cancer receiving TACE treatment can help to reduce the perioperative pain level,improve the patient discomfort,increase the patient's satisfaction degree,and improve the ability of medical staff in performing PCA management and evidence-based practices.

Objective:To compare and analyze the parameters of image quality of virtual mono-energetic images(VMIs)and conventional computed tomography(CT)images of dual-energy CT(DECT)imaging for the coracoclavicular ligament,and to optimize the image quality of DECT imaging for coracoclavicular ligament.Methods:The DECT image data of shoulder joints of 50 patients who received DECT scan in the First People's Hospital Affiliated to Shanghai Jiao Tong University were retrospectively analyzed.450 VMIs at energy levels of 40 to 120 keV were obtained through the Syngo.via VB20 workstation,and these VMIs were divided into three groups:low energy level(40,50,60 keV),medium energy level(70,80,90 keV),and high energy level(100,110,120 keV).The contrast-to-noise ratio(CNR),the direction of coracoclavicular ligament's rows,and the displayed subjective quality scores of attachment points of VMIs were compared with those of conventional CT images.The results of MRI examination were used as the"gold standard"to assess the effectiveness of VMIs in diagnosing coracoclavicular ligament injuries of patients with acromioclavicular joint dislocation.The diagnostic efficacies of VMIs'the three groups and conventional images were assessed by using receiver operating characteristic(ROC)curve.Results:The CNR values of diagonal ligament and conical ligament at 40 keV of low energy level group of VMIs for coracoclavicular ligament were respectively 14.09±3.27 and 13.9±3.06,and those of medium energy level group were respectively 11.89±4.01 and 12.17±4.08,and those of high energy level were respectively 9.69±4.25 and 9.78±4.33.The CNR value of low energy level group was significantly higher than that of medium and high energy level groups,and the differences were statistically significant(t=21.1,16.3,P<0.05),respectively.The results of ROC curve analysis indicated that the sensitivity,specificity and area under curve(AUC)value of the low energy level group were relatively higher in diagnosing coracoclavicular ligament injury,which were respectively 90.05%,91.95%and 0.965.There was high consistence in assessing coracoclavicular ligament injury between DECT's VMIs and MRI examination(Kappa=0.896).Conclusion:DECT's VMIs can better display the rows and attachment points of diagonal ligament and conical ligament,and the VMIs quality at low energy level(40 to 70 keV)is the best,which has better diagnostic efficacy in diagnosing coracoclavicular ligament injury.

Objective To study the therapeutic effects of Yigan Fupi decoction(YGFP)on irritable bowel syndrome(IBS)and its mechanism of action in repairing the intestinal barrier and reducing IBS sensitivity through the PKA/PKC-CREB pathway.Methods Baby rats separated from their mother were randomly divided into a model control(M)and a YGFP group,while baby rats without maternal separation were used as a normal control(N)group.The YGFP group was given YGFP for 4 weeks.Abdominal withdrawal reflux was used to evaluate intestinal sensitivity.Liquid chromatography tandem mass spectrometry and ELISA were used to detect bile acid metabolite concentrations and serum levels of interleukin(IL)-6 and CXCL1,respectively.HE staining was used to observe pathological changes in the colon,and Western Blot and immunohistochemistry were used to analyze the relative protein expression levels of PKA,PKC,CREB,5HT2AR,5-HT7R,ZO-1,and Claudin 1.Results Compared with the normal control group,the M group showed a significantly decreased visceral pain threshold,significantly increased levels of total bile acid metabolites,IL-6,and CXCL1,significantly increased relative expression of PKA,PKC,CREB,5HT2AR,and 5-HT7R,and significantly decreased relative expression of ZO-1 and Claudin 1.Compared with the M group,the YGFP group showed a significantly increased visceral pain threshold,significantly reduced levels of total bile acid metabolites,IL-6,and CXCL1,significantly reduced relative expression of PKA,PKC,CREB,5HT2AR,and 5-HT7R,and increased relative expression of ZO-1 and Claudin 1.Conclusions YGFP effectively improved IBS through a mechanism that may involve repair of the intestinal barrier and reduced sensitivity through the PKA/PKC-CREB pathway.

Objective To investigate stress distributions of the knee joint at 0 and 15th day after anterior cruciate ligament reconstruction(ACLR)under a compressive force through the axis of the femoral shaft onto the proximal femur.Methods A three-dimensional(3D)finite element model of the human knee joint incorporating viscoelastic material properties was developed.The one-dimensional(1D)Prony series viscoelastic constitutive model parameters for articular cartilage,menisci,ligaments,and anterior cruciate ligament(ACL)grafts were determined by fitting experimental creep curves.The viscoelastic parameters of ACL grafts at 15th day after ACLR surgery were extrapolated.Finite element simulations were then performed to analyze the von Mises stress distributions in knee ligaments,ACL grafts,articular cartilage,and menisci under 1.5 kN vertical downward compressive load applied to the femur,with loading durations of 1 second and 600 seconds.Results At 15th day after ACLR surgery,the initial relaxation modulus and equilibrium modulus of human ACL grafts remained elevated compared to native ACL tissues,resulting in a significantly higher stress concentration within the grafts relative to healthy ACL.Despite the compromised mechanical properties of the grafts after ACLR surgery,the vertical downward compressive force applied to the femur under both short-term(1s)and prolonged(600 s)loading durations,exhibited a minimal biomechanical impact on articular cartilage and meniscal structures.Conclusions Following ACLR,vertical compressive loads during weight-bearing rehabilitation exercises such as standing demonstrate minimal impact on articular cartilage and meniscus,while promoting fibrous regeneration of the graft.This renders such exercises a prudent early-stage rehabilitation strategy.Graft preparation requires balanced consideration of elastic and viscous properties,with grafts exhibiting higher relaxation modulus and viscosity coefficient than healthy ACL proving more effective in maintaining early postoperative knee stability.

Objective:To systematically evaluate the risk factors for dysphagia among community-dwelling older adults.Methods:A comprehensive literature search was conducted in databases, including China National Knowledge Infrastructure, Wanfang Data, VIP, PubMed, Medline, Embase, CINAHL, PsycINFO, Web of Science, and the Cochrane Library, with the search ending on July 31, 2024. The quality of cross-sectional studies was assessed using the Agency for Healthcare Research and Quality (AHRQ) criteria, while cohort and case-control studies were evaluated using the Newcastle-Ottawa Scale (NOS). Meta-analysis was performed using Stata 18.Results:A total of 26 studies were included. The prevalence of dysphagia in community-dwelling older adults ranged from 7.9% to 63.7%. The following were identified as the risk factors for dysphagia ( P<0.05) : advanced age [ OR=1.17, 95% CI (1.08, 1.28) ], history of coughing or choking [ OR=7.25, 95% CI (3.66, 14.33) ], poor oral health [ OR=1.99, 95% CI (1.63, 2.43) ], impaired tongue-lip motor function [ OR=3.41, 95% CI (1.48, 7.85) ], reduced tongue pressure [ OR=1.63, 95% CI (1.16, 2.32) ], chewing dysfunction [ OR=2.18, 95% CI (1.57, 3.04) ], medication use history [ OR=1.22, 95% CI (1.02, 1.47) ], malnutrition [ OR=1.92, 95% CI (1.04, 3.56) ], history of the comorbid disease [ OR=4.18, 95% CI (2.61, 6.71) ], history of stroke [ OR=3.27, 95% CI (1.69, 6.33) ], depression [ OR=3.18, 95% CI (2.18, 4.65) ], frailty [ OR=1.43, 95% CI (1.12, 1.82) ], and male gender [ OR=2.91, 95% CI (1.70, 4.96) ] . Conclusions:Medical staff should pay close attention to the above-mentioned risk factors and develop targeted prevention strategies to reduce the incidence of dysphagia in community-dwelling older adults.

Objective To investigate stress distributions of the knee joint at 0 and 15th day after anterior cruciate ligament reconstruction(ACLR)under a compressive force through the axis of the femoral shaft onto the proximal femur.Methods A three-dimensional(3D)finite element model of the human knee joint incorporating viscoelastic material properties was developed.The one-dimensional(1D)Prony series viscoelastic constitutive model parameters for articular cartilage,menisci,ligaments,and anterior cruciate ligament(ACL)grafts were determined by fitting experimental creep curves.The viscoelastic parameters of ACL grafts at 15th day after ACLR surgery were extrapolated.Finite element simulations were then performed to analyze the von Mises stress distributions in knee ligaments,ACL grafts,articular cartilage,and menisci under 1.5 kN vertical downward compressive load applied to the femur,with loading durations of 1 second and 600 seconds.Results At 15th day after ACLR surgery,the initial relaxation modulus and equilibrium modulus of human ACL grafts remained elevated compared to native ACL tissues,resulting in a significantly higher stress concentration within the grafts relative to healthy ACL.Despite the compromised mechanical properties of the grafts after ACLR surgery,the vertical downward compressive force applied to the femur under both short-term(1s)and prolonged(600 s)loading durations,exhibited a minimal biomechanical impact on articular cartilage and meniscal structures.Conclusions Following ACLR,vertical compressive loads during weight-bearing rehabilitation exercises such as standing demonstrate minimal impact on articular cartilage and meniscus,while promoting fibrous regeneration of the graft.This renders such exercises a prudent early-stage rehabilitation strategy.Graft preparation requires balanced consideration of elastic and viscous properties,with grafts exhibiting higher relaxation modulus and viscosity coefficient than healthy ACL proving more effective in maintaining early postoperative knee stability.