Background Depressive symptoms have become a significant factor affecting the physical and mental health of the occupational population, and workers in petroleum refining enterprises face multiple stressors in their work environment. Objective To explore the impact of occupational noise exposure on depressive symptoms among workers in a petroleum refining enterprise. Methods This cross-sectional study was conducted in July 2024 using a questionnaire survey among workers of a petroleum refining enterprise in Hainan Province. Basic information of the subjects was collected. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to measure depressive symptoms, the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) scale was used to assess sleep quality, and the Chinese version of the Effort-Reward Imbalance (ERI) scale was used to evaluate occupational stress. Chi-square test was employed to compare the differences in reporting depressive symptoms among populations with different characteristics. Binary logistic regression models were used to analyze the impact of occupational noise exposure and other factors on depressive symptoms. Results The overall positive rate of depressive symptoms in the study population was 42.7%. The results of the multifactor analysis indicated that compared with the control group, employees in both the low-exposure and high-exposure groups had elevated odds of depressive symptoms, with OR (95%CI) of 2.244 (1.131, 4.454) and 1.970 (1.009, 3.850), respectively. This association remained robust after adjusting for potential confounders, including gender, age, work tenure, and other occupational exposures. Additionally, female [OR (95%CI)=1.483 (1.039, 2.118)], exposure to benzene, toluene, or xylene [OR (95%CI)=1.621 (1.208, 2.174)], sleep disturbance [OR (95%CI)=3.772 (2.942, 4.838)], and occupational stress [OR (95%CI)=2.018 (1.575, 2.585)] were also significantly associated with higher odds of depressive symptoms. Conclusion The positive rate of depressive symptoms is relatively high among employees in this petrochemical enterprise, and occupational noise exposure may be a risk factor for depressive symptoms.

Objective:To investigate the impact of receptor-interacting protein kinase 3 (RIPK3) on major adverse cardiovascular events (MACE) in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI), as well as the predictive performance of RIPK3 combined with traditional cardiovascular risk factors.Methods:This study was a single-center prospective cohort study. It included patients with AMI who underwent PCI at Peking Union Medical College Hospital between September 2017 and November 2017. Baseline clinical data were collected, and plasma samples were obtained 6 hours after PCI to measure RIPK3 levels. Follow-up was conducted via outpatient visits or phone calls to record the occurrence of MACE, including cardiovascular death, hospitalization for heart failure, and vascular events (recurrent AMI or stroke). The predictive performance of RIPK3, traditional cardiovascular risk factors and their combination for MACE was compared using receiver operating characteristic (ROC) curves. Patients were divided into low- and high-RIPK3 level groups based on the optimal cutoff value of RIPK3. Multivariate Cox proportional hazards regression analysis was used to assess the impact of RIPK3 levels on MACE after PCI in AMI patients. Kaplan-Meier survival curves were plotted, and the log-rank test was used to compare MACE incidence between the low-and high-RIPK3 groups.Results:A total of 103 AMI patients who underwent PCI were included, aged 63.0 (56.0, 69.0) years, and 83 (80.6%) were male. The follow-up time was 5.17 (2.81, 5.17) years, during which 44 patients (42.7%) experienced MACE. The ROC curve analysis showed that the area under the curve ( AUC) for traditional cardiovascular risk factors was 0.68 (95% CI: 0.58-0.78), while the AUC for plasma RIPK3 was 0.72 (95% CI: 0.62-0.82). The combined AUC for traditional risk factors and RIPK3 was 0.75 (95% CI: 0.65-0.85). Multivariate Cox proportional hazards regression analysis indicated that plasma RIPK3 level is greater than or equal to the optimal cutoff value of 440.9 μg/L ( HR=3.31, 95% CI: 1.53-8.30, P=0.005) was an independent risk factor for MACE in AMI patients after PCI. Kaplan-Meier survival analysis demonstrated that the high-RIPK3 group had a significantly higher risk of MACE after PCI compared to the low-RIPK3 group (log-rank P=0.006). Conclusions:Elevated plasma RIPK3 level is an independent risk factor for MACE in AMI patients after PCI. Plasma RIPK3 combined with traditional cardiovascular risk factors can more effectively predict the occurrence of MACE in AMI patients after PCI. AMI patients with RIPK3≥440.9 μg/L have a higher risk of MACE after PCI.

Objective:Reviewed the scope of the application of time-driven activity based costing(TDABC) in nursing costing, and the connotation of time-driven job costing, the current status of research, and the evaluation of the application effect were systematically sorted out. In order to provide an effective method for the improvement of nursing cost accounting level in China.Methods:In accordance with the scope review methodology of Arksey and O′Malley, the Cochrane Library, PubMed, Web of Science, Embase, Scopus, CINAHL, SinoMed, CNKI, Wanfang and VIP Database were systematically searched for relevant literature on the application of nursing costingrelated literature on time-driven job costing. The time frame was from the construction of the database to March 1, 2024. Summarization and analysis were conducted independently by 2 trained and qualified researchers, and third-party experts were invited to share decision-making in case of disagreement.Results:Twenty-seven literatures from nine countries were included. A review of the literature revealed that time-driven job costing is used throughout the entire process of nursing costing, and the results of its application include optimizing the allocation of nursing resources, accurately accounting for the true costs of clinical care pathways and processes, and assisting in the analysis of nursing cost decisions.Conclusions:TDABC has been widely recognized internationally, effectively supporting refined cost management and promoting decision-making optimisation. However, the current development of TDABC in nursing costing in China is yet to be perfected. In the future, we should deeply explore the combination of TDABC with the local healthcare system, and promote its wide application in China, so as to achieve the dual optimisation of cost control and nursing quality, and to better reflect the economic and social value of nursing services.

Objective:To explore the application of near-infrared spectroscopy monitoring in the diagnosis of necrotizing enterocolitis (NEC) in extremely/very low birth weight infants.Methods:Extremely/very low birth weight infants suspected of having NEC who were hospitalized in the Neonatal Intensive Care Unit of Guangzhou Women and Children′s Medical Center from September 2019 to November 2021 were selected as the research subjects. The regional intestinal oxygen saturation (rintSO 2) and regional cerebral oxygen saturation (rcSO 2) of the children within 72 hours after the onset were monitored by near-infrared spectrometer. The mean values of rintSO 2 and rcSO 2, intestinal fractional tissue oxygen extraction (intFTOE), and splanchnic-cerebral oxygenation ratio (SCOR) during the monitoring period were calculated. According to whether NEC was diagnosed or not, the patients were divided into the non-NEC group and the NEC group. The NEC group was further divided into the common NEC group and the severe NEC group. The rintSO 2, rcSO 2, intFTOE and SCOR of each group were compared. Results:A total of 78 cases were included, including 50 cases in the non-NEC group and 28 cases in the NEC group. Among them, there were 17 cases in the common NEC group and 11 cases in the severe NEC group. The rcSO 2 in the NEC group was lower than that in the non-NEC group (65.2±6.1 vs 73.2±7.0), and the SCOR was higher than that in the non-NEC group (0.88±0.05 vs 0.81±0.07), and the differences were statistically significant (all P<0.05). There was no statistically significant difference in rintSO 2 and intFTOE between the two groups (all P>0.05). Both rintSO 2 and rcSO 2 in the severe NEC group were lower than those in the common NEC group [(52.0±4.6 vs 61.2±5.0) and (60.3±3.8 vs 68.3±5.0)], and intFTOE was higher than that in the common NEC group (0.46±0.05 vs 0.36±0.06). The differences were all statistically significant (all P<0.05). There was no statistically significant difference in SCOR between the two groups (all P>0.05). Conclusions:The monitoring values of near-infrared spectroscopy are correlated with the incidence of NEC in extremely/very low birth weight infants. Lower rcSO 2 and higher SCOR are helpful for identifying NEC, while lower rintSO 2, rcSO 2 and higher intFTOE are helpful for identifying severe NEC.

Objective:To explore the application of near-infrared spectroscopy monitoring in the diagnosis of necrotizing enterocolitis (NEC) in extremely/very low birth weight infants.Methods:Extremely/very low birth weight infants suspected of having NEC who were hospitalized in the Neonatal Intensive Care Unit of Guangzhou Women and Children′s Medical Center from September 2019 to November 2021 were selected as the research subjects. The regional intestinal oxygen saturation (rintSO 2) and regional cerebral oxygen saturation (rcSO 2) of the children within 72 hours after the onset were monitored by near-infrared spectrometer. The mean values of rintSO 2 and rcSO 2, intestinal fractional tissue oxygen extraction (intFTOE), and splanchnic-cerebral oxygenation ratio (SCOR) during the monitoring period were calculated. According to whether NEC was diagnosed or not, the patients were divided into the non-NEC group and the NEC group. The NEC group was further divided into the common NEC group and the severe NEC group. The rintSO 2, rcSO 2, intFTOE and SCOR of each group were compared. Results:A total of 78 cases were included, including 50 cases in the non-NEC group and 28 cases in the NEC group. Among them, there were 17 cases in the common NEC group and 11 cases in the severe NEC group. The rcSO 2 in the NEC group was lower than that in the non-NEC group (65.2±6.1 vs 73.2±7.0), and the SCOR was higher than that in the non-NEC group (0.88±0.05 vs 0.81±0.07), and the differences were statistically significant (all P<0.05). There was no statistically significant difference in rintSO 2 and intFTOE between the two groups (all P>0.05). Both rintSO 2 and rcSO 2 in the severe NEC group were lower than those in the common NEC group [(52.0±4.6 vs 61.2±5.0) and (60.3±3.8 vs 68.3±5.0)], and intFTOE was higher than that in the common NEC group (0.46±0.05 vs 0.36±0.06). The differences were all statistically significant (all P<0.05). There was no statistically significant difference in SCOR between the two groups (all P>0.05). Conclusions:The monitoring values of near-infrared spectroscopy are correlated with the incidence of NEC in extremely/very low birth weight infants. Lower rcSO 2 and higher SCOR are helpful for identifying NEC, while lower rintSO 2, rcSO 2 and higher intFTOE are helpful for identifying severe NEC.

Objective:Reviewed the scope of the application of time-driven activity based costing(TDABC) in nursing costing, and the connotation of time-driven job costing, the current status of research, and the evaluation of the application effect were systematically sorted out. In order to provide an effective method for the improvement of nursing cost accounting level in China.Methods:In accordance with the scope review methodology of Arksey and O′Malley, the Cochrane Library, PubMed, Web of Science, Embase, Scopus, CINAHL, SinoMed, CNKI, Wanfang and VIP Database were systematically searched for relevant literature on the application of nursing costingrelated literature on time-driven job costing. The time frame was from the construction of the database to March 1, 2024. Summarization and analysis were conducted independently by 2 trained and qualified researchers, and third-party experts were invited to share decision-making in case of disagreement.Results:Twenty-seven literatures from nine countries were included. A review of the literature revealed that time-driven job costing is used throughout the entire process of nursing costing, and the results of its application include optimizing the allocation of nursing resources, accurately accounting for the true costs of clinical care pathways and processes, and assisting in the analysis of nursing cost decisions.Conclusions:TDABC has been widely recognized internationally, effectively supporting refined cost management and promoting decision-making optimisation. However, the current development of TDABC in nursing costing in China is yet to be perfected. In the future, we should deeply explore the combination of TDABC with the local healthcare system, and promote its wide application in China, so as to achieve the dual optimisation of cost control and nursing quality, and to better reflect the economic and social value of nursing services.

Objective:To investigate the impact of receptor-interacting protein kinase 3 (RIPK3) on major adverse cardiovascular events (MACE) in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI), as well as the predictive performance of RIPK3 combined with traditional cardiovascular risk factors.Methods:This study was a single-center prospective cohort study. It included patients with AMI who underwent PCI at Peking Union Medical College Hospital between September 2017 and November 2017. Baseline clinical data were collected, and plasma samples were obtained 6 hours after PCI to measure RIPK3 levels. Follow-up was conducted via outpatient visits or phone calls to record the occurrence of MACE, including cardiovascular death, hospitalization for heart failure, and vascular events (recurrent AMI or stroke). The predictive performance of RIPK3, traditional cardiovascular risk factors and their combination for MACE was compared using receiver operating characteristic (ROC) curves. Patients were divided into low- and high-RIPK3 level groups based on the optimal cutoff value of RIPK3. Multivariate Cox proportional hazards regression analysis was used to assess the impact of RIPK3 levels on MACE after PCI in AMI patients. Kaplan-Meier survival curves were plotted, and the log-rank test was used to compare MACE incidence between the low-and high-RIPK3 groups.Results:A total of 103 AMI patients who underwent PCI were included, aged 63.0 (56.0, 69.0) years, and 83 (80.6%) were male. The follow-up time was 5.17 (2.81, 5.17) years, during which 44 patients (42.7%) experienced MACE. The ROC curve analysis showed that the area under the curve ( AUC) for traditional cardiovascular risk factors was 0.68 (95% CI: 0.58-0.78), while the AUC for plasma RIPK3 was 0.72 (95% CI: 0.62-0.82). The combined AUC for traditional risk factors and RIPK3 was 0.75 (95% CI: 0.65-0.85). Multivariate Cox proportional hazards regression analysis indicated that plasma RIPK3 level is greater than or equal to the optimal cutoff value of 440.9 μg/L ( HR=3.31, 95% CI: 1.53-8.30, P=0.005) was an independent risk factor for MACE in AMI patients after PCI. Kaplan-Meier survival analysis demonstrated that the high-RIPK3 group had a significantly higher risk of MACE after PCI compared to the low-RIPK3 group (log-rank P=0.006). Conclusions:Elevated plasma RIPK3 level is an independent risk factor for MACE in AMI patients after PCI. Plasma RIPK3 combined with traditional cardiovascular risk factors can more effectively predict the occurrence of MACE in AMI patients after PCI. AMI patients with RIPK3≥440.9 μg/L have a higher risk of MACE after PCI.

Objective To explore the efficacy of repeated transcranial magnetic stimulation(rTMS)combined with flupentixol and melitracen tablets on post-stroke depression(PSD)and to evaluate the predictive value of depressive symptom dimensions on the efficacy.Methods PSD patients diagnosed and treated in the department of rehabilitation medicine of Jiaozhou Central Hospital of Qingdao from January 2021 to December 2023 were selected as the research subjects,all patients were treated with rTMS combined with flupentixol and melitracen tablets.The National Institutes of Health Stroke Scale(NIHSS),Hamilton Depression(HAMD),and Barthel Index(BI)of PSD patients before and after treatment were evaluated and compared.PSD patients were divided into the effective group and the ineffective group based on treatment effectiveness,and Logistic regression was used to explore the relationship between depression symptom dimensions and treatment outcomes.Using the receiver operating characteristic(ROC)curve to explore the predictive value of depression symptom dimensions on the efficacy of PSD patients.Results A total of 80 PSD patients were included in this study,of which 68 cases were effective in treatment and 12 cases were ineffective in treatment.Compared with before treatment,PSD patients showed a significant decrease in HAMD score,NIHSS score(P＜0.05),and BI score was significant increased(P＜0.05).The observed mood(OM)score,cognitive score,and neurological symptom(NS)score of PSD patients in the effective group were higher than those in the ineffective group,and the differences were statistically significant(P＜0.05).Logistic regression analysis showed that high-level OM score,cognitive score,and NS score were independent protective factors for effective PSD treatment.ROC analysis showed that the baseline OM score,cognitive score,and NS score for ineffective treatment were 0.744[95％CI(0.568,0.921)],0.734[95％CI(0.572,0.896)],and 0.709[95％CI 0.534,0.884)],respectively.Conclusion rTMS combined with flupentixol and melitracen tablets can significantly improve depression symptoms and neurological impairment,and improve the ability of daily living.Moreover,depressive symptom dimensions at baseline can predict the treatment effects of PSD patients.

Objective:To understand the current status of financial toxicity in patients with heart failure and the factors affecting it, and to provide ideas for making personalized and informed decisions.Methods:Using a scoping review methodological framework, PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, VIP, Wanfang, and SinoMed Databases were searched and screened for relevant literature on financial toxicity in patients with heart failure, with a timeframe of January 1, 2014-October 31, 2023, respectively. Relevant literature was identified based on inclusion and exclusion criteria, and data were extracted, collected, summarized, and the findings were reported.Results:Ten literatures that met the inclusion and exclusion criteria were identified. The results showed 5 cross-sectional surveys, 2 qualitative studies, and 1 each of reviews, mixed studies and commentaries. Heart failure patients generally faced high levels of financial toxicity, the incidence and severity of patient financial toxicity varied somewhat between study outcomes. Factors influencing financial toxicity in heart failure patients included age, education level, family income level, discussion of medical costs with physicians, type of insurance the patient had, and occupational status.Conclusions:In the future, we can develop and apply a specialized assessment tool for financial toxicity in heart failure patients in China, further explore the factors affecting financial toxicity in heart failure patients, and formulate personalized treatment plans and financial support strategies for patients according to the influencing factors, so as to reduce the impact of financial toxicity on heart failure patients.

Childhood arterial ischemic stroke (AIS) refers to an ischemic stroke caused by intracranial artery stenosis or occlusion that occurs between the ages of 29 days and 18 years. Although relatively rare, AIS is an important cause of disability or death in children. The etiologies and risk factors for AIS in childhood are significantly different from those in adults. This article reviews the common causes and risk factors for AIS in childhood.