Objective:To study the application effect of the Hazard Analysis and Critical Control Point(HACCP)system in risk assessment and dynamic management of operational safety of medical equipment in surgery rooms.Methods:Based on the HACCP principle,hazard analysis and risk assessment were conducted on the operational safety of equipment in surgery room,and the critical control points were determined,and measures of monitor and management were formulated to conduct whole-process dynamic management for equipment in surgery room.A total of 120 medical equipment in use in the surgery room of Shaanxi Provincial Cancer Hospital from January 2022 to January 2024 were selected.According to random number table method,they were divided into conventional management mode group(60 equipment that received conventional management mode)and dynamic management mode group(60 equipment that received the mode of risk assessment and dynamic management based on HACCP system for operational safety of medical equipment in surgery rooms)to receive different managements.The effect,operational quality,the score of management standardization,and management level for equipment in managing and controlling risk of safety of equipment were compared between two management modes.Results:The average pressure-related injury,electrical injury,extravasation of body fluid,and incidence of unqualified cleaning and disinfection of equipment in the dynamic management mode group were respectively(3.01±1.01)%,(2.65±0.78)%,(1.65±0.64)%and(1.15±0.16)%,all of which were lower than those in the conventional management mode group,and the differences were statistically significant(t=16.311,13.434,12.018,12.629,P<0.05).The average utilization rate,cost-benefit amplification and social benefit amplification of the equipment in the dynamic management mode group were respectively(95.36±2.87)%,(7.98±1.32)%and(10.68±2.36)%,all of which were higher than those in the conventional management mode group,and the average operating rate in the dynamic management mode group was(9.87±1.54)%,which was lower than that in the conventional management mode group,and the differences of the above indicators were significant(t=7.657,15.567,10.354,12.466,P<0.05).The scores of the standard degrees of use and operation,disinfection and sterilization,operation and maintenance,and repairing fault of equipment in the dynamic management mode group were higher than those in the conventional management mode group,and the differences of the above data between two groups were statistically significant(t=16.289,11.415,13.396,9.420,P<0.05),respectively.The rate of standard placement,the rate of reasonable recording and integrity rate of equipment in the dynamic management mode group were higher than those in the conventional management mode group,and the failure rate was lower than that of the conventional management mode group,and the differences of the above indicators between the two groups were statistically significant(x2=6.708,7.070,8.491,13.333,P<0.05).Conclusion:The risk assessment and dynamic management based on HACCP system for operational safety of medical equipment in surgery room can improve the management effect for equipment in surgery room,and reduce the operational risk of equipment,and realize the whole-process management and control for medical equipment in surgery room.

Objective To discuss the efficacy of direct resin filling restoration,improved atraumatic restorative treatment(ART),and Hall technique in treating deciduous molars in children.Methods A total of 120 children with 180 deciduous molars who came to the Department of Oral Surgery of our hospital from January 2023 to August 2023 were selected and randomly divided into three groups:direct resin filling restoration group(40 people,60 teeth),improved ataumatic restorative treatment group(40 people,62 teeth),and Hall technique group(40 people,58 teeth).The behavioral performance classification and degree of anxiety of the children during the treatment process and the treatment time were compared among the three groups.The clinical efficacy after 3 months,6 months,and 12 months of treatment was compared and the reasons for failure were analyzed.Results The treatment time of the Hall technique group was significantly shorter than that of the improved ART group and direct filling group,and the differences in treatment time of the three groups had statistical significance(P＜0.05).The Hall technique and improved ART technique were more easily accepted by the chil-dren,and the degree of anxiety and behavioral performance classification of the three groups had statistically significant differences(P＜0.05).At the 12-month follow-up,the success rate of the direct filling restoration group was significantly different from that of the im-proved ART technique group and the Hall technique group,and the difference was statistically significant(P＜0.05).However,the suc-cess rate of the improved ART technique group was not significantly different from that of the Hall technique group(P＞0.05).Conclu-sion The success rate of the improved ART technique group and the Hall technique group is higher than that of the direct filling resto-ration group,and is more easily accepted by children.The pain level and degree of anxiety are lighter,and the treatment time of the Hall technique is shorter,which is more conducive to the repair of tooth decay.

Objective:To explore the application of BOPPPS(Bridge-in,Objective,Pre-assessment,Participatory Learning,Post-assessment,Summary)combined with Direct Observation of Procedural Skills(DOPS)in anesthesiology teaching under the background of medical-educational collaboration.Methods:A total of 60 students majoring in anesthesiology were selected as the research objects.A total of 30 students in grade 2018 were enrolled in the control group and receired traditional teaching mode.A total of 30 students in grade 2019 were enrolled in the research group and received BOPPPS teaching mode.The assessment of the internship after graduation for both groups adopted the DOPS assessment mode.Two groups of students were subject to pre-enrollment assessment,including process evaluations,such as theoretical class attendance,classroom interaction,pre-test scores,post-test scores,and the final theoretical test score.A comprehensive evaluation of teachers'teaching effect was conducted.When the two groups were discharged from the department,in addition to the assessment of professional theoretical knowledge of anesthesia and the operation of conventional anesthesia skills,they also underwent nine DOPS assessments.Results:There was no statistical difference between the two groups in the attendance(P＞0.05).The classroom interaction,pre-test scores,post-test scores,final test scores and total test scores in the study group were higher than those in the control group(P＜0.05).In terms of comprehensive evaluation of teaching effect,there was no statistical difference between the two groups in the evaluation of teachers'teaching attitude(P＞0.05).However,the research group reported higher satisfaction in teaching skills,methods,student-teacher interaction,and classroom engagement(P＜0.05).Both the theoretical and practical scores in the research group were higher than those in the control group(P＜0.05).The DOPS assessment results showed that the research group was superior to the control group in terms of indication mastery,operation completion,teamwork and problem-solving ability,and comprehensive ability performance(P＜0.05).Conclusion:The application effect of BOPPPS combined with DOPS in anesthesiology teaching is better than the conventional teaching mode.

Purpose To evaluate the application value of CE-Boost technology in head and neck CT angiography(CTA)with low tube voltage,low contrast agent dosage and low injection rate.Materials and Methods A prospective study was conducted on patients who underwent head and neck CTA at Ji'nan People's Hospital Affiliated to Shandong First Medical University from September to December 2023.Using block randomization,patients were divided into group A(n=30)and group B(n=30).Group A underwent conventional scanning with 120 kV tube voltage,50 ml iodinated contrast agent and 5.0 ml/s injection rate;while group B underwent scanning with 100 kV tube voltage,30 ml iodinated contrast agent and 3.0 ml/s injection rate.CE-Boost images(group B2)were generated by performing flexible subtraction between the enhanced images of group B(group B1)and non-contrast images.CT values,noise,signal-to-noise ratio and contrast-to-noise ratio of major vessels were measured and calculated.Subjective image quality was assessed using a 5-point scale.Vascular CT values,noise,signal-to-noise ratio,contrast-to-noise ratio,subjective scores and radiation dose were compared among the three groups.Results No significant differences in noise were observed among group A,B1 and B2(all P>0.05).The aortic arch CT values,signal-to-noise ratio and contrast-to-noise ratio in group B2 were significantly higher than those in group B1 and A(all P<0.05),while group B1 exhibited significantly lower values than group A(all P<0.05).For other vessels,group B2 demonstrated significantly higher CT values,signal-to-noise ratio and contrast-to-noise ratio than group B1(all P<0.05),but no significant differences were found compared with group A(all P>0.05).Subjective scores were significantly higher in group A[5(5,5)point]and group B2[5(5,5)point]than in group B1[4(3,4)point](Z=-4.790,-4.564,both P<0.001),with no significant difference between groups A and B2(Z=-1.076,P=0.163).Group B reduced iodine intake and injection rate by 40%compared with group A(iodine intake:11.1 g vs.18.5 g;injection rate:3.0 ml/s vs.5.0 ml/s)and achieved a 30%reduction in effective radiation dose[(1.02±0.95)mSv vs.(1.44±1.66)mSv,t=12.217,P<0.001].Conclusion For patients with body mass index<28 kg/m2,CE-Boost combined with 100 kV tube voltage,30 ml iodinated contrast agent and 3.0 ml/s injection rate in head and neck CTA significantly reduces radiation dose,iodine load and injection rate while maintaining image quality.

Objective:To investigate the mediating effect of work engagement on the relationship between nurses′ perception of authentic leadership and their innovative behavior, providing insights for enhancing nurses′ innovative practices.Methods:A convenience sampling method was employed to recruit registered nurses from 37 hospitals in Anhui Province between January and March 2022. The Authentic Leadership Questionnaire, Utrecht Work Engagement Scale and Nurse Innovative Behavior Scale were utilized to conduct a cross-sectional survey. SPSS 25.0 was used to analyze the correlations among nurses′ perception of authentic leadership, work engagement, and innovative behavior, while AMOS 26.0 was employed to assess the mediating effect of work engagement between nurses′ perception of authentic leadership and innovative behavior.Results:A total of 3 200 questionnaires were distributed, and 2 994 valid questionnaires were collected. Among the 2 994 participating nurses, 2 907 (97.1%) were female and 87 (2.9%) were male, 1 002 (33.5%) aged 22-25 years, 1 374 (45.9%) aged 26-39 years, 467 (15.6%) aged 40-49 years, and 151 (5.0%) aged 50 years or older. The total scores of the Authentic Leadership Questionnaire, Utrecht Work Engagement Scale and Nurse Innovative Behavior Scale were (68.23 ± 13.15), (51.49 ± 11.65) and (38.28 ± 8.35) points, respectively. Pearson correlation analysis revealed significant positive correlations between nurses′ perception of authentic leadership and work engagement ( r=0.473, P<0.01), between nurses′ perception of authentic leadership and innovative behavior ( r=0.530, P<0.01), and between work engagement and innovative behavior ( r=0.553, P<0.01). The mediating effect analysis indicated that work engagement partially mediates the relationship between nurses′ perception of authentic leadership and innovative behavior ( β=0.18, P<0.01), with a mediation effect ratio of 34.62%. Conclusions:Nurses′ perception of authentic leadership can indirectly influence their innovative behavior through work engagement. It is recommended that nursing managers prioritize the enhancement of authentic leadership and foster work engagement among nurses to stimulate their innovative behavior.

ObjectiveTo investigate the incidence rate of sarcopenia in patients with Wilson’s disease （WD）-related liver cirrhosis， as well as the risk factors for sarcopenia and their impact on clinical outcomes. MethodsA total of 140 patients with WD-related liver cirrhosis who were treated in The First Affiliated Hospital of Anhui University of Chinese Medicine from January 2019 to June 2020， and according to the third lumbar skeletal muscle mass index （L3 SMI）， the patients were divided into sarcopenia group and non-sarcopenia group. Nutritional risk screening， anthropometric measurements， and blood biochemical tests were performed for the patients to identify the influencing factors for sarcopenia. The patients were followed up for 36 — 48 months， and survival status and complications were compared between the two groups. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the chi-square test and the Mann-Whitney U rank sum test were used for comparison of categorical data between two groups. A binary Logistic regression analysis was used to investigate the influencing factors for sarcopenia， and univariate and multivariate Cox regression analyses were used to investigate the risk factors for the prognosis of patients with WD-related liver cirrhosis. The Kaplan-Meier survival curve was plotted， and the Log-rank test was used for comparison between groups. ResultsAmong the 140 patients with WD-related liver cirrhosis， 53 （37.9%） developed sarcopenia， with significantly lower body mass index （BMI） and L3 SMI than the patients without sarcopenia （t=10.550 and 3.982， both P<0.001）. The multivariate Logistic regression analysis showed that age （odds ratio ［OR］=2.243， 95% confidence interval ［CI］： 1.196 — 4.208， P=0.012）， sex （OR=0.450， 95%CI： 0.232 — 0.872， P=0.018）， BMI （OR=0.126， 95%CI： 0.089 — 0.294， P<0.001）， and hepatic encephalopathy （OR=8.367， 95%CI： 2.423 — 28.897， P<0.001） were the main influencing factors for sarcopenia in patients with WD-related liver cirrhosis. Compared with the non-sarcopenia group， the sarcopenia group had significantly higher mortality rate （χ²=6.158， P=0.019） and significantly higher incidence rates of infection （χ²=8.008， P=0.040）， recurrent abdominal/pleural efflux （χ²=17.742， P<0.001）， and hepatic encephalopathy （χ²=4.338， P=0.039）. The multivariate Cox regression analysis showed that sarcopenia （hazard ratio ［HR］=4.685， P=0.002） and hepatic encephalopathy （HR=19.156， P<0.001） were independent risk factors for death in patients with WD-related liver cirrhosis. The Kaplan-Meier survival curve analysis showed a significant reduction in survival rate in the patients with sarcopenia （P=0.003）. ConclusionSarcopenia is one of the manifestations of malnutrition in patients with WD-related liver cirrhosis， which increases the risk of mortality and other complications and has an adverse effect on prognosis. There is an increased risk of sarcopenia in male patients or patients with hepatic encephalopathy， a lower level of BMI or an older age.

Objective To analyze the relationship between abnormal expression of serum neurohemoglobin(NGB)and myelin basic protein(MBP)and the cerebral neurodevelopment of neonates with hypoxic-ischemic encephalopathy(HIE).Methods A total of 89 preterm infants with HIE admitted in the hospital between January 2023 and March 2024 were selected as the observation group,and 60 preterm infants without HIE during the same period were selected as the control group.Serum levels of MBP,NGB and secretagogues in two groups were detected,and the neonates amplitude integration electroencephalogram score was evaluated.The neurological function of neonates was evaluated using 20 items of Neonatal Behavioral Neurological As-sessment(NBNA).The correlation test and diagnostic value were evaluated using Spearman method and re-ceiver operating characteristic(ROC)curve.Results The serum levels of NGB,MBP and secretagogue in the ob-servation group were higher than those in the control group(P<0.05),and the amplitude integration electroencepha-logram score was lower than that in the control group(P<0.05).The serum MBP,NGB and secretagogue levels in the mild,moderate,and severe groups increased sequentially(P<0.05),NBNA score and amplitude integration e-lectroencephalogram score decreased sequentially(P<0.05).The levels of NGB,MBP and secretagogue were the risk factors affecting NBNA score(P<0.05),and the amplitude integration electroencephalogram score was a protective factor affecting NBNA score(P<0.05).The area under the curve of NGB and MBP in diag-nosing HIE was greater than 0.8,which had high application value.Conclusion Serum NGB and MBP levels are closely related to the severity of HIE,and have certain connection with NBNA score.Elevated levels of NGB and MBP in neonates with HIE may be related to the body's stress response to nerve damage,which could reflect to some extent the brain nerve function damage in with HIE.

OBJECTIVE To study the clinical efficacy of Professor Li Bingmao's Tongfu Xiere Quyu Shuli Prescription in the treatment of patients with functional dyspepsia(FD)of spleen and stomach damp-heat and qi stagnation and blood stasis type.METH-ODS A total of 206 patients with functional dyspepsia of spleen and stomach damp-heat and qi stagnation and blood stasis type diag-nosed by Hengshui People's Hospital were included in the study and randomly divided into a study group and a control group with 103 cases in each group.During the treatment,3 cases dropped out in each group.The control group adopted the conventional Western medicine treatment plan for functional dyspepsia(mosapride+rabeprazole),and the study group took Tongfu Xiere Quyu Shuli Pre-scription on the basis of the treatment of the control group.The treatment course of both groups was 4 weeks.The traditional Chinese medicine(TCM)syndrome scores,psychological status[self-rating anxiety scale(SAS),self-rating depression scale(SDS),and quality of life[Nepean dyspepsia life quality index(NDLQI)of the two groups of patients before and after treatment were observed and the clinical efficacy was evaluated;serum motilin(MTL),ghrelin,gastrin(GAS),corticotropin-releasing hormone(CRH)and pep-sinogen(PG Ⅰ,PG Ⅱ)were measured by enzyme-linked immunosorbent assay;changes in gastric motility indexes were analyzed by electrogastrogram analyzer;changes in intestinal flora were detected by instillation method.The occurrence of adverse reactions in the two groups of patients was monitored during treatment.RESULTS After treatment,the TCM syndrome scores of the two groups were significantly reduced(P<0.05,P<0.01),and the score in the study group was lower than that in the control group(P<0.01).The total effective rate of the study group was significantly higher than that in the control group(P<0.01).After treatment,the expression levels of MTL,Ghrelin,GAS,PG Ⅰ and PG Ⅱ in the two groups increased,and CRH decreased,and the improvement degree of the study group was better than that of the control group(P<0.01).After treatment,the main frequency and slow wave percentage of the electrogastrogram increased in the two groups,and the study group was better than that of the control group(P<0.01).After treat-ment,the number of bifidobacteria and lactobacilli in the two groups increased,and the number in the study group was greater than that in the control group,while the number of enterobacteria,enterococci and yeast decreased,and the number in the study group was less than that in the control group(P<0.01).There was no significant difference in adverse reactions between the two groups(P>0.05).CONCLUSION Tongfu Xiere Quyu Shuli Prescription is effective in the treatment of FD patients with spleen and stomach damp-heat syndrome,and can improve FD clinical symptoms,quality of life,anxiety and depression symptoms,regulate gastrointesti-nal hormone expression levels,gastric motility and intestinal flora expression,and does not increase adverse reactions,and is safe and reliable.

OBJECTIVE To study the clinical efficacy of Professor Li Bingmao's Tongfu Xiere Quyu Shuli Prescription in the treatment of patients with functional dyspepsia(FD)of spleen and stomach damp-heat and qi stagnation and blood stasis type.METH-ODS A total of 206 patients with functional dyspepsia of spleen and stomach damp-heat and qi stagnation and blood stasis type diag-nosed by Hengshui People's Hospital were included in the study and randomly divided into a study group and a control group with 103 cases in each group.During the treatment,3 cases dropped out in each group.The control group adopted the conventional Western medicine treatment plan for functional dyspepsia(mosapride+rabeprazole),and the study group took Tongfu Xiere Quyu Shuli Pre-scription on the basis of the treatment of the control group.The treatment course of both groups was 4 weeks.The traditional Chinese medicine(TCM)syndrome scores,psychological status[self-rating anxiety scale(SAS),self-rating depression scale(SDS),and quality of life[Nepean dyspepsia life quality index(NDLQI)of the two groups of patients before and after treatment were observed and the clinical efficacy was evaluated;serum motilin(MTL),ghrelin,gastrin(GAS),corticotropin-releasing hormone(CRH)and pep-sinogen(PG Ⅰ,PG Ⅱ)were measured by enzyme-linked immunosorbent assay;changes in gastric motility indexes were analyzed by electrogastrogram analyzer;changes in intestinal flora were detected by instillation method.The occurrence of adverse reactions in the two groups of patients was monitored during treatment.RESULTS After treatment,the TCM syndrome scores of the two groups were significantly reduced(P<0.05,P<0.01),and the score in the study group was lower than that in the control group(P<0.01).The total effective rate of the study group was significantly higher than that in the control group(P<0.01).After treatment,the expression levels of MTL,Ghrelin,GAS,PG Ⅰ and PG Ⅱ in the two groups increased,and CRH decreased,and the improvement degree of the study group was better than that of the control group(P<0.01).After treatment,the main frequency and slow wave percentage of the electrogastrogram increased in the two groups,and the study group was better than that of the control group(P<0.01).After treat-ment,the number of bifidobacteria and lactobacilli in the two groups increased,and the number in the study group was greater than that in the control group,while the number of enterobacteria,enterococci and yeast decreased,and the number in the study group was less than that in the control group(P<0.01).There was no significant difference in adverse reactions between the two groups(P>0.05).CONCLUSION Tongfu Xiere Quyu Shuli Prescription is effective in the treatment of FD patients with spleen and stomach damp-heat syndrome,and can improve FD clinical symptoms,quality of life,anxiety and depression symptoms,regulate gastrointesti-nal hormone expression levels,gastric motility and intestinal flora expression,and does not increase adverse reactions,and is safe and reliable.

Objective To discuss the efficacy of direct resin filling restoration,improved atraumatic restorative treatment(ART),and Hall technique in treating deciduous molars in children.Methods A total of 120 children with 180 deciduous molars who came to the Department of Oral Surgery of our hospital from January 2023 to August 2023 were selected and randomly divided into three groups:direct resin filling restoration group(40 people,60 teeth),improved ataumatic restorative treatment group(40 people,62 teeth),and Hall technique group(40 people,58 teeth).The behavioral performance classification and degree of anxiety of the children during the treatment process and the treatment time were compared among the three groups.The clinical efficacy after 3 months,6 months,and 12 months of treatment was compared and the reasons for failure were analyzed.Results The treatment time of the Hall technique group was significantly shorter than that of the improved ART group and direct filling group,and the differences in treatment time of the three groups had statistical significance(P＜0.05).The Hall technique and improved ART technique were more easily accepted by the chil-dren,and the degree of anxiety and behavioral performance classification of the three groups had statistically significant differences(P＜0.05).At the 12-month follow-up,the success rate of the direct filling restoration group was significantly different from that of the im-proved ART technique group and the Hall technique group,and the difference was statistically significant(P＜0.05).However,the suc-cess rate of the improved ART technique group was not significantly different from that of the Hall technique group(P＞0.05).Conclu-sion The success rate of the improved ART technique group and the Hall technique group is higher than that of the direct filling resto-ration group,and is more easily accepted by children.The pain level and degree of anxiety are lighter,and the treatment time of the Hall technique is shorter,which is more conducive to the repair of tooth decay.