Objective:To evaluate the effect of preoperative oral carbohydrate intake on postoperative nausea and vomiting (PONV) in elderly patients undergoing gynecological laparoscopic surgery.Methods:This study was a randomized controlled trial. One hundred elderly patients, aged≥65 yr, with a body mass index of 18-30 kg/m 2, with American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, who underwent gynecological laparoscopic surgery at the Baoding First Central Hospital from March 2023 to June 2024, were selected. Stratification was conducted by age (65-74 yr/≥75 yr) using an online randomization tool, and the patients were randomly divided into conventional fasting group (group C) and oral carbohydrate group (group P), with 50 cases in each group. Patients took oral carbohydrate drinks of 4 ml/kg at 2 h before operation, with total amount ≤400 ml in group P, while patients received conventional preoperative fasting protocols in group C. The occurrence and severity of PONV within 48 h postoperatively were observed. The visual analogue scale scores for hunger and thirst, State-Trait Anxiety Inventory scale scores, length of stay in the postanesthesia care unit, duration of hospital stay, time to first flatus, time to first ambulation, and patient′s satisfaction were recorded in the two groups. Results:Compared with group C, the incidence and severity of PONV were significantly decreased within 48 h after surgery, the visual analogue scale scores for hunger and thirst and State-Trait Anxiety Inventory scale scores were significantly decreased after entering the operating room, the length of stay in the postanesthesia care unit, time to first flatus and time to first ambulation were significantly shortened, and the patient′s satisfaction was significantly increased in group P ( P<0.05). Conclusions:Oral carbohydrate intake before operation can effectively reduce the occurrence and severity of PONV and improve the quality of postoperative recovery in elderly patients undergoing gynecological laparoscopic surgery.

Objective To investigate the association between antenatal white blood cell count(WBC)and the risk of histological chorioamnionitis(HCA)in pregnant women with late pregnancy premature rupture of membranes(PROM).Methods A retrospective analysis was performed on totally 118 pregnant women with PROM in late pregnancy from March 2018 to August 2021 in the hospital.They were divided into HCA group and non-HCA group according to the presence or absence of HCA.The general clinical data,laboratory indica-tors and delivery outcomes of the two groups were compared.Univariate and multivariate Logistic regression were used to analyze the association between prenatal WBC and HCA risk.Generalized additive models were used for curve fitting,and segmented regression models were used to further explain the nonlinear relationship between maternal prenatal WBC and HCA risk.Results The prenatal WBC of the HCA group was signifi-cantly higher than that of the non-HCA group(P＜0.001).After adjusting for covariates,elevated prenatal WBC increased the risk of HCA,with an OR of 1.190(95％CI:1.006-1.406,P=0.042).Curve fitting showed that there was a nonlinear relationship between prenatal WBC and HCA risk,and the log-likelihood ratio test of WBC at the inflection point 13.5×109/L(95％CI:11.75-14.56)was statistically significant(P=0.029).For the three groups of prenatal WBC,the risk of HCA in pregnant women gradually increased with the increase of WBC level,which was 0.314(95％CI:0.200-0.456)in the normal group,0.439(95％CI:0.252-0.645)in the high group,and 0.682(95％CI:0.354-0.893)in the elevated group.Conclusion The higher the prenatal WBC of pregnant women with PROM in late pregnancy,the greater the risk of HCA,but there is no simple linear relationship between the two,and there is a threshold effect.

Objective To analyze the main epidemiological characteristics of fungal infection in this hospital in the past 7 years,and to provide reference for clinical treatment and prevention and control strategies of fun-gal infection.Methods The fungal data and clinical data of related patients isolated from clinical samples in Peking Union Medical College Hospital from early January 2018 to the end of May 2024 were selected,and the main epidemiological characteristics of fungal infection in this hospital were identified and described through multi-angle statistical analysis.Results A total of 4 479 patients with filamentous fungal infection were en-rolled.The proportion of male patients[57.5％(2 576/4 479)]was higher than that of female patients[42.5％(1 903/4 143)],mainly distributed in internal medicine,Intensive Care Unit(ICU)and emergency de-partment,among which internal medicine accounted for the highest proportion[50.0％(2 241/4 479)].About 90.0％of the specimens were from the lower respiratory tract,in addition to specimens from skin and soft tis-sue,tissue,ear and blood culture.In terms of seasonal distribution,there are more patients in winter.The fun-gi were mainly composed of Aspergillus,Mucor,Cerdosporium,Fusarium and Penicillium,among which As-pergillus was the most abundant,accounting for 74.6％of the total.Aspergillus fumigatus was the most a-bundant Aspergillus,accounting for 42.5％of the total Aspergillus(1 418/3 340).Among the related infec-tions caused by mold,Aspergillus was the most common in the lower respiratory tract,accounting for 76.8％.Among them,Aspergillus fumigatus accounted for the highest proportion(33.6％).98.6％of the molds infected the ear were Aspergillus,of which Aspergillus niger and Aspergillus terreus were the most common.Skin infections are mainly caused by Sporothrix schenckii,Trichophyton rubrum,Microsporum ca-nis.The results of in vitro drug sensitivity test showed that the four common Aspergillus isolated in this hos-pital were sensitive to voriconazole,and amphotericin B had better antifungal activity against Mucorales in vitro.Conclusion Based on the main epidemiological characteristics of fungal infections in this hospital,it is recommended that special attention be paid to the admission of patients in the respiratory department during the peak infection period in autumn and winter.In the treatment of fungal infections in different regions and on different body parts,attention should be paid to the differences in the distribution of bacterial species.

Objective To explore the effect of classroom pivotal response teaching(CPRT)-based fun-damental motor skills intervention on the motor coordination ability in children with autism spectrum disorder(ASD).Methods Seventeen boys with ASD(aged 5～9 years)were recruited from a leading au-tism rehabilitation center.According to the principle of convenience sampling,the school-age class 3(n=9)was taken as the experimental group,and class 1 and 2(n=8)were chosen as the control group.Before the intervention,there was no significant difference between the two groups in terms of social communication skills.The experimental group was given CPRT-based fundamental motor skills in-tervention 3 times/week,60 minutes/session,for 9 weeks,while the control group did not receive the intervention.Before and after the intervention,as well as 4 weeks after the intervention,both groups were evaluated their motor coordination skills(manual dexterity,aiming and catching,and balance)us-ing the movement assessment battery for children(Movement-ABC).Repeated measures ANOVA was used to compare the differences in the total Movement-ABC scores and scores across its subdomains between the experimental group and the control group during different intervention periods.Results(1)After the intervention,the scores of experimental group were significantly higher than the control group in total motor skills,aiming and catching,and balance[F(1,15)=14.308,P<0.01;F(1,15)=7.244,P<0.05;F(1,15)=9.362,P<0.01].Moreover,4 weeks after the intervention,the scores of the former group were also significantly higher than the latter in all the above measurements[F(1,15)=11.670,P<0.01;F(1,15)=5.549,P<0.05;F(1,15)=9.209,P<0.01].(2)After the intervention,there was an improvement in manual dexterity in the experimental group,but without significant differences compared with the control group[F(1.316,19.736)=4.795,P>0.05].Conclusion The CPRT-based fundamental motor skills inter-vention can improve and sustain motor coordination among children with ASD,primarily through en-hanced performance in aiming,catching and balancing.

Objective:To evaluate the effect of preoperative oral carbohydrate intake on postoperative nausea and vomiting (PONV) in elderly patients undergoing gynecological laparoscopic surgery.Methods:This study was a randomized controlled trial. One hundred elderly patients, aged≥65 yr, with a body mass index of 18-30 kg/m 2, with American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, who underwent gynecological laparoscopic surgery at the Baoding First Central Hospital from March 2023 to June 2024, were selected. Stratification was conducted by age (65-74 yr/≥75 yr) using an online randomization tool, and the patients were randomly divided into conventional fasting group (group C) and oral carbohydrate group (group P), with 50 cases in each group. Patients took oral carbohydrate drinks of 4 ml/kg at 2 h before operation, with total amount ≤400 ml in group P, while patients received conventional preoperative fasting protocols in group C. The occurrence and severity of PONV within 48 h postoperatively were observed. The visual analogue scale scores for hunger and thirst, State-Trait Anxiety Inventory scale scores, length of stay in the postanesthesia care unit, duration of hospital stay, time to first flatus, time to first ambulation, and patient′s satisfaction were recorded in the two groups. Results:Compared with group C, the incidence and severity of PONV were significantly decreased within 48 h after surgery, the visual analogue scale scores for hunger and thirst and State-Trait Anxiety Inventory scale scores were significantly decreased after entering the operating room, the length of stay in the postanesthesia care unit, time to first flatus and time to first ambulation were significantly shortened, and the patient′s satisfaction was significantly increased in group P ( P<0.05). Conclusions:Oral carbohydrate intake before operation can effectively reduce the occurrence and severity of PONV and improve the quality of postoperative recovery in elderly patients undergoing gynecological laparoscopic surgery.

Objective To explore the effect of classroom pivotal response teaching(CPRT)-based fun-damental motor skills intervention on the motor coordination ability in children with autism spectrum disorder(ASD).Methods Seventeen boys with ASD(aged 5～9 years)were recruited from a leading au-tism rehabilitation center.According to the principle of convenience sampling,the school-age class 3(n=9)was taken as the experimental group,and class 1 and 2(n=8)were chosen as the control group.Before the intervention,there was no significant difference between the two groups in terms of social communication skills.The experimental group was given CPRT-based fundamental motor skills in-tervention 3 times/week,60 minutes/session,for 9 weeks,while the control group did not receive the intervention.Before and after the intervention,as well as 4 weeks after the intervention,both groups were evaluated their motor coordination skills(manual dexterity,aiming and catching,and balance)us-ing the movement assessment battery for children(Movement-ABC).Repeated measures ANOVA was used to compare the differences in the total Movement-ABC scores and scores across its subdomains between the experimental group and the control group during different intervention periods.Results(1)After the intervention,the scores of experimental group were significantly higher than the control group in total motor skills,aiming and catching,and balance[F(1,15)=14.308,P<0.01;F(1,15)=7.244,P<0.05;F(1,15)=9.362,P<0.01].Moreover,4 weeks after the intervention,the scores of the former group were also significantly higher than the latter in all the above measurements[F(1,15)=11.670,P<0.01;F(1,15)=5.549,P<0.05;F(1,15)=9.209,P<0.01].(2)After the intervention,there was an improvement in manual dexterity in the experimental group,but without significant differences compared with the control group[F(1.316,19.736)=4.795,P>0.05].Conclusion The CPRT-based fundamental motor skills inter-vention can improve and sustain motor coordination among children with ASD,primarily through en-hanced performance in aiming,catching and balancing.

The report of the 20th National Congress of the Communist Party of China has made a major deployment to promote the expansion of high-quality medical resources and balanced regional layout, and the construction of national regional medical centers is an important measure to implement the landing. By analyzing the " three co-construction" mode of the National Children′s Regional Medical Center of Henan Children′s Hospital (Beijing Children′s Hospital Zhengzhou Hospital), this paper systematically introduced the internal and external decision-making, management and operation of the regional medical center from four aspects: management, talent, discipline and system. The practice and effectiveness in talent introduction and training, salary distribution, two-way communication, assessment and incentive, discipline construction, technology application, sharing and evaluation of scientific and technological innovation, institutional linkage and integration, as well as the construction of a hierarchical diagnosis and treatment system, were put forward. Suggestions such as construction according to local conditions, strengthening internal coordination, and optimizing external guarantee were put forward, so as to provide practical reference for the in-depth promotion of other national regional medical center construction projects.

In the past decades, significant progress has been achived in cartilage regeneration. The traditional techniques for constructing tissue engineering cartilage scaffold mainly include pore agent method (or template method), phase separation method, gas foaming method, freeze-drying method, electrospinning method, etc. Cartilage is heterogeneous, and it is difficult for traditional scaffolds to simulate the high anisotropy of cartilage. Therefore, functional regeneration of cartilage is challenging. With the progress of three-dimensional(3D) printing technology, it is possible to prepare functional bionic scaffolds with fine structure and gradient changes through co-deposition of biomaterials, cells and active biomolecules, so as to achieve functional cartilage regeneration. This article reviewed 3D printing technology of cartilage tissue engineering, and the application of 3D printing technology in cartilage regeneration at different anatomical positions (articular cartilage, auricle cartilage, nasal cartilage). In addition, the importance of preparing bionic constructs with regional structure gradient and regional composition gradient was discussed. 3D bioprinting technology, 4D printing techniques, smart biomaterials brought hope for the construction of bionic tissues and organs.

Objective To observe the changes in functional connectivity(FC)of raphe nucleus in patients with first-episode depression complicated with suicidal ideation(SI).Methods Ninety-eight first-episode depression patients were prospectively enrolled and assigned into SI group(n=56)or non SI group(n=42)based on complicated with SI or not,while 47 healthy volunteers were recruited as control group.Resting-state functional MRI was performed.FC between dorsal raphe nucleus(DRN),median raphe nucleus(MRN)and the whole brain were analyzed and compared among 3 groups and between each 2 groups,and the correlations of FC of different brain regions with clinical data of SI group were explored.Results Compared with control group,FC between DRN and left cerebellum and left putamen in SI group and non SI group decreased(all P＜0.05),between MRN and right inferior temporal gyrus increased but between MRN and left inferior frontal gyrus,right superior occipital gyrus,left inferior parietal lobule,left putamen decreased(all P＜0.05).FC between DRN and left putamen in SI group was higher than that in non SI group(P＜0.05).FC between MRN and right central posterior gyrus of SI group increased compared with that in the rest 2 groups(both P＜0.05).FC between MRN and left putamen in SI group was positively correlated with body mass score of Hamilton depression scale-24(HAMD-24)(rs=0.297,P=0.026).Conclusion Abnormal changes of FC between raphe nucleus and cortex,also between raphe nucleus and subcortical area occurred,and FC between MRN and left putamen positively correlated with body mass score of HAMD-24 in patients with first-episode depression complicated with SI.

The presence of high-level talents plays a crucial role in ensuring the successful establishment of national regional medical centers.It presents the high-level talent management experience of Henan Children's Hospital,aiming to facilitate the coordinated development of pediatrics in Central China.To address the practical challenges and difficulties encountered in high-level talent management within hospitals,lean talent management is achieved by standardizing the management structure,clarifying management objectives,refining the management mechanism,establishing a performance appraisal incentive system,and implementing an integrated'induction and utilization'management approach.These measures effectively facilitate the development of national children's regional medical centers.