Objective To develop a preoperative question prompt list(QPL)for older patients with benign prostatic hyperplasia(BPH)and evaluate its effectiveness in application.Methods This trial adopted a randomized controlled design.The QPL was developed by literature review,expert discussions,and Delphi consultation.Convenience sampling was used to subject 76 older BPH inpatients treated in our department,and then they were randomly divided into control(routine communication,n=38)and intervention(QPL-assisted communication,n=38)groups.Number of the questions patient asking,communication duration,information recall,and communication quality were compared between the 2 groups.Results In the 2 rounds of expert consultation,the response rate of questionnaire was 94.44%and 100%,the authority coefficient was 0.89 and 0.93,the coefficient of variation was 0.05～0.22 and 0～0.11,and Kendall's coefficients was 0.645(Chi-square=87.782,P<0.001)and 0.733(Chi-square=74.789,P<0.001),respectively.The final QPL included 3 themes and 7 questions.The intervention group asked more questions(4.03±1.89 vs 2.11±1.27,P<0.05)but spent similar time for communication(8.18±2.11 vs 7.67±1.72 min,P>0.05).At 1 d before discharge,better information recall(8.74±1.12 vs 6.49±1.68,P<0.001)and communication quality(60.06±6.25 vs 54.86±7.98,P<0.05)were observed in the intervention group when compared with the control group.Conclusion Our developed preoperative communication QPL is of scientificalness and effectiveness for elderly BPH patients.This tool can not only encourage question-asking behavior,but also improve information recall and communication quality in the patients.

Objective To compare the clinical efficacy of abdominal ultrasound-guided endoscopic retrograde appendicitis therapy(ERAT)with laparoscopic appendectomy(LA)for acute uncomplicated appendicitis using propensity score matching.Methods The clinical data of 441 patients with acute uncomplicated appendicitis admitted to the Third People's Hospital of Yunnan Province from March 2020 to April 2023 were collected.The cases were classified based on the differences in surgical method and divided into the ERAT group(n = 30)and LA group(n = 411).The clinical efficacy of patients was compared between the two groups after reducing confounding bias by propensity score matching(PSM).Results After PSM,a total of 30 pairs of patients in the two groups were successfully matched,and the baseline data of the two groups met the requirements for comparability.At 24 hours after the operation,the ERAT group exhibited lower white blood cells,neutrophil counts,and C-reactive protein levels compared to the LA group,and these differences were statistically significant(P<0.05).There was no significant difference in the operation time and total effective rate between the ERAT group and the LA group(P>0.05).However,the ERAT group had lower intraoperative blood loss and shorter pain relief time compared to the LA group,and these differences were statistically significant(P<0.05).Conclusion Abdominal ultrasound-guided endoscopic retrograde appendicitis treatment is an effective,safe,and feasible technique with good prospects for the treatment of acute uncomplicated appendicitis.

Objective:To explore the classification performance of combined model constructed from CT signs combined with radiomics for discriminating COVID-19 pneumonia and other viral pneumonia.Methods:The clinical and CT imaging data of 181 patients with viral pneumonia confirmed by reverse transcription-polymerase chain reaction in 15 hospitals of Yunnan Province from March 2015 to March 2020 were analyzed retrospectively. The 181 patients were divided into COVID-19 group (89 cases) and non-COVID-19 group (92 cases), which were further divided into training cohort (126 cases) and test cohort (55 cases) at a ratio of 7∶3 using random stratified sampling. The CT signs of pneumonia were determined and the radiomics features were extracted from the initial unenhanced chest CT images to build independent and combined models for predicting COVID-19 pneumonia. The diagnostic performance of the models were evaluated using receiver operating characteristic (ROC) analysis, continuous net reclassification index (NRI) calibration curve and decision curve analysis.Results:The combined models consisted of 3 significant CT signs and 14 selected radiomics features. For the radiomics model alone, the area under the ROC curve (AUC) were 0.904 (sensitivity was 85.5%, specificity was 84.4%, accuracy was 84.9%) in the training cohort and 0.866 (sensitivity was 77.8%, specificity was 78.6%, accuracy 78.2%) in the test cohort. After combining CT signs and radiomics features, AUC of the combined model for the training cohort was 0.956 (sensitivity was 91.9%, specificity was 85.9%, accuracy was 88.9%), while that for the test cohort was 0.943 (sensitivity was 88.9%, specificity was 85.7%, accuracy was 87.3%). The AUC values of the combined model and the radiomics model in the differentiation of COVID-19 group and the non-COVID-19 group were significantly different in the training cohort ( Z=-2.43, P=0.015), but difference had no statistical significance in the test cohort ( Z=-1.73, P=0.083), and further analysis using the NRI showed that the combined model in both the training cohort and the test cohort had a positive improvement ability compared with radiomics model alone (training cohort: continuous NRI 1.077, 95 %CI 0.783-1.370; test cohort: continuous NRI 1.421, 95 %CI 1.051-1.790). The calibration curve showed that the prediction probability of COVID-19 predicted by the combined model was in good agreement with the observed value in the training and test cohorts; the decision curve showed that a net benefit greater than 0.6 could be obtained when the threshold probability of the combined model was 0-0.75. Conclusion:The combination of CT signs and radiomics might be a potential method for distinguishing COVID-19 and other viral pneumonia with good performance.

Objective:To explore the value of multiphasic CT-based radiomics signature in predicting the invasive behavior of pancreatic solid pseudopapillary neoplasm (pSPN).Methods:The multiphasic CT images of patients with pSPN confirmed by postoperative pathology in the First Affiliated Hospital of Zhengzhou University from January 2012 to January 2021 were analyzed retrospectively. There were 23 cases of invasiveness and 59 cases of non-invasiveness. The region of interest(ROI) was artificially delineated layer by layer in the plain scan, arterial-phase and venous-phase images, respectively. The 1 316 image features were extracted from each ROI. The data set was divided into training and validation sets with a ratio of 7∶3 by stratified random sampling, and synthetic minority oversampling technique (SMOTE) algorithm was used for oversampling in the training set to generate invasive and non-invasive balanced data for building the training model. The constructed model was validated in the validation set. The receiver operating characteristic(ROC) analysis was used to evaluate model performance and the Delong′s test was applied to compare the area under the ROC curve (AUC) of different predict models. The improvement for classification efficiency of each independent model or their combinations were also assessed by net reclassification improvement (NRI) and integrated discrimination improvement (IDI) indices.Results:After feature extraction, 2, 6 and 3 features were retained to construct plain-scanned model, arterial-phase and venous-phase models, respectively. Seven independent-phase and combined-phase models were established. Except the plain-scanned model, the AUC values of other models were greater than 0.800. The arterial-phase model had the best efficiency for classification among all independent-phase models. The AUC values of arterial-phase model in the SMOTE training and validation sets were 0.913 and 0.873, respectively. By combining the radiomics signature of the arterial-phase and venous-phase models, the AUC values of training and validation sets increased to 0.934 and 0.913 respectively. There were no significant differences of the AUC values between the scan-arterial venous-phase model and arterial venous-phase model in both training and validation sets (both P>0.05). The NRI and IDI indexes showed that the combined form of plain-scan model and arterial-venous-phase model could not significantly improve the classification efficiency in the validation set (both NRI and IDI<0). Conclusions:The arterial-phase CT-based radiomics model has a good predictive performance in the invasive behavior of pSPN, and the combination with a venous-phase radiomics model can further improve the model performance.

Objective:The arsenic content of drinking water in Aksu Prefecture of Xinjiang Uygur Autonomous Region (referred to as Xinjiang) was analyzed to understand the distribution of arsenic content and arsenic form of water in each county and city.Methods:In 2020, a total of 117 waterworks and villages (towns) under the jurisdiction of waterworks in 7 counties and 2 cities were randomly sampled, arsenic content in water was detected by atomic fluorescence spectrometry, and arsenic form in water was detected by liquid chromatography atomic fluorescence spectrometry.Results:A total of 626 water samples were collected, 614 water samples with water arsenic content < 0.01 mg/L, accounting for 98.08%; 12 water samples with water arsenic content 0.01 - < 0.05 mg/L, accounting for 1.92%; and there was no water sample with arsenic content ≥0.05 mg/L. The form of arsenic in excessive water sample in Aksu Prefecture was found to be five-valent arsenate. The arsenic content in the water of Awati County was the highest (0.004 6 mg/L).Conclusions:There are still some counties and cities with high arsenic content in water in Aksu Prefecture, and there are still hidden dangers of drinking-water brone endemic arsenism. Therefore, the water treatment technology should be improved or the water sources should be changed to prevent endemic arsenism.

BACKGROUND:Toxic cytarabine is often used to prepare highly purified neurons in experimental studies addressing central nervous system diseases. However, the intervention time of cytarabine is little reported. OBJECTIVE:To determine the optimal intervention time of cytarabine(final concentration 10μmol/L) in primary culture of rat cortical neurons. METHODS:Rat primary cortical neurons were cultured in Neurobasal+B27 medium, and 10μmol/L cytarabine were added at 12, 24, 36 and 48 hours after culture, respectively. Half of the medium were changed every 48 hours. The morphology of neurons was observed under inverted microscope at 7 days. The purity and differentiation of neurons maturity were identified by immunocytochemistry method of neuron specific enolization enzyme staining. Morphometric analysis for all neuron-specific enolase positive cells was performed by Multifunction Computer Image Analysis System. RESULTS AND CONCLUSION:After addition of cytarabine at 24 hours of culture, the purity of neurons was more than 90%, well-differentiated cortical neurons accounted for 89.00%, and the area of neuronal body was the largest with the longest synapses. There were more neuron cells with transparent cytoplasm, and large nucleus. The cell body had good refraction and strong stereo sense. The neurons with 3-4 synapses and 3-4 bifurcates formed a good network structure. These results illustrate that although it willbe beneficial for the purity of neurons to add cytarabine early in neuron culture process, it will make obvious effect on neuronal differentiation. The highly purified and well-grown cerebral cortical neurons will be obtained after cultured in neurolbasal medium, which cytarabine is added to at 24 hours of culture.

Objective:To explore the relationship between air pollution and the number of pneumonia hospitalization in a children's hospital in Changsha.Methods:Children who have been in this hospital for the treatment of pneumonia between December 2013 and December 2015 were enrolled in this study.Based on daily meteorological data and air pollution data from December 2013 to December 2015 in Changsha,we constructed a generalized additive model to analyze the relationship between air pollution and the number of pneumonia hospitalization.Results:During the research,the average concentration of PM2.5 and PM10 exceeded the Grade Ⅱ national standards for air quality.The average concentration of SO2 exceeded the Grade Ⅰ national standards.The change of all the 3 main air pollution indexes showed strong statistical relationship with the change of the number of pneumonia hospitalization (P＜0.05),among which,the impact of SO2 ranked number 1,followed by PM2.5 and PM10.Effect of atmospheric pollution on the number of pneumonia boys was basically same as that in the total pneumonia children (P＜0.05).The effect on girls showed no statistical relationship in both models (P＞0.05).Conclusion:The concentrations of SO2'PM2.5 and PM10 are positively correlated with pneumonia hospitalization number of children,and their effect on boys is more obvious than that in the girls.

Objective To understand health literacy levels in elderly people aged 60 years and above in Hunan, and explore factors related to health literacy.Methods Hunan residents aged 60 years and above were randomly recruited by the multistage stratified cluster sampling method.A total of 611 elderly people from 13 counties of Hunan were included in the study, which was conducted through questionnaires.Results The median health literacy score for elderly people aged 60 years and above was 51.00 (4-90), and it was lower than that for people under 60 years old, which was 56.00.Single factor analysis found that education level, occupation, number of family members, and household income each had an influence on health literacy scores (H=59.526, 20.609, 17.214, and 50.749, respectively;P=0.000, 0.002, 0.001 and 0.000, respectively).The number of people with basic health literacy accounted for 10.6％ (65/611) of the total.Multiple logistic regression analysis found that chronic disease was a factor affecting basic health literacy.Compared with elderly people without chronic diseases, a higher percentage of people with basic health literacy was among elderly people with chronic diseases (OR =1.870, 95％ CI: 1.037-3.373).Conclusions The health literacy level is lower in elderly people aged 60 years and above than those under 60 years old in Hunan.Only 10.6％ (65/611) of them show basic health literacy.Education level, occupation, number of family members, and household income are the factors related to health literacy.Health education about healthy lifestyle and behavior as well as chronic disease prevention and control should be increased in order to improve the health literacy level in elderly people.

The violence behavior is a kind of aggressive behaviors or attempt to hurt another person psychologically,physically or in other forms.Recently,violent incidents occur more and more frequently,and especially among teenagers.A number of concerns on violence continue to rise,and interpersonal violence is the most concerned type.Perpetrators are violence implementers who determine the occurrence and outcome of violence.Many studies provided the risk factors of interpersonal violence,that expounds the influence of personal level,interpersonal relationship,community background and social factors of interpersonal violence.The establishment of the socioecological risk-factor structural model which focuses on the perpetrators' indi vidual,is of great significance for the effective intervention for interpersonal violence.

OBJECTIVE: To comprehensively evaluate the interventional effect on unexpected injury among children and adolescents in China, and to provide scientific basis for the injury control strategy.
 METHODS: Meta analysis was utilized to analyze the selected literatures. After heterogeneity test of the data, a relevant model was chosen to estimate the combined effect values relative risk (RR) and the corresponding 95% confidence interval (95% CI). Subgroup analysis were performed based on the intervention measures, objects and places. Sensitivity and publication bias were analyzed.
 RESULTS: A total of 18 papers were included in the Meta analysis with a sample size of 32 599. The combined RR value was 0.54 (95% CI 0.44 to 0.68). Subgroup analysis showed that the RR value of health education and comprehensive intervention were 0.59 and 0.50, respectively, with no significant difference between them (P>0.05). The RR values of the interventions in school alone, in school and community or in community alone were 0.51, 0.78 or 0.63. The RR values on children alone, children and parents or parents alone were 0.53, 0.65 or 0.35. The differences were significant when the interventions were performed among different places or objects (P<0.05). Sensitivity analysis revealed that meta-analysis results were relatively stable.
 CONCLUSION The targeted interventions were significant in the prevention of unexpected injuries among children and adolescents. It is worth further promoting and spreading.
Adolescent ; Child ; China ; Humans ; Schools ; Wounds and Injuries ; epidemiology ; prevention & control