PURPOSE: To judge the injury mode and injury severity of the real human body through the measured values of anthropomorphic test devices (ATD) injury indices, the mapping relationship of lumbar injury between ATD and human body model (HBM) was explored. METHODS: Through the ATD model and HBM simulation, the mapping relationship of lumbar injury between the 2 subjects was explored. The sled environment consisted of a semi-rigid seat with an adjustable seatback angle and a 3-point seat belt system with a seatback-mounted D-ring. Three seatback recline states of 25°, 45°, and 65° were designed, and the seat pan angle was maintained at 15°. A 23 g, 47 km/h pulse was used. The validity of the finite element model of the sled was verified by the comparison of ATD simulation and test results. ATD model was the test device for human occupant restraint for autonomous vehicles (THOR-AV) dummy model and HBM was the total human model for safety (THUMS) v6.1. The posture of the 2 models was adjusted to adapt to the 3 seat states. The lumbar response of THOR-AV and the mechanical and biomechanical data on L1 - L5 vertebrae of THUMS were output, and the response relationship between THOR-AV and THUMS was descriptive statistically analyzed. RESULTS: Both THOR-AV and THUMS were submarined in the 65° seatback angle case. With the change of seatback angle, the lumbar spine axial compression force (F_z) of THOR-AV and THUMS changed in the similar trend. The maximum F_z ratio of THOR-AV to THUMS at 25° and 45° seatback angle cases were 1.6 and 1.7. The flexion moment (M_y) and the time when the maximum M_y occurred in the 2 subjects were very different. In particular, the form of moment experienced by the L1 - L5 vertebrae of THUMS also changed. The changing trend of M_y measured by THOR-AV over time can reflect the changing trend of maximum stress of L1 and L2 of THUMS. CONCLUSION The F_z of ATD and HBM presents a certain proportional relationship, and there is a mapping relationship between the 2 subjects on F_z. The mapping function can be further clarified by applying more pulses and adopting more seatback angles. It is difficult to map M_y directly because they are very different in ATD and HBM. The M_y of ATD and stress of HBM lumbar showed a similar change trend over time, and there may be a hidden mapping relationship.
Humans ; Lumbar Vertebrae/injuries* ; Finite Element Analysis ; Biomechanical Phenomena ; Manikins ; Spinal Injuries/physiopathology*

AIM To establish a UPLC method for the simultaneous content determination of liquiritin,ammonium glycyrrhizate,naringin,neohesperidin,hesperidin,rosmarinic acid,baicalin,wogonoside,baicalein,wogonin and praeruptorin A in Tongxuan Lifei Pills,and to make chemometric investigation.METHODS The analysis was performed on a 30 ℃ thermostatic SVEA C18 column(2.1 mm×150 mm,2.5 μm),with the mobile phase comprising of acetonitrile-0.1％phosphoric acid flowing at 0.5 mL/min in a gradient elution manner,and the detection wavelength was set at 250 nm.Subsequently,cluster analysis,principal component analysis and partial least square discriminant analysis were performed.RESULTS Eleven constituents showed good linear relationships within their own ranges(R2＞0.990 0),whose average recoveries were 90.00％-98.32％with the RSDs of 0.35％-1.89％.Forty batches of samples were clustered into 3 types.Baicalein,baicalin,liquiritin,wogonin,wogonoside and neohesperidin were taken as quality differential markers.CONCLUSION This simple and reproducible method can provide the basis for quality control and evaluation of Tongxuan Lifei Pills.

Objective To investigate the benefits and challenges of the reform in evidence-based obstetric nursing practice in clinical nursing,therefore to provide a reference for initiating and keeping the reform in evidence-based nursing practices.Methods A method of descriptive phenomenological research was conducted between January and February 2024 in our hospital on 10 selected clinical nurses by purposive sampling.An outline for interviews was developed based on literature review and expert interviews,followed by semi-structured interviews with the nurses.Core themes were extracted with Colaizzi's seven-step analysis.Results Three themes and 12 sub-themes were summarised in this study.The 3 core themes that were identified among the nurses included:acceptance of evidence-based nursing practice reform(with 3 domains regarding knowledge,decision-making and action),perception of the benefits of the reform in evidence-based nursing practice(with 5 domains regarding the professionalism and scientific nature of clinical nursing,improvement of patient experience and nursing outcomes,enhancement of nursing quality and safety,promotion of innovation in on-the-job training and education,and facilitation of collaboration within the nursing team),and perception in the challenges of reform in evidence-based nursing practice(with 4 domains regarding the stress and challenges,doubts and resistance,poor cooperation between doctors and nurses,and risks in clinical decision-making).Conclusion The acceptance regarding reform in evidence-based nursing practice varies among the nurses.It is necessary to promote the acceptance,provide the targeted guidance and intervene in the factors of benefits and challenges among the nurses,hence to facilitate a smooth implementation of the reform in evidence-based nursing practice.

Objective:To analyze the coupling coordination relationship and spatial correlation among the service demand,resource allocation and utilization efficiency of Traditional Chinese Medicine(TCM),aiming to provide theoretical support and optimization strategies for achieving the coordinated operation of the TCM systems in various provinces and promoting the coordinated development of TCM in different provinces.Methods:The data were collected from the China Health and Family Planning Statistical Yearbook(2013-2017)and the China Health Statistics Yearbook(2018-2023),the entropy method was employed to determine the weight of each evaluation index within the subsystems.A coupling coordination degree model and spatial econometric model were applied to assess the coupling coordination values and spatial correlations of the TCM system across various provinces in China.Results:In 2022,the national average coupling coordination degree was 0.603,with values of 0.648,0.577,and 0.563 for the eastern,central,and western regions,respectively.The western region had the highest number of provinces classified as"disordered type".A spatial clustering effect of the coupling coordination degree across 30 provinces.Conclusions:While the allocation of TCM resources has shown steady improvement,the demand for TCM services and utilization efficiency have exhibited a declining trend.The coupling coordination degree follows a decreasing gradient from east to west and exhibits significant spatial effects,a regional collaborative development mechanism for TCM should be established.

Objective:To construct a risk warning model for severe mycoplasma pneumoniae pneumonia(SMPP)children based on clinical data,laboratory indicators and imaging indicators.Methods:162 Mycoplasma pneumoniae pneumonia(MPP)children who were admitted in Foshan Women and Children Hospital from January 2021 to December 2023 were selected,64 SMPP children were included in severe group,the remaining 98 children were included in mild group.The general data,laboratory indicators and imaging indicators of the children were collected.The influencing factors for the occurrence of SMPP were analyzed by univariate and multivariate logistic regression models,and a risk warning model for the occurrence of SMPP children was constructed based on multivariate logistic regression model.The predictive value of the risk warning model for the occurrence of SMPP were analyzed by receiver operating characteristic(ROC)curve.Results:The proportion of 3 years old ≤ age＜6 years old,course of disease,body temperature,fever course,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),lactate dehydrogenase(LDH),cyanosis of lips,positive triconcave sign,pleural effusion,lesion site was the lower lobe,abnormal electrocardiogram and extrapulmonary manifestations in severe group were significantly higher than those in mild group(P＜0.05),there were no significant differences in gender,white blood cell count(WBC),neutrophil ratio and procalcitonin(PCT)between the two groups(P＞0.05).Multivariate logistic regression analysis model showed that,3 years old ≤age＜6 years old,high body temperature,long fever course,CRP elevated,ESR elevated,LDH elevated,cyanosis of lips,positive triconcave sign,pleural effusion,lesion site was the lower lobe,abnormal electrocardiogram and extrapulmonary manifestations were risk factors for the occurrence of SMPP(P＜0.05).ROC curve analysis showed that,the area under the curve(AUC)of the risk warning model was 0.829,the sensitivity was 84.82％,and the specificity was 78.15％,the actual prediction curve of the risk warning model was in good agreement with the prediction curve,the decision curve showed that,the threshold probability range of the model was 4.61％～88.14％.Conclusion:The risk warning model based on clinical multi parameters such as general data,laboratory indicators and imaging indicators has certain predictive value for the occurrence of SMPP.

Objective:To construct a risk warning model for severe mycoplasma pneumoniae pneumonia(SMPP)children based on clinical data,laboratory indicators and imaging indicators.Methods:162 Mycoplasma pneumoniae pneumonia(MPP)children who were admitted in Foshan Women and Children Hospital from January 2021 to December 2023 were selected,64 SMPP children were included in severe group,the remaining 98 children were included in mild group.The general data,laboratory indicators and imaging indicators of the children were collected.The influencing factors for the occurrence of SMPP were analyzed by univariate and multivariate logistic regression models,and a risk warning model for the occurrence of SMPP children was constructed based on multivariate logistic regression model.The predictive value of the risk warning model for the occurrence of SMPP were analyzed by receiver operating characteristic(ROC)curve.Results:The proportion of 3 years old ≤ age＜6 years old,course of disease,body temperature,fever course,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),lactate dehydrogenase(LDH),cyanosis of lips,positive triconcave sign,pleural effusion,lesion site was the lower lobe,abnormal electrocardiogram and extrapulmonary manifestations in severe group were significantly higher than those in mild group(P＜0.05),there were no significant differences in gender,white blood cell count(WBC),neutrophil ratio and procalcitonin(PCT)between the two groups(P＞0.05).Multivariate logistic regression analysis model showed that,3 years old ≤age＜6 years old,high body temperature,long fever course,CRP elevated,ESR elevated,LDH elevated,cyanosis of lips,positive triconcave sign,pleural effusion,lesion site was the lower lobe,abnormal electrocardiogram and extrapulmonary manifestations were risk factors for the occurrence of SMPP(P＜0.05).ROC curve analysis showed that,the area under the curve(AUC)of the risk warning model was 0.829,the sensitivity was 84.82％,and the specificity was 78.15％,the actual prediction curve of the risk warning model was in good agreement with the prediction curve,the decision curve showed that,the threshold probability range of the model was 4.61％～88.14％.Conclusion:The risk warning model based on clinical multi parameters such as general data,laboratory indicators and imaging indicators has certain predictive value for the occurrence of SMPP.

AIM To establish a UPLC method for the simultaneous content determination of liquiritin,ammonium glycyrrhizate,naringin,neohesperidin,hesperidin,rosmarinic acid,baicalin,wogonoside,baicalein,wogonin and praeruptorin A in Tongxuan Lifei Pills,and to make chemometric investigation.METHODS The analysis was performed on a 30 ℃ thermostatic SVEA C18 column(2.1 mm×150 mm,2.5 μm),with the mobile phase comprising of acetonitrile-0.1％phosphoric acid flowing at 0.5 mL/min in a gradient elution manner,and the detection wavelength was set at 250 nm.Subsequently,cluster analysis,principal component analysis and partial least square discriminant analysis were performed.RESULTS Eleven constituents showed good linear relationships within their own ranges(R2＞0.990 0),whose average recoveries were 90.00％-98.32％with the RSDs of 0.35％-1.89％.Forty batches of samples were clustered into 3 types.Baicalein,baicalin,liquiritin,wogonin,wogonoside and neohesperidin were taken as quality differential markers.CONCLUSION This simple and reproducible method can provide the basis for quality control and evaluation of Tongxuan Lifei Pills.

Objective To investigate the benefits and challenges of the reform in evidence-based obstetric nursing practice in clinical nursing,therefore to provide a reference for initiating and keeping the reform in evidence-based nursing practices.Methods A method of descriptive phenomenological research was conducted between January and February 2024 in our hospital on 10 selected clinical nurses by purposive sampling.An outline for interviews was developed based on literature review and expert interviews,followed by semi-structured interviews with the nurses.Core themes were extracted with Colaizzi's seven-step analysis.Results Three themes and 12 sub-themes were summarised in this study.The 3 core themes that were identified among the nurses included:acceptance of evidence-based nursing practice reform(with 3 domains regarding knowledge,decision-making and action),perception of the benefits of the reform in evidence-based nursing practice(with 5 domains regarding the professionalism and scientific nature of clinical nursing,improvement of patient experience and nursing outcomes,enhancement of nursing quality and safety,promotion of innovation in on-the-job training and education,and facilitation of collaboration within the nursing team),and perception in the challenges of reform in evidence-based nursing practice(with 4 domains regarding the stress and challenges,doubts and resistance,poor cooperation between doctors and nurses,and risks in clinical decision-making).Conclusion The acceptance regarding reform in evidence-based nursing practice varies among the nurses.It is necessary to promote the acceptance,provide the targeted guidance and intervene in the factors of benefits and challenges among the nurses,hence to facilitate a smooth implementation of the reform in evidence-based nursing practice.

Objective:To analyze the coupling coordination relationship and spatial correlation among the service demand,resource allocation and utilization efficiency of Traditional Chinese Medicine(TCM),aiming to provide theoretical support and optimization strategies for achieving the coordinated operation of the TCM systems in various provinces and promoting the coordinated development of TCM in different provinces.Methods:The data were collected from the China Health and Family Planning Statistical Yearbook(2013-2017)and the China Health Statistics Yearbook(2018-2023),the entropy method was employed to determine the weight of each evaluation index within the subsystems.A coupling coordination degree model and spatial econometric model were applied to assess the coupling coordination values and spatial correlations of the TCM system across various provinces in China.Results:In 2022,the national average coupling coordination degree was 0.603,with values of 0.648,0.577,and 0.563 for the eastern,central,and western regions,respectively.The western region had the highest number of provinces classified as"disordered type".A spatial clustering effect of the coupling coordination degree across 30 provinces.Conclusions:While the allocation of TCM resources has shown steady improvement,the demand for TCM services and utilization efficiency have exhibited a declining trend.The coupling coordination degree follows a decreasing gradient from east to west and exhibits significant spatial effects,a regional collaborative development mechanism for TCM should be established.

Background/Aims: Despite the high efficacy of direct-acting antivirals (DAAs), approximately 1–3% of hepatitis C virus (HCV) patients fail to achieve a sustained virological response. We conducted a nationwide study to investigate risk factors associated with DAA treatment failure. Machine-learning algorithms have been applied to discriminate subjects who may fail to respond to DAA therapy. Methods: We analyzed the Taiwan HCV Registry Program database to explore predictors of DAA failure in HCV patients. Fifty-five host and virological features were assessed using multivariate logistic regression, decision tree, random forest, eXtreme Gradient Boosting (XGBoost), and artificial neural network. The primary outcome was undetectable HCV RNA at 12 weeks after the end of treatment. Results: The training (n=23,955) and validation (n=10,346) datasets had similar baseline demographics, with an overall DAA failure rate of 1.6% (n=538). Multivariate logistic regression analysis revealed that liver cirrhosis, hepatocellular carcinoma, poor DAA adherence, and higher hemoglobin A1c were significantly associated with virological failure. XGBoost outperformed the other algorithms and logistic regression models, with an area under the receiver operating characteristic curve of 1.000 in the training dataset and 0.803 in the validation dataset. The top five predictors of treatment failure were HCV RNA, body mass index, α-fetoprotein, platelets, and FIB-4 index. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of the XGBoost model (cutoff value=0.5) were 99.5%, 69.7%, 99.9%, 97.4%, and 99.5%, respectively, for the entire dataset. Conclusions Machine learning algorithms effectively provide risk stratification for DAA failure and additional information on the factors associated with DAA failure.