OBJECTIVE To analyze the clinical characteristics and influential factors of drug-induced liver injury （DILI） in children caused by intravenous azithromycin. METHODS Clinical data of 157 DILI pediatric cases caused by intravenous azithromycin， reported by the Hengshui Adverse Drug Reaction Monitoring Center from January 2015 to January 2025， were collected as the observation group. Clinical data of pediatric patients who received intravenous azithromycin but did not develop DILI during the same period at Hengshui People’s Hospital were collected in a 1∶1 ratio to serve as the control group. The clinical classification， severity and prognosis of DILI in pediatric patients from the observation group were analyzed. Univariate and multivariate Logistic regression analyses were used to screen the independent risk factors for DILI in children caused by intravenous azithromycin. RESULTS Among 157 DILI cases， 92 cases （58.60%） had hepatocellular injury-type， 51 cases （32.48%） had cholestatic-type， and 14 cases （8.92%） had mixed-type. DILI severity was grade 1 in 117 cases （74.52%）， grade 2 in 33 cases （21.02%）， and grade 3 in 7 cases （4.46%）. Liver function had all recovered after stopping medication and symptomatic treatment. Combined with acetaminophen [OR＝3.769， 95%CI （1.615， 8.235）， P＝0.021]， daily dose of azithromycin＞10 mg/kg [OR＝ 2.237， 95%CI （1.075， 4.655）， P＝0.034] were independent risk factors for DILI in children caused by intravenous azithromycin. CONCLUSIONS Hepatocellular injury-type and cholestatic-type are relatively common in children with DILI caused by intravenous azithromycin， with mild severity being predominant and showing a favorable prognosis. Combination with acetaminophen and daily dose＞10 mg/kg are independent risk factors for azithromycin-induced DILI in children.

This paper reviews the current status, evaluation tools, influencing factors, and intervention measures of social alienation in colorectal cancer patients with enterostomy, in order to provide reference for the research on social alienation in colorectal cancer patients with enterostomy in China.

Objective:To evaluate the methodological quality and measurement characteristics of children's needs assessment tools.Methods:Literature on children's needs assessment tools was searched in Cochrane Library, PubMed, Embase, Web of Science, CINAHL, China National Knowledge Infrastructure (CNKI), WanFang Data, VIP, and China Biology Medicine disc. The search period was from database establishment to April 2, 2023. The Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guideline was used to evaluate the methodological quality and measurement characteristics of assessment tools, and integrate the evaluation results to form recommendations.Results:Six studies were included in total. The recommended opinions for the two evaluation tools (Needs of Children Questionnaire and Male Adolescent Health Needs-Assessment Scale) were A level. The recommended opinions for the four evaluation tools were B level. The Male Adolescent Health Needs-Assessment Scale had high cultural specificity.Conclusions:The evidence quality of the Needs of Children Questionnaire is relatively high and can be temporarily recommended for use, but other measurement characteristics still need further verification.

Objective:To explore the predictive value of helper T cell(Th)immune response indicators for asthma control in children with cough variant asthma(CVA)and its relationship with the risk of recurrence.Methods:A total of 112 children with CVA in Hengshui City People's Hospital from August 2020 to August 2021 were selected,all received conventional western medicine treat-ment,and were divided into well-controlled group(n=85)and poorly-controlled group(n=27)according to their asthma control status after 4 weeks of treatment.compare the general data,pulmonary function indexes before treatment[forced expiratory volume in 1 se-cond(FEV1),FEV1/forced vital capacity(FVC)],Th immune response indexes(Th1/Th2,IL-2,IFN-γ,IL-4,IL-10)levels,ana-lyze the correlation between Th immune response indicators and pulmonary function indicators,and predict the value of asthma control in children with CVA.After 6 months of follow-up,the recurrence situation in the well-controlled group was counted,the Th immune response indexes before treatment were compared between the children with recurrence and those without recurrence,and the relation-ship between Th immune response indexes and recurrence were analyzed.Results:Before treatment,the levels of FEV1,FEV1/FVC,Th1/Th2,IL-2 and IFN-γ in the poor control group were lower than those in the well-controlled group,and the levels of IL-4 and IL-10 were higher than those in the well-controlled group(P<0.05).Th1/Th2,IL-2,IFN-γ levels were positively correlated with FEV1,FEV1/FVC before treatment in children with CVA,and IL-4,IL-10 levels were negatively correlated with FEV1,FEV1/FVC(P<0.05);the areas under the curve(AUC)of Th1/Th2,IL-2,IFN-γ,IL-4 and IL-10 levels before treatment for predicting poor asthma control in children with CVA were all>0.7,and the combined predicted AUC(0.933)was the largest;before treatment,the levels of Th1/Th2,IL-2 and IFN-γ in the relapsed children in the group were lower than those of the non-relapsed children,and the levels of IL-4 and IL-10 were higher than those of the non-relapsed children(P<0.05);The levels of Th1/Th2,IL-2,and IFN-γ before treat-ment were negatively correlated with CVA recurrence,while IL-4 and IL-10 levels were positively correlated with CVA recurrence(P<0.05).Conclusion:Th immune response index has a certain value in predicting asthma control in children with CVA,and is closely related to the recurrence of CVA.

Objective:To synthesize the real experiences of medical staff's organizational silence behavior.Methods:A systematic search was conducted in databases including PubMed, Web of Science, Embase, Cochrane Library, CINAHL, EBSCO, ProQuest, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biology Medicine disc, collecting qualitative studies on medical staff's experiences related to organizational silence behavior. The search period covered the establishment of the databases until June 2024. The quality of the included studies was assessed using the Joanna Briggs Institute's qualitative research quality evaluation standards, and results were integrated using an aggregative synthesis approach.Results:A total of 10 studies were included, with 65 findings summarized into 11 new categories, which were further synthesized into four overarching conclusions: organizational silence is complex, with respect and concern coexisting, many factors contribute to organizational silence, medical staff experience negative emotions as a result of organizational silence, there is a desire for recognition and support.Conclusions:The experience of organizational silence behavior among medical staff is complex. Managers should focus on this issue, encourage individuals to voice their concerns, provide diverse support mechanisms, and enhance positive experiences to reduce the prevalence of organizational silence.

Objective To evaluate and integrate the facilitators and barriers to adherence to diet or exercise interventions in patients with overweight or obesity.Methods PubMed,Web of Science,Embase,CINAHL,Cochrane Library,China National Knowledge Infrastructure,Wanfang,and VIP Chinese Biomedical Literature Database were searched by computer from the establishment of the database to October 14,2023.The 2016 edition of the Joanna Briggs Institute(JBI)evidence-based health care center qualitative research evaluation criteria was used to evaluate and integrate the included literature.Results A total of 19 studies were included,and 38 outcomes were distilled into 12 categories,and the results were consolidated into facilitators(disease threat perception,self-body perception,self-adjustment,sense of responsibility,social support)and barriers to intervention adherence(poor treatment benefit,low self-efficacy,lack of knowledge,competitive priorities,extemal environmental constraints,economic conditions,poor intervention design).Conclusion There are many facilitators and barriers of diet or exercise intervention perceived by patients.It is suggested that follow-up intervention research should be used as a reference to improve the treatment compliance of patients.

Objective To systematically evaluate qualitative studies on the experience of transition from adolescent to adult medical care for patients with congenital heart disease(CHD),and to provide a reference for exploring CHD transition management options and developing intervention strategies.Methods A computerized search of PubMed,Embase,Web of Science,Cochrane Library,EBSCO,CINAHL,China Knowledge Network,Wanfang database,Vipshop database,and China Biomedical Literature Database for qualitative studies on the transition experience of CHD patients from adolescence to adult medical care was conducted for the period from the establishment of the database to April 2023.The quality of the literature was evaluated using the Joanna Briggs Institute(JBI)Australian Centre for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research(2016),and the results were integrated using meta-integration methods.Results A total of 9 studies were included,and 49 research results were extracted,and 11 categories were summarized.The final synthesis included 4 integrated results:①Complex attitudes towards healthcare transition,with both attachment and expectation:attachment to paediatric healthcare providers,expectation of transition to adult healthcare providers.(2)Facing multiple healthcare transition challenges:lack of adequate preparation for healthcare transition,parents withdrawing from the role of disease manager,large differences in services between paediatric and adult healthcare providers.③Expect to receive multiple supports:expect to receive comprehensive health education from healthcare personnel,expect healthcare institutions to set up healthcare transition counselling clinics and achieve handover of illness,expect to receive companionship and support from parents,expect to receive understanding and help from peers.④ Per-ceived benefits of medical transition:increased ability to manage illness,role change and personal growth.Conclusion Adolescents with CHD have a complex experience of transitioning to adult healthcare,and healthcare professionals should be attentive to their feelings,encourage them to deal with challenges positively,and provide adequate information and joint parental and peer support to facilitate a smooth transition to adult healthcare for adolescents.

Objective to analyze the Budget Execution Rate of administrative departments in sample hospitals,and to realize the cost control of Budget performance integration with Balanced Score Card(BSC)Financial Dimension Quantitative Assessment.Methods The budget and execution data of 23 administrative departments were collected from January to June in the sample 2023.The budget execution rate was calculated and cleaned,and the data were segmented by histogram.Using the financial dimension 25 to divide by the total number of items in each department's budget to obtain the scoreof each item in each department,and using the interpolation method to calculate the cost scores of each department,then into the performance appraisal.Results(1)Each item score should be multiplied by item coefficient,and then sum up;(2)The total score of self-executing Project+the total score of centralized executing project.(3)Cost score:1 the scores of 8 departments of non-homing items were 5.54～15.76,2 the scores of 15 departments of homing items were 7.68～17.06.Conclusion It adopts the concept of BSC and Hospital Resource Planning as the cost control of administrative departments to make up for the lack of qualitative and quantitative BSC;can focus on monitoring the dispersion of large data;histogram score results of segmentation objective and easy to operate,makes the interpolation calculation more credible.In a word,it provides quantitative ideas and methods in the aspects of different responsibilities and difficult performance evaluation.

Objective to analyze the Budget Execution Rate of administrative departments in sample hospitals,and to realize the cost control of Budget performance integration with Balanced Score Card(BSC)Financial Dimension Quantitative Assessment.Methods The budget and execution data of 23 administrative departments were collected from January to June in the sample 2023.The budget execution rate was calculated and cleaned,and the data were segmented by histogram.Using the financial dimension 25 to divide by the total number of items in each department's budget to obtain the scoreof each item in each department,and using the interpolation method to calculate the cost scores of each department,then into the performance appraisal.Results(1)Each item score should be multiplied by item coefficient,and then sum up;(2)The total score of self-executing Project+the total score of centralized executing project.(3)Cost score:1 the scores of 8 departments of non-homing items were 5.54～15.76,2 the scores of 15 departments of homing items were 7.68～17.06.Conclusion It adopts the concept of BSC and Hospital Resource Planning as the cost control of administrative departments to make up for the lack of qualitative and quantitative BSC;can focus on monitoring the dispersion of large data;histogram score results of segmentation objective and easy to operate,makes the interpolation calculation more credible.In a word,it provides quantitative ideas and methods in the aspects of different responsibilities and difficult performance evaluation.

Objective to analyze the Budget Execution Rate of administrative departments in sample hospitals,and to realize the cost control of Budget performance integration with Balanced Score Card(BSC)Financial Dimension Quantitative Assessment.Methods The budget and execution data of 23 administrative departments were collected from January to June in the sample 2023.The budget execution rate was calculated and cleaned,and the data were segmented by histogram.Using the financial dimension 25 to divide by the total number of items in each department's budget to obtain the scoreof each item in each department,and using the interpolation method to calculate the cost scores of each department,then into the performance appraisal.Results(1)Each item score should be multiplied by item coefficient,and then sum up;(2)The total score of self-executing Project+the total score of centralized executing project.(3)Cost score:1 the scores of 8 departments of non-homing items were 5.54～15.76,2 the scores of 15 departments of homing items were 7.68～17.06.Conclusion It adopts the concept of BSC and Hospital Resource Planning as the cost control of administrative departments to make up for the lack of qualitative and quantitative BSC;can focus on monitoring the dispersion of large data;histogram score results of segmentation objective and easy to operate,makes the interpolation calculation more credible.In a word,it provides quantitative ideas and methods in the aspects of different responsibilities and difficult performance evaluation.