Objective To analyze the efficacy of the"sandwich"technique for treating varicocele(VC).Methods A total of 310 patients with VC(365 affected veins)were selected and divided into interventional treatment group and non-interventional treatment group.The baseline data,hospitalization data,and 6-month follow-up data of the two groups were analyzed.Results The age of patients in the interventional treatment group was significantly lower than that in the non-interventional treatment group(P＜0.05).The surgical time and hospital stay in the interventional treatment group were significantly lower than those in the non-interventional treatment group(P＜0.05).In the non-interventional treatment group,two patients experienced surgical site infections,and one patient opted for interventional treatment due to recurrence after non-interventional treatment.After surgery,the diameter of the spermatic vein significantly decreased in both the interventional and non-interventional treatment(P＜0.05).Conclusion The"sandwich"technique(embolization coil combined with foam sclerotherapy)is an effective treatment for VC.

Objective To Observe the clinical characteristics and prognosis of patients with the acute macular neuroretinopathy(AMN)associated with novel coronavirus infection(COVID-19).Methods The data of 13 patients diagnosed with COVID-19-associated AMN attending the Department of Ophthalmology of the Affiliated Hospital of Yunnan University from December 2022 to February 2023,as well as 13 case reports in PubMed and Web of Science databases from 2020 to 2023 and a case series study totaling 41 patients were retrospectively selected and analyzed for their ophthalmic imaging and prognostic outcomes in clinic.Results A total of 13 cases with 25 eyes in the clinical case group were included in the study with a mean age of 30.23±6.02 years,of which 10 were females.The literature case group consisted of 41 cases and 72 eyes with a mean age of 30.12±13.24 years,including 31 female patients.(1)Duration between COVID-19 symptoms/diagnosis and ophthalmic symptoms:3(2.0,4.0)days in the clinical case group and 2(0.75,5.0)days in the literature case group.(2)Clinical characteristics:12(92.31％)of the clinical case group had the binocular onset and the literature case group,31(75.61％)had the binocular onset.The symptoms in both groups were mainly dark spots in vision,followed by decreased visual acuity.(3)Ancillary examinations:optical coherence tomography(OCT)showed the ellipsoid zone(EZ)and/or chimeric zone(IZ)breaks with strong reflections in the outer plexiform layer(OPL)and outer nuclear layer(ONL)in 13 patients in the clinical case group,and the near-infrared photography(NIR)showed the low-reflective wedge-shaped foci around the center of the macula,and some patients'optical coherence tomography angiography(OCTA)showed deep capillary lesions,and some patients'OCTA showed low reflectivity.Reduced blood flow in the deep capillary layer(DCP)and choroidal capillary layer(CC)was observed in all patients,7 patients with cotton-wool spots also had the reduced blood flow in the superficial capillary layer(SCP),and 33 patients in the case group in the literature had the visible EZ and/or IZ breaks on OCT.(4)Treatment and prognosis:11 out of 13 patients were treated with oral glucocorticoids,2 were under the observation.After year,the condition of 23 patients had been improved,1 case had visual field defects,1 case had retinal vein occlusion secondary to macular edema,and 1 case had a hyporeflective signal in the outer nuclear layer(ONL)and outer plexiform layer(OPL).Conclusion The age of onset of AMN related to COVID-19 is slightly older,with more cases involving both eyes.The main symptom is visual field scotoma,often accompanied by decreased vision.Near-infrared imaging shows low-reflective wedge-shaped lesions around the fovea,and OCT shows mainly disruption of the EZ and/or IZ.OCTA shows decreased blood flow density in the DCP and CC layers.The visual prognosis of AMN related to COVID-19 is good,but vigilance is needed for the occurrence of complications such as retinal vein occlusion.

Objective:To explore the application effectiveness of the treatment interference protocol (TIP) in managing physical restraints for patients in the Emergency Intensive Care Unit (EICU) .Methods:Using a convenience sampling method, 98 patients admitted to the EICU of Lihuili Hospital, Ningbo Medical Center, from April 2020 to April 2022 were selected as the study subjects. They were randomly divided into two groups using a random number table, with 49 patients in each group. The control group received physical restraint management based on the experience of medical staff, while the observation group received management based on the TIP. The levels of knowledge, attitude, and practice regarding physical restraints among nurses before and after the intervention were compared. Additionally, the physical restraint conditions (total restraint time and proportion of patients subjected to physical restraints), incidence of unplanned extubation, and occurrence of restraint-related complications were compared between the two groups.Results:After the intervention, nurses demonstrated statistically significant improvements in knowledge, attitude, practice, and overall scores related to physical restraints ( P<0.05). The physical restraint rate in the observation group was 26.53% (13/49), significantly lower than the control group at 46.94% (23/49) ( P<0.05). The total duration of physical restraints in the observation group was also shorter than that in the control group ( P<0.05). There was no significant difference in the incidence of unplanned extubation between the two groups ( P>0.05). However, the incidence of restraint-related complications in the observation group was lower than that in the control group ( P<0.05) . Conclusions:TIP effectively improves nurses' knowledge, attitude, practice levels regarding physical restraints, reduces the proportion of patients subjected to physical restraints, decreases the occurrence of restraint-related complications, and shortens the duration of physical restraints without increasing the risk of unplanned extubation.

Objective To analyze the efficacy of the"sandwich"technique for treating varicocele(VC).Methods A total of 310 patients with VC(365 affected veins)were selected and divided into interventional treatment group and non-interventional treatment group.The baseline data,hospitalization data,and 6-month follow-up data of the two groups were analyzed.Results The age of patients in the interventional treatment group was significantly lower than that in the non-interventional treatment group(P＜0.05).The surgical time and hospital stay in the interventional treatment group were significantly lower than those in the non-interventional treatment group(P＜0.05).In the non-interventional treatment group,two patients experienced surgical site infections,and one patient opted for interventional treatment due to recurrence after non-interventional treatment.After surgery,the diameter of the spermatic vein significantly decreased in both the interventional and non-interventional treatment(P＜0.05).Conclusion The"sandwich"technique(embolization coil combined with foam sclerotherapy)is an effective treatment for VC.

Objective:To explore the application effectiveness of the treatment interference protocol (TIP) in managing physical restraints for patients in the Emergency Intensive Care Unit (EICU) .Methods:Using a convenience sampling method, 98 patients admitted to the EICU of Lihuili Hospital, Ningbo Medical Center, from April 2020 to April 2022 were selected as the study subjects. They were randomly divided into two groups using a random number table, with 49 patients in each group. The control group received physical restraint management based on the experience of medical staff, while the observation group received management based on the TIP. The levels of knowledge, attitude, and practice regarding physical restraints among nurses before and after the intervention were compared. Additionally, the physical restraint conditions (total restraint time and proportion of patients subjected to physical restraints), incidence of unplanned extubation, and occurrence of restraint-related complications were compared between the two groups.Results:After the intervention, nurses demonstrated statistically significant improvements in knowledge, attitude, practice, and overall scores related to physical restraints ( P<0.05). The physical restraint rate in the observation group was 26.53% (13/49), significantly lower than the control group at 46.94% (23/49) ( P<0.05). The total duration of physical restraints in the observation group was also shorter than that in the control group ( P<0.05). There was no significant difference in the incidence of unplanned extubation between the two groups ( P>0.05). However, the incidence of restraint-related complications in the observation group was lower than that in the control group ( P<0.05) . Conclusions:TIP effectively improves nurses' knowledge, attitude, practice levels regarding physical restraints, reduces the proportion of patients subjected to physical restraints, decreases the occurrence of restraint-related complications, and shortens the duration of physical restraints without increasing the risk of unplanned extubation.

Abstract In November 2023, the Jinhua Center for Disease Control and Prevention received a report from a company indicating 3 cases of pulmonary tuberculosis. An on-site epidemiological investigation was immediately conducted. A total of 3 cases were reported, with an attack rate of 9.68%. The first case had cough and expectoration for more than a year, and diagnosed with rifampicin-resistant pulmonary tuberculosis on November 16, 2023, and the other 2 cases were his colleagues who were diagnosed with rifampicin-resistant pulmonary tuberculosis and etiology negative pulmonary tuberculosis on November 20 and 21, respectively. Based on the on-site investigation and laboratory test results, it was a cluster of rifampicin-resistant pulmonary tuberculosis. The likely cause of the spread might be the lack of timely medical attention for the first case, which led to the infection of other colleagues through contact transmission. Eight close contacts screened positive for purified protein derivative (PDD) or recombinantMycobacterium tuberculosisfusion protein skin test (EC-ST), given the injection of mycobaeterium vaccae vaccine, and no new cases of tuberculosis detected in the 3-month follow-up. The outbreak highlighted the necessity for the company to enhance health education concerning the prevention and treatment of pulmonary tuberculosis, implement regular health monitoring and enhance the physical examination for employee in order to increase sensitivity to pulmonary tuberculosis.

Objective:To compare the accuracy of dynamic navigation system,fully-guided and Pilot-drill guided implant surgery in anterior dental aesthetic area.Methods:45 patients underwent single tooth implantation in anterior dental aesthetic area were random-ly divided into 3 groups(n=15).Dynamic navigation system imlanting(A),3D printing fully-guided template with ASTRA EV assis-ted orthopedic implantation(B)and Pilot-drill guided implantation(C)were respectively used for the patients in group A,B and C.The deviation between the preoperative design and actual results were measured by CBCT and/or 3D reconstruction with navigation de-sign software or 3SHAPE software.SPSS 25.0 software package was used and(x)±s was used for descriptive analysis,results were pair-wise compared among the 3 groups using ANOVA.Results:Data were normally distributed and the variance of the data was homoge-neous.In group A,the distance deviation of implant top center was(0.571±0.196)mm,the horizontal deviation was(0.405±0.222)mm,the distance deviation of implant apical center was(0.449±0.267)mm,the vertical deviation was(0.312±0.223)mm,the de-viation of the connection angle between the two centers was 2.257°±0.989°.In group B,those were(0.520±0.242)mm,(0.219±0.201)mm,(0.643±0.284)mm,(0.464±0.292)mm and 1.272°±0.951° respectively.In group C those were(1.179±0.365)mm,(0.667±0.276)mm,(1.518±0.566)mm,(0.967±0.444)mm and 2.568°±0.632°.The deviation of all the measurments of group A and B was lower than those of group C(P＜0.05).The deviation of the connection angle between the 2 centers of group B was less than that of group A(P＜0.05),but no statistical significance(P＞0.05)was found in other 4 measured items.Conslusion:The accuracy of the dynamic navigation system and the fully-guided implantation is significantly higher than that of the Pilot-drill guided implantation,but is not statistically significant between dynamic navigation and the fully-guided system.

Patients with diabetic retinopathy often experience diabetes distress when facing the challenges of the disease, which has adverse effects on their health outcomes. This paper summarizes the current situation of diabetes distress in patients with diabetic retinopathy, and the assessment tools, influencing factors, and intervention measures, aiming to provide a reference for healthcare professionals to conduct intervention studies.

Objective To construct an intervention program for diabetic retinopathy(DR)patients undergoing surgery based on the theory of'Timing It Right'.Methods Guided by the theory of'Timing It Right',based on literature review and semi-structured interview,the first draft of the intervention program was formulated.From December 2022 to February 2023,15 medical and nursing experts in ophthalmology and endocrinology from 5 provinces(cities)in Zhejiang,Sichuan,Shanxi,Chongqing and Shanghai were interviewed by Delphi expert for 2 rounds to seek their advice and revision,and the final draft was formed.Results The effective recovery rate of 2 rounds of expert consultations was 93.75％and 100％.The authority coefficients were 0.87.The importance and feasibility of Kendall'W coordination coefficients were 0.325,0.138 and 0.193,0.141 in 2 rounds,respectively(P＜0.001).The finalized intervention program consisted of 6 months,which included 5 first-level items,18 second-level items and 43 third-level items.Conclusion The intervention program for DR patients undergoing surgery based on the theory of'Timing It Right'is reliable,scientific,feasible and practical,and it can meet the needs of such patients,providing a reference for improving their self-management ability,improving their negative emotions and delaying disease progression.

Znic (Zn) alloys with good cytocompatibility and suitable degradation rate have been a kind of biodegradable metal with great potential for clinical applications. This paper summarizes the biological role of degradable Zn alloy as bone implant materials, discusses the mechanical properties of different Zn alloys and their advantages and disadvantages as bone implant materials, and analyzes the influence of different processing strategies (such as alloying and additive manufacturing) on the mechanical properties of Zn alloys. This paper provides systematic design approaches for biodegradable Zn alloys as bone implant materials in terms of the material selection, product processing, structural topology optimization, and assesses their application prospects with a view to better serve the clinic.
Orthopedics ; Zinc ; Alloys ; Dental Materials ; Prostheses and Implants