OBJECTIVE: To compare the effectiveness of early versus delayed closed reduction and percutaneous Kirschner wire fixation in the treatment of pediatric supracondylar humerus fractures. METHODS: A retrospective analysis was conducted on 468 children with supracondylar humerus fractures, who were admitted between January 2020 and December 2023 and met the inclusion criteria. Among them, 187 children were treated during 12 hours after injury (early operation group) and 281 were treated after 12 hours (delayed operation group). There was no significant difference between the two groups ( P>0.05) in the gender, age, injury mechanism, fracture side and type, while there was significant difference in interval from injury to operation ( P<0.05). The operative outcomes, including the operation time, intraoperative blood loss, the length of hospital stay, fracture healing time, elbow function assessed by Flynn criteria at 3 months after operation, and complications, were compared. RESULTS: Compared to the delayed operation group, the early operation group demonstrated significantly shorter operation time and less intraoperative blood loss ( P<0.05). There was no significant difference in the length of hospital stay between the two groups ( P>0.05). All children were followed up 3-12 months. The follow-up time was (6.7±2.9) months in the early operation group and (6.9±2.8) months in the delayed operation group, showing no significant difference between the two groups ( P>0.05). There was no significant difference in the fracture healing time between the two groups ( P>0.05). At 3 months after operation, the early operation group exhibited superior Flynn elbow functional outcomes to the delayed operation group ( P<0.05). In the early operation group, there was 1 case of fracture non-union and 3 cases of cubital varus deformity after operation. In the delayed operation group, there was 1 case of nerve injury, 7 cases of fracture non-union, and 12 cases of cubital varus deformity after operation. There was significant difference in the incidence of complications between the two groups ( P<0.05). One case of the early operation group and 10 cases of the delayed operation group underwent secondary operation, showing no significant difference in the incidence of secondary operation between the two groups ( P>0.05). CONCLUSION For pediatric supracondylar humerus fractures, early closed reduction and percutaneous Kirschner wire fixation can reduce operation time, minimize intraoperative blood loss and postoperative complications, and improve the functional recovery compared to delayed operation.
Humans ; Humeral Fractures/surgery* ; Bone Wires ; Retrospective Studies ; Male ; Female ; Child ; Fracture Fixation, Internal/instrumentation* ; Child, Preschool ; Treatment Outcome ; Operative Time ; Fracture Healing ; Length of Stay ; Closed Fracture Reduction/methods* ; Blood Loss, Surgical ; Time Factors ; Time-to-Treatment ; Postoperative Complications/epidemiology*

Objective:To investigate the effect of a rapid rehabilitation nursing model under the theoretical framework of Rogers' Science of Unitary Human Beings in the postoperative care of children undergoing radical operation on Hirschsprung's disease.Methods:A total of 91 children with Hirschsprung's disease and their parents who underwent radical surgery at the Children's Hospital Affiliated to Zhengzhou University (Henan Children's Hospital, Zhengzhou Children's Hospital) between January 2022 and January 2024 were selected by convenience sampling. Using a computer-generated random number table, they were randomly divided into an intervention group ( n=46) and a control group ( n=45). The control group received routine surgical nursing, while the intervention group received a rapid rehabilitation nursing model based on Rogers' theoretical framework in addition to routine care. Postoperative pain stress, anorectal function, gastrointestinal functional recovery, and parental satisfaction were compared between the two groups. Results:On the third postoperative day, the intervention group had lower scores on the FLACC scale, better anorectal function, and shorter times to first bowel sound, first anal exhaust, and first defecation than the control group. The overall parental satisfaction rate in the intervention group was 86.96% (40/46), higher than 51.11% (23/45) in the control group, and the differences were statistically significant (all P<0.05) . Conclusions:The rapid rehabilitation nursing model under the theoretical framework of Rogers' Science of Unitary Human Beings showed significant effectiveness in children undergoing radical operation on Hirschsprung's disease. It reduced postoperative pain, promoted recovery of anorectal and gastrointestinal function, and improved parental satisfaction.

Objective To investigate the anti-hepatocellular carcinoma mechanism of Chloranthus fortunei(A.Gray)Solms-Laub.via network pharmacology,molecular docking techniques and in vitro experiments.Methods Chemical composition of Chloranthus fortunei(A.Gray)Solms-Laub.was searched by literature.Swiss Target Prediction was used to find corresponding targets.STRING was used to construct protein-protein interactions network(PPI).DAVID was used to enrich GO analysis and KEGG pathway.AutoDock Vina 1.1.2 and Pymol visualisation was used for docking and validation.Results Chloranthus fortunei(A.Gray)Solms-Laub.had 61 active components,685 targets,and 279 intersections with disease targets.The PPI showed that the main active components were Luteolin,Chloranthalactone C,Shizukanolide H,Esculetin,7-Hydroxycoumarin.The key targets were GAPDH,VEGFA,STAT3,JUN,HSP90AA1,AKT1,CTNNB1,CASP3,and ALB.Biological process(BP)involved protein phosphorylation,signal transduction,regulation of RNA polymerase II promoter transcription,cell proliferation,apoptosis.Cellular component(CC)involved cytoplasm,nucleus,cell membrane,cellular exosome.Molecular function(MF)involves protein binding,ATPase,threonine kinase,protein kinase activity.KEGG involved cancer pathway,metabolic pathway,PI3K-Akt signalling pathway,cancer proteoglycans,lipids and atherosclerosis,cytomegalovirus infection,microRNAs in cancer,human T-cell leukaemia virus type 1,Ras signalling pathway,MAPK signalling pathway.Molecular docking showed that silverweed lactone H had a strong affinity for each of the other target proteins,indicating that this component plays a key role.The results of RT-qPCR assay and WB assay showed that there were significant differences in gene and protein expression levels before and after drug administration.Conclusion The Chinese medicine in Chloranthus fortunei(A.Gray)Solms-Laub.can treat hepatocellular carcinoma through the MAPK pathway,and the main active ingredients have good docking effects with the core target proteins of the disease.

Objective:To investigate the effect of a rapid rehabilitation nursing model under the theoretical framework of Rogers' Science of Unitary Human Beings in the postoperative care of children undergoing radical operation on Hirschsprung's disease.Methods:A total of 91 children with Hirschsprung's disease and their parents who underwent radical surgery at the Children's Hospital Affiliated to Zhengzhou University (Henan Children's Hospital, Zhengzhou Children's Hospital) between January 2022 and January 2024 were selected by convenience sampling. Using a computer-generated random number table, they were randomly divided into an intervention group ( n=46) and a control group ( n=45). The control group received routine surgical nursing, while the intervention group received a rapid rehabilitation nursing model based on Rogers' theoretical framework in addition to routine care. Postoperative pain stress, anorectal function, gastrointestinal functional recovery, and parental satisfaction were compared between the two groups. Results:On the third postoperative day, the intervention group had lower scores on the FLACC scale, better anorectal function, and shorter times to first bowel sound, first anal exhaust, and first defecation than the control group. The overall parental satisfaction rate in the intervention group was 86.96% (40/46), higher than 51.11% (23/45) in the control group, and the differences were statistically significant (all P<0.05) . Conclusions:The rapid rehabilitation nursing model under the theoretical framework of Rogers' Science of Unitary Human Beings showed significant effectiveness in children undergoing radical operation on Hirschsprung's disease. It reduced postoperative pain, promoted recovery of anorectal and gastrointestinal function, and improved parental satisfaction.

Objective:To explore the latent categories of nurses' perception of high-performance work systems (HPWS) through latent profile analysis and analyze the differences in characteristics and influencing factors among different categories.Methods:A convenience sampling method was used to select 3 450 clinical nurses from ClassⅡ、Ⅲ hospitals in 12 regions of China between June and July 2024. General information questionnaires, the Perceived High-Performance Work System Scale, and the Nurse Voice Behavior Scale were used for data collection. Latent profile analysis was conducted to analyze nurses' perception of HPWS, and multi-class logistic regression was used to examine the influencing factors for different categories.Results:A total of 3 450 questionnaires were collected, with 3 385 valid responses, yielding an effective response rate of 98.12%. Nurses' perception of HPWS had an average score of (70.46±12.21), which could be divided into three latent categories: low perception (17%, 559/3 385), moderate perception (42%, 1 433/3 385), and high perception (41%, 1 393/3 385). The multi-class logistic regression analysis showed that job nature, title, position, years of service, monthly income, health impact on work, work duration, and monthly night shifts were significant factors influencing nurses' perception of HPWS ( P<0.05) . Conclusions:There is heterogeneity in the nurses' perception of HPWS. Nursing managers should focus on nurses with low perception of HPWS and provide interventions and support based on the characteristics and influencing factors of each category to improve nurses' voice behaviors.

Objective To investigate the anti-hepatocellular carcinoma mechanism of Chloranthus fortunei(A.Gray)Solms-Laub.via network pharmacology,molecular docking techniques and in vitro experiments.Methods Chemical composition of Chloranthus fortunei(A.Gray)Solms-Laub.was searched by literature.Swiss Target Prediction was used to find corresponding targets.STRING was used to construct protein-protein interactions network(PPI).DAVID was used to enrich GO analysis and KEGG pathway.AutoDock Vina 1.1.2 and Pymol visualisation was used for docking and validation.Results Chloranthus fortunei(A.Gray)Solms-Laub.had 61 active components,685 targets,and 279 intersections with disease targets.The PPI showed that the main active components were Luteolin,Chloranthalactone C,Shizukanolide H,Esculetin,7-Hydroxycoumarin.The key targets were GAPDH,VEGFA,STAT3,JUN,HSP90AA1,AKT1,CTNNB1,CASP3,and ALB.Biological process(BP)involved protein phosphorylation,signal transduction,regulation of RNA polymerase II promoter transcription,cell proliferation,apoptosis.Cellular component(CC)involved cytoplasm,nucleus,cell membrane,cellular exosome.Molecular function(MF)involves protein binding,ATPase,threonine kinase,protein kinase activity.KEGG involved cancer pathway,metabolic pathway,PI3K-Akt signalling pathway,cancer proteoglycans,lipids and atherosclerosis,cytomegalovirus infection,microRNAs in cancer,human T-cell leukaemia virus type 1,Ras signalling pathway,MAPK signalling pathway.Molecular docking showed that silverweed lactone H had a strong affinity for each of the other target proteins,indicating that this component plays a key role.The results of RT-qPCR assay and WB assay showed that there were significant differences in gene and protein expression levels before and after drug administration.Conclusion The Chinese medicine in Chloranthus fortunei(A.Gray)Solms-Laub.can treat hepatocellular carcinoma through the MAPK pathway,and the main active ingredients have good docking effects with the core target proteins of the disease.

Objective:To explore the latent categories of nurses' perception of high-performance work systems (HPWS) through latent profile analysis and analyze the differences in characteristics and influencing factors among different categories.Methods:A convenience sampling method was used to select 3 450 clinical nurses from ClassⅡ、Ⅲ hospitals in 12 regions of China between June and July 2024. General information questionnaires, the Perceived High-Performance Work System Scale, and the Nurse Voice Behavior Scale were used for data collection. Latent profile analysis was conducted to analyze nurses' perception of HPWS, and multi-class logistic regression was used to examine the influencing factors for different categories.Results:A total of 3 450 questionnaires were collected, with 3 385 valid responses, yielding an effective response rate of 98.12%. Nurses' perception of HPWS had an average score of (70.46±12.21), which could be divided into three latent categories: low perception (17%, 559/3 385), moderate perception (42%, 1 433/3 385), and high perception (41%, 1 393/3 385). The multi-class logistic regression analysis showed that job nature, title, position, years of service, monthly income, health impact on work, work duration, and monthly night shifts were significant factors influencing nurses' perception of HPWS ( P<0.05) . Conclusions:There is heterogeneity in the nurses' perception of HPWS. Nursing managers should focus on nurses with low perception of HPWS and provide interventions and support based on the characteristics and influencing factors of each category to improve nurses' voice behaviors.

A growing body of evidence has linked the gut microbiota to liver metabolism. The manipulation of intestinal microflora has been considered as a promising avenue to promote liver health. However, the effects of Lactobacillus gasseri LA39, a potential probiotic, on liver metabolism remain unclear. Accumulating studies have investigated the proteomic profile for mining the host biological events affected by microbes, and used the germ-free (GF) mouse model to evaluate host-microbe interaction. Here, we explored the effects of L. gasseri LA39 gavage on the protein expression profiles of the liver of GF mice. Our results showed that a total of 128 proteins were upregulated, whereas a total of 123 proteins were downregulated by treatment with L. gasseri LA39. Further bioinformatics analyses suggested that the primary bile acid (BA) biosynthesis pathway in the liver was activated by L. gasseri LA39. Three differentially expressed proteins (cytochrome P450 family 27 subfamily A member 1 (CYP27A1), cytochrome P450 family 7 subfamily B member 1 (CYP7B1), and cytochrome P450 family 8 subfamily B member 1 (CYP8B1)) involved in the primary BA biosynthesis pathway were further validated by western blot assay. In addition, targeted metabolomic analyses demonstrated that serum and fecal β‍-muricholic acid (a primary BA), dehydrolithocholic acid (a secondary BA), and glycolithocholic acid-3-sulfate (a secondary BA) were significantly increased by L. gasseri LA39. Thus, our data revealed that L. gasseri LA39 activates the hepatic primary BA biosynthesis and promotes the intestinal secondary BA biotransformation. Based on these findings, we suggest that L. gasseri LA39 confers an important function in the gut‒liver axis through regulating BA metabolism.
Mice ; Animals ; Bile Acids and Salts/metabolism* ; Lactobacillus gasseri ; Proteomics ; Liver/metabolism* ; Biotransformation

Objective:To evaluate the efficacy of long-pulsed 1 064-nm Nd:YAG laser combined with a topical emulsion containing Camellia reticulata and Radix Notoginseng in the treatment of melasma. Methods:A total of 80 patients with melasma were enrolled from Department of Dermatology, People′s Hospital of Ningxia Hui Autonomous Region from June 2019 to June 2020, and randomly and equally divided into control group and observation group by using a random number table: 40 patients in the control group were treated with long-pulsed 1 064-nm Nd:YAG laser once every 2 weeks for 6 sessions as a course of treatment; another 40 in the observation group were treated with the same laser therapy as the control group and a topical emulsion containing Camellia reticulata and Radix Notoginseng twice a day for 3 months as a course of treatment. Melasma area and severity index (MASI), clinical efficacy, patient satisfaction rate and safety were compared between the 2 groups before and/or after treatment. Results:After 4- and 8-week treatment, there was no significant difference in the MASI score between the observation group (14.57 ± 3.22 points, 10.00 ± 2.94 points, respectively) and control group (14.74 ± 3.11 points, 11.31 ± 3.00 points, respectively; both P>0.05). After 12-week treatment, the MASI score was significantly lower in the observation group (4.80 ± 2.78 points) than in the control group (7.07 ± 3.22 points, t = -3.38, P<0.01). After 3-month treatment, the response rate was significantly higher in the observation group (36 cases, 90%) than in the control group (31 cases, 77.5%; χ2 = 4.58, P < 0.001) ; however, there was no significant difference in the patient satisfaction rate between the observation group (87.5%) and control group (72.5%, χ2 = 7.26, P = 0.06). In addition, no significant difference in the occurrence of adverse reactions was observed between the observation group (5 cases, 12.5%) and control group (7 cases, 17.5%; P > 0.05) . Conclusion:Compared with the long-pulsed 1 064-nm Nd:YAG laser alone, the topical emulsion containing Camellia reticulata and Radix Notoginseng in combination with the long-pulsed 1 064-nm Nd:YAG laser is more effective for the treatment of melasma, with higher patient satisfaction and less adverse reactions.

Objective:To explore effects of the total number of night shifts on BMI of medical workers in recent 5 years.Methods:This study was a cross-sectional study. Using the convenient sampling method, data of medical workers in Affiliated Hospital of Jining Medical University were collected from January 2016 to December 2020. The medical examination data of medical workers were obtained from the electronic information system of medical examination center, and the number of night shift and basic information of medical workers are extracted from the human resource management department. The covariates in this study included categorical variables and continuous variables. Categorical variables included gender, job title and job type. Continuous variables included age, working years, systolic blood pressure, diastolic blood pressure, white blood cells, red blood cells, hemoglobin, average hemoglobin volume, platelets, ALT, total bilirubin, total protein, albumin, urea, creatinine, uric acid, triacylglycerol, Total cholesterol, HDL-C, LDL-C and glucose. The relationship between the number of night shift and BMI was processed by generalized addition model and smoothing curve fitting.Results:Finally, a total of 908 medical workers were selected for data analysis. The average number of night shifts for 908 medical workers in 5 years was (339.0±30.8) , and the average BMI was (22.88±2.08) kg/m 2. After adjusting for confounding factors, the number of night shift showed a non-linear relationship with BMI, and the number of inflection points was 634. On the left of the inflection point, there was no significant relationship between the number of night shifts and BMI ( P=0.829) . The relationship between the two on the right side of the inflection point was significant, the effect size and 95% confidence interval were 0.02 and 0.01-0.03, respectively. Conclusions:BMI value of medical workers increases significantly with the increase of night shift number when the number of night shift is more than 634 in recent 5 years. Hospital managers can calculate and plan the number of night shifts per year to reduce the effect of night shifts on the health of medical workers.