To evaluate patient satisfaction levels in a gynecological teaching clinic and to explore its associated influencing factors, so as to provide evidence for optimizing the operational model of teaching clinics.

The effectiveness and professionalism of hospice care services for children with cancer are of great significance for improving their quality of life and reducing the mental and economic burden on their families. Currently， a relatively complete quality evaluation system for hospice care for children with cancer has been established abroad， while research in this field in China is still in its infancy. By elaborating on the concept and connotation of quality assessment of hospice care for children with cancer in detail， systematically reviewing the research status of quality assessment of hospice care for children with cancer abroad， and addressing the problems and challenges faced by quality assessment of hospice care for children with cancer in China， corresponding inspirations and improvement strategies were proposed， aiming to provide a reference for improving the quality of hospice care for children with cancer in China.

AIM: To investigate the clinical features of acute exacerbation chronic obstructive pulmonary disease (AECOPD) of complicated with type 2 diabetes mellitus (T2DM), and analyze the related clinical features and risk factors. METHODS: This was a single-center cross-sectional study. From March 2020 to January 2023, 479 hospitalized patients with AECOPD in the department of respiratory and critical care medicine, Suining Central Hospital were included. There were 215 patients in AECOPD group and 60 patients in AECOPD with T2DM group. The collected variables included demographic data, complications, blood routine, infection index, random blood glucose, blood gas analysis and lung function. The adoption rate and constituent ratio of the basic description classification data were expressed as mean standard deviation for the normal distribution measurement data and median interquartile range for the skew distribution measurement data. T-test was used for normal distribution and non - parameter test was used for non-normal distribution. The categorical variables were tested by chi-square test. Rank sum test was used for rank variable data. Binary logistic regression model was used to investigate the independent factors associated with T2DM in patients with AECOPD. Finally, the results of logistic regression were verified and visualized by nomogram, validation curve, ROC curve and DCA curve. P<0.05 was a significant statistical difference. RESULTS: Univariate analysis showed that there were significant differences in body mass index (BMI), essential hypertension, coronary heart disease, atrial fibrillation (AF), pulmonary function (GOLD stage), blood neutrophil (NS), blood lymphocyte (LYM), arterial blood gas PaCO2, Alanine transaminase (ALT) and random blood glucose (RBG) between the two groups (P<0.05). The binary logistic regression model (C-index=0.847) was constructed with the above 10 variables, the results showed that BMI (OR=1.309), Af (OR= 8.188), LYM counts (OR=0.474), PaCO2 (OR=1.082) and RBG (OR=1.434) were independently associated with type 2 diabetes in patients with AECOPD (all P>0.05). The results of logistic regression were verified and visualized by Nomogram and its-associated ccurves. The MAE and AUC curves were 0.021 and 0.847 respectively, indicating that the model had good prediction consistency and accuracy. The DCA curve showed that Nomogram's risk threshold ranged from 0.01 to 0.99, suggesting that nomogram's model had better clinical predictive value. CONCLUSION: Our results showed that increased BMI, PaCO2 and random glucose, decreased blood lymphocyte, and atrial fibrillation is an independent clinical feature of AECOPD with T2DM. These results suggest that the immune function of patients with AECOPD and T2DM are more severely impaired and more likely to be accompanied by atrial fibrillation, which is a potential cause of poor prognosis in these patients. Meanwhile, this conclusion needs to be further verified in multicenter study with large sample size.

AIM:To investigate the clinical fea-tures of acute exacerbation chronic obstructive pul-monary disease(AECOPD)of complicated with type 2 diabetes mellitus(T2DM),and analyze the relat-ed clinical features and risk factors.METHODS:This was a single-center cross-sectional study.From March 2020 to January 2023,479 hospitalized pa-tients with AECOPD in the department of respirato-ry and critical care medicine,Suining Central Hospi-tal were included.There were 215 patients in AE-COPD group and 60 patients in AECOPD with T2DM group.The collected variables included demograph-ic data,complications,blood routine,infection in-dex,random blood glucose,blood gas analysis and lung function.The adoption rate and constituent ra-tio of the basic description classification data were expressed as mean standard deviation for the nor-mal distribution measurement data and median in-terquartile range for the skew distribution measure-ment data.T-test was used for normal distribution and non-parameter test was used for non-normal distribution.The categorical variables were tested by chi-square test.Rank sum test was used for rank variable data.Binary logistic regression model was used to investigate the independent factors associ-ated with T2DM in patients with AECOPD.Finally,the results of logistic regression were verified and visualized by nomogram,validation curve,ROC curve and DCA curve.P＜0.05 was a significant sta-tistical difference.RESULTS:Univariate analysis showed that there were significant differences in body mass index(BMI),essential hypertension,cor-onary heart disease,atrial fibrillation(AF),pulmo-nary function(GOLD stage),blood neutrophil(NS),blood lymphocyte(LYM),arterial blood gas PaCO2,Alanine transaminase(ALT)and random blood glu-cose(RBG)between the two groups(P＜0.05).The binary logistic regression model(C-index=0.847)was constructed with the above 10 variables,the results showed that BMI(OR=1.309),Af(OR=8.188),LYM counts(OR=0.474),PaCO2(OR=1.082)and RBG(OR=1.434)were independently associat-ed with type 2 diabetes in patients with AECOPD(all P＞0.05).The results of logistic regression were verified and visualized by Nomogram and its-associ-ated ccurves.The MAE and AUC curves were 0.021 and 0.847 respectively,indicating that the model had good prediction consistency and accuracy.The DCA curve showed that Nomogram's risk threshold ranged from 0.01 to 0.99,suggesting that nomo-gram's model had better clinical predictive value.CONCLUSION:Our results showed that increased BMI,PaCO2 and random glucose,decreased blood lymphocyte,and atrial fibrillation is an indepen-dent clinical feature of AECOPD with T2DM.These results suggest that the immune function of pa-tients with AECOPD and T2DM are more severely impaired and more likely to be accompanied by atrial fibrillation,which is a potential cause of poor prognosis in these patients.Meanwhile,this conclu-sion needs to be further verified in multicenter study with large sample size.

AIM:To investigate the clinical fea-tures of acute exacerbation chronic obstructive pul-monary disease(AECOPD)of complicated with type 2 diabetes mellitus(T2DM),and analyze the relat-ed clinical features and risk factors.METHODS:This was a single-center cross-sectional study.From March 2020 to January 2023,479 hospitalized pa-tients with AECOPD in the department of respirato-ry and critical care medicine,Suining Central Hospi-tal were included.There were 215 patients in AE-COPD group and 60 patients in AECOPD with T2DM group.The collected variables included demograph-ic data,complications,blood routine,infection in-dex,random blood glucose,blood gas analysis and lung function.The adoption rate and constituent ra-tio of the basic description classification data were expressed as mean standard deviation for the nor-mal distribution measurement data and median in-terquartile range for the skew distribution measure-ment data.T-test was used for normal distribution and non-parameter test was used for non-normal distribution.The categorical variables were tested by chi-square test.Rank sum test was used for rank variable data.Binary logistic regression model was used to investigate the independent factors associ-ated with T2DM in patients with AECOPD.Finally,the results of logistic regression were verified and visualized by nomogram,validation curve,ROC curve and DCA curve.P＜0.05 was a significant sta-tistical difference.RESULTS:Univariate analysis showed that there were significant differences in body mass index(BMI),essential hypertension,cor-onary heart disease,atrial fibrillation(AF),pulmo-nary function(GOLD stage),blood neutrophil(NS),blood lymphocyte(LYM),arterial blood gas PaCO2,Alanine transaminase(ALT)and random blood glu-cose(RBG)between the two groups(P＜0.05).The binary logistic regression model(C-index=0.847)was constructed with the above 10 variables,the results showed that BMI(OR=1.309),Af(OR=8.188),LYM counts(OR=0.474),PaCO2(OR=1.082)and RBG(OR=1.434)were independently associat-ed with type 2 diabetes in patients with AECOPD(all P＞0.05).The results of logistic regression were verified and visualized by Nomogram and its-associ-ated ccurves.The MAE and AUC curves were 0.021 and 0.847 respectively,indicating that the model had good prediction consistency and accuracy.The DCA curve showed that Nomogram's risk threshold ranged from 0.01 to 0.99,suggesting that nomo-gram's model had better clinical predictive value.CONCLUSION:Our results showed that increased BMI,PaCO2 and random glucose,decreased blood lymphocyte,and atrial fibrillation is an indepen-dent clinical feature of AECOPD with T2DM.These results suggest that the immune function of pa-tients with AECOPD and T2DM are more severely impaired and more likely to be accompanied by atrial fibrillation,which is a potential cause of poor prognosis in these patients.Meanwhile,this conclu-sion needs to be further verified in multicenter study with large sample size.

Objective:To systematically evaluate the qualitative research on the decision-making participation experience of parents of terminally ill neonates in neonatal intensive care unit (NICU).Methods:Qualitative research on the decision-making participation experience of parents of terminally ill neonates in NICU were searched from PubMed,Web of Science,Embase,CINAHL,Cochrane Library,Sinomed,China National Knowledge Infrastructure (CNKI),Wanfang,and VIP databases,with the search period from the establishment of the database to August 2023.The quality of the literature was evaluated using the qualitative research quality evaluation standard of the Joanna Briggs Institute (JBI) in Australia,and the literature was summarized using a synthesizing meta-synthesis method.Results:A total of 13 articles of literature were included,as well as 33 results were extracted and classified into 12 new categories and synthesized into 4 integrative outcomes,including participation tendency,role experience,obstacles,and needs on parental decision-making of terminally ill neonates.Conclusion:Parents of terminally ill neonates in NICU face difficult decision-making choices.Medical staff need to work together with parents to determine their ideal role in decision-making and develop personalized communication content.Society,hospitals,and families need to create a supportive social and psychological environment to provide parents with information and emotional support,as well as improve the coping ability of parents of terminally ill neonates in decision-making.

OBJECTIVE To establish UHPLC-ELSD fingerprint and multi-component content determination methods, compare the differences in sheep bile from different regions, and conduct antioxidant activity research to provide a basis for the in-depth development and utilization of sheep bile. METHODS Used UHPLC-ELSD method to establish 21 batches of bile fingerprints of sheep from different origins and conduct similarity analysis. Measured the content of 6 components, DPPH and ABTS free radical scavenging ability, iron ion reduction ability, and conducted entropy weighted TOPSIS and grey correlation analysis. RESULTS A total of 11 common peaks were identified in the fingerprint spectra of 21 batches of sheep bile. Through comparison with the control sample, 6 components were identified, including taurocholic acid(TCA), glycocholic acid(GCA), taurochenodeoxycholic acid(TCDCA), tauroursodeoxycholic acid(TDCA), glycodeoxycholic acid(GDCA), and cholic acid(CA). Except for 4 batches of samples, the similarity of the fingerprint spectra was greater than 0.90. The total content range of 6 components in the freeze-dried powder of 21 batches of sheep bile was 55.34% to 86.08%. The highest content of taurocholic acid ranged from 34.74% to 60.86%, indicating significant differences in the content of the six components in samples from different regions. Sheep bile from different regions had antioxidant activity, and there were also certain differences. The results of entropy weighted TOPSIS analysis using six component contents as variables showed that the top ten scoring groups were S2, S18, S16, S9, S8, S21, S1, S10, S20, and S15, indicating good quality and slightly better bile quality from sheep in the northern region. The grey correlation analysis results between the content of 6 components and 3 antioxidant indicators showed that all 6 components were correlated with each antioxidant indicator, and TCA, TDCA, and TCDCA had the highest correlation, which might be important components for sheep bile to exert antioxidant effects. CONCLUSION The use of entropy weighted TOPSIS and grey correlation analysis methods can effectively analyze the quality differences and antioxidant active components of sheep bile from different regions, providing scientific basis for its quality evaluation.

Mutations in the SAMD9 and SAMD9L genes are associated with MIRAGE syndrome and ATXPC syndrome, respectively. This study reports the clinical characteristics and genetic analysis of one case with SAMD9 mutation (c.3809T > A, p.F1270Y) and two cases with SAMD9L mutations (c.2675T > G, p.M892R; c.1096T > G, p.F366V and c.4517T > C, p.L1506p), none of which have been previously reported. All patients presented with recurrent infections, growth retardation, and myelodys-plasia, with varying degrees of involvement of multiple systems, including respiratory, gastrointestinal, immune, endocrine, neurological, and reproductive systems. In terms of treatment, two patients underwent regular intravenous immunoglobulin and their clinical symptoms improved, while one patient had a favorable recovery following hematopoietic stem cell transplantation at the age of 1 year and 5 months of age. SAMD9/SAMD9L gene mutations, therefore, chould be considered in children with recurrent infections, myelodysplasia, pancytopenia, and growth retardation. Early genetic testing is crucial for timely diagnosis and treatment, which may improve patient outcomes.

AIM:To investigate the clinical fea-tures of acute exacerbation chronic obstructive pul-monary disease(AECOPD)of complicated with type 2 diabetes mellitus(T2DM),and analyze the relat-ed clinical features and risk factors.METHODS:This was a single-center cross-sectional study.From March 2020 to January 2023,479 hospitalized pa-tients with AECOPD in the department of respirato-ry and critical care medicine,Suining Central Hospi-tal were included.There were 215 patients in AE-COPD group and 60 patients in AECOPD with T2DM group.The collected variables included demograph-ic data,complications,blood routine,infection in-dex,random blood glucose,blood gas analysis and lung function.The adoption rate and constituent ra-tio of the basic description classification data were expressed as mean standard deviation for the nor-mal distribution measurement data and median in-terquartile range for the skew distribution measure-ment data.T-test was used for normal distribution and non-parameter test was used for non-normal distribution.The categorical variables were tested by chi-square test.Rank sum test was used for rank variable data.Binary logistic regression model was used to investigate the independent factors associ-ated with T2DM in patients with AECOPD.Finally,the results of logistic regression were verified and visualized by nomogram,validation curve,ROC curve and DCA curve.P＜0.05 was a significant sta-tistical difference.RESULTS:Univariate analysis showed that there were significant differences in body mass index(BMI),essential hypertension,cor-onary heart disease,atrial fibrillation(AF),pulmo-nary function(GOLD stage),blood neutrophil(NS),blood lymphocyte(LYM),arterial blood gas PaCO2,Alanine transaminase(ALT)and random blood glu-cose(RBG)between the two groups(P＜0.05).The binary logistic regression model(C-index=0.847)was constructed with the above 10 variables,the results showed that BMI(OR=1.309),Af(OR=8.188),LYM counts(OR=0.474),PaCO2(OR=1.082)and RBG(OR=1.434)were independently associat-ed with type 2 diabetes in patients with AECOPD(all P＞0.05).The results of logistic regression were verified and visualized by Nomogram and its-associ-ated ccurves.The MAE and AUC curves were 0.021 and 0.847 respectively,indicating that the model had good prediction consistency and accuracy.The DCA curve showed that Nomogram's risk threshold ranged from 0.01 to 0.99,suggesting that nomo-gram's model had better clinical predictive value.CONCLUSION:Our results showed that increased BMI,PaCO2 and random glucose,decreased blood lymphocyte,and atrial fibrillation is an indepen-dent clinical feature of AECOPD with T2DM.These results suggest that the immune function of pa-tients with AECOPD and T2DM are more severely impaired and more likely to be accompanied by atrial fibrillation,which is a potential cause of poor prognosis in these patients.Meanwhile,this conclu-sion needs to be further verified in multicenter study with large sample size.

AIM:To investigate the clinical fea-tures of acute exacerbation chronic obstructive pul-monary disease(AECOPD)of complicated with type 2 diabetes mellitus(T2DM),and analyze the relat-ed clinical features and risk factors.METHODS:This was a single-center cross-sectional study.From March 2020 to January 2023,479 hospitalized pa-tients with AECOPD in the department of respirato-ry and critical care medicine,Suining Central Hospi-tal were included.There were 215 patients in AE-COPD group and 60 patients in AECOPD with T2DM group.The collected variables included demograph-ic data,complications,blood routine,infection in-dex,random blood glucose,blood gas analysis and lung function.The adoption rate and constituent ra-tio of the basic description classification data were expressed as mean standard deviation for the nor-mal distribution measurement data and median in-terquartile range for the skew distribution measure-ment data.T-test was used for normal distribution and non-parameter test was used for non-normal distribution.The categorical variables were tested by chi-square test.Rank sum test was used for rank variable data.Binary logistic regression model was used to investigate the independent factors associ-ated with T2DM in patients with AECOPD.Finally,the results of logistic regression were verified and visualized by nomogram,validation curve,ROC curve and DCA curve.P＜0.05 was a significant sta-tistical difference.RESULTS:Univariate analysis showed that there were significant differences in body mass index(BMI),essential hypertension,cor-onary heart disease,atrial fibrillation(AF),pulmo-nary function(GOLD stage),blood neutrophil(NS),blood lymphocyte(LYM),arterial blood gas PaCO2,Alanine transaminase(ALT)and random blood glu-cose(RBG)between the two groups(P＜0.05).The binary logistic regression model(C-index=0.847)was constructed with the above 10 variables,the results showed that BMI(OR=1.309),Af(OR=8.188),LYM counts(OR=0.474),PaCO2(OR=1.082)and RBG(OR=1.434)were independently associat-ed with type 2 diabetes in patients with AECOPD(all P＞0.05).The results of logistic regression were verified and visualized by Nomogram and its-associ-ated ccurves.The MAE and AUC curves were 0.021 and 0.847 respectively,indicating that the model had good prediction consistency and accuracy.The DCA curve showed that Nomogram's risk threshold ranged from 0.01 to 0.99,suggesting that nomo-gram's model had better clinical predictive value.CONCLUSION:Our results showed that increased BMI,PaCO2 and random glucose,decreased blood lymphocyte,and atrial fibrillation is an indepen-dent clinical feature of AECOPD with T2DM.These results suggest that the immune function of pa-tients with AECOPD and T2DM are more severely impaired and more likely to be accompanied by atrial fibrillation,which is a potential cause of poor prognosis in these patients.Meanwhile,this conclu-sion needs to be further verified in multicenter study with large sample size.