Objective To evaluate the reliability and validity of the Chinese version of the Repeatable Battery for the Assessment of Neuropsychological Status(RBANS)in patients with maintenance hemodialysis(MHD).Methods The general information and medical history of 84 MHD patients were collected,and the Mini-Mental State Exam(MMSE),Montreal Cognitive Assessment Scale(MoCA),and RBANS were conducted.The reliability of the scale was assessed by Cronbach α and split-half reliability.The structure and convergent validity of the scale were assessed by confirmatory factor analysis,and the RBANS scores'correlation to MoCA and MMSE scores was analyzed by Spearman correlation analysis.The predictive value of the RBANS total score on cognitive impairment(CI)was analyzed by receiver operating characteristic(ROC)curve.Results The Cronbach's alpha coefficient of the RBANS total scale was 0.896,split-half reliability was 0.911,and reliability for the five dimensions of the RBANS ranged from 0.618 to 0.791.Confirmatory factor analysis indicated that the overall fit of the five-dimensional model of the RBANS scale was acceptable(χ2/df=1.587,root mean square error of approximation=0.084,comparative fit index=0.967,incremental fit index=0.968,Tucker-Lewis index=0.947,goodness of fit index=0.891).The average variance extracted(AVE)for the five dimensions of the RBANS ranged from 0.525 to 0.863,while the composite reliability(CR)ranged from 0.733 to 0.926,indicating good convergent validity of the scale.Furthermore,Spearman correlation analysis revealed that the total RBANS score was negatively correlated to the age of MHD patients and positively correlated to years of education,as well as the total scores of MMSE and MoCA(all P<0.01).The ROC curve analysis indicated that the area under the curve(AUC)for the total RBANS score in predicting CI was 0.891(P<0.01),suggesting a high predictive value.Conclusion The Chinese version of RBANS has good reliability and validity in MHD patients,and can be used as a measure of cognitive function in MHD patients.

To summarize the first aid and nursing experience of a patient with enterobacter aerogenes infection complicated by septic shock after oral floor cancer surgery. The patient was admitted to the Department of Oral and Maxillofacial Surgery at the Second Affiliated Hospital of Zhejiang University School of Medicine in August 2023. This patient who developed enterobacter aerogenes infection complicated by septic shock after surgery for oral floor cancer was treated with a comprehensive approach. In response to the patient's rapid onset, rapid progression of the condition, and critical situation, the following key points of nursing care were formulated and implemented: this included the rapid identification of septic shock, precise execution of emergency interventions; effectiveion of airway management, active prevention of airway obstruction; implement refined nursing care, awareness of leukocyte crisis, preventing secondary infection; establishing blood alert mechanism, implementing monitoring and protection management; implementing phased progressive nutritional support, improveing the nutritional status of patients. After 21 days of intensive treatment and nursing care, the patient made a full recovery and was discharged. A 6-month follow-up revealed that the patient remained in stable condition with no recurrence.

To summarize the first aid and nursing experience of a patient with enterobacter aerogenes infection complicated by septic shock after oral floor cancer surgery. The patient was admitted to the Department of Oral and Maxillofacial Surgery at the Second Affiliated Hospital of Zhejiang University School of Medicine in August 2023. This patient who developed enterobacter aerogenes infection complicated by septic shock after surgery for oral floor cancer was treated with a comprehensive approach. In response to the patient's rapid onset, rapid progression of the condition, and critical situation, the following key points of nursing care were formulated and implemented: this included the rapid identification of septic shock, precise execution of emergency interventions; effectiveion of airway management, active prevention of airway obstruction; implement refined nursing care, awareness of leukocyte crisis, preventing secondary infection; establishing blood alert mechanism, implementing monitoring and protection management; implementing phased progressive nutritional support, improveing the nutritional status of patients. After 21 days of intensive treatment and nursing care, the patient made a full recovery and was discharged. A 6-month follow-up revealed that the patient remained in stable condition with no recurrence.

Objective To evaluate the reliability and validity of the Chinese version of the Repeatable Battery for the Assessment of Neuropsychological Status(RBANS)in patients with maintenance hemodialysis(MHD).Methods The general information and medical history of 84 MHD patients were collected,and the Mini-Mental State Exam(MMSE),Montreal Cognitive Assessment Scale(MoCA),and RBANS were conducted.The reliability of the scale was assessed by Cronbach α and split-half reliability.The structure and convergent validity of the scale were assessed by confirmatory factor analysis,and the RBANS scores'correlation to MoCA and MMSE scores was analyzed by Spearman correlation analysis.The predictive value of the RBANS total score on cognitive impairment(CI)was analyzed by receiver operating characteristic(ROC)curve.Results The Cronbach's alpha coefficient of the RBANS total scale was 0.896,split-half reliability was 0.911,and reliability for the five dimensions of the RBANS ranged from 0.618 to 0.791.Confirmatory factor analysis indicated that the overall fit of the five-dimensional model of the RBANS scale was acceptable(χ2/df=1.587,root mean square error of approximation=0.084,comparative fit index=0.967,incremental fit index=0.968,Tucker-Lewis index=0.947,goodness of fit index=0.891).The average variance extracted(AVE)for the five dimensions of the RBANS ranged from 0.525 to 0.863,while the composite reliability(CR)ranged from 0.733 to 0.926,indicating good convergent validity of the scale.Furthermore,Spearman correlation analysis revealed that the total RBANS score was negatively correlated to the age of MHD patients and positively correlated to years of education,as well as the total scores of MMSE and MoCA(all P<0.01).The ROC curve analysis indicated that the area under the curve(AUC)for the total RBANS score in predicting CI was 0.891(P<0.01),suggesting a high predictive value.Conclusion The Chinese version of RBANS has good reliability and validity in MHD patients,and can be used as a measure of cognitive function in MHD patients.

Objective To observe the expression of Galectin-3 in peritoneal dialysis (PD) fluid in patients with different dialysis ages, and to conduct correlation analysis with vascular endothelial growth factor (VEGF) , fi-bronectin (FN) and related clinical indicators.Methods A total of 109 PD patients who were regularly followed up in the department of nephrology were divided into four groups according to different peritoneal dialysis ages.The concentrations of Galectin-3, VEGF and FN were determined by enzyme-linked immunosorbent assay.The expres-sion of Galectin-3 in peritoneal dialysate of the 4 groups was compared, the correlation with VEGF, FN and clinical related indexes was analyzed, and the correlation was analyzed by Spearman test.Results The concentration of VEGF in peritoneal dialysis patients in group D significantly increased (P<0.05) .Galectin-3 expression levels were positively correlated with VEGF (r =0.358 , P =0.022) , but not significantly correlated with FN (r =0.121, P=0.452).Galectin-3 was positively correlated with clinical indicators parathyroid hormone (PTH) (r=0.201, P=0.037), C-reactive protein (CRP) (r=0.357, P<0.001), left ventricular posterior wall dimensions (LVPWD) (r=0.213, P=0.026), and negatively correlated with clinical indicators total cholesterol (TC) (r=-0.316, P=0.001).Conclusion The concentration of Galectin-3 in the dialysate of long-term peritoneal dialy-sis patients is significantly elevated, indicating that the expression of galectin-3 increases with the extension of peri-toneal dialysis time, suggesting that the detection of galectin-3 levels may be helpful for the evaluation of early peri-toneal fibrosis.The positive correlation with VEGF may suggest its role in promoting peritoneal angiogenesis and fi-brosis.Moreover, it is positively correlated with clinical indicators PTH, CRP and LVPWD, suggesting that it has certain clinical guiding significance on microinflammatory state and myocardial remodeling.

ObjectiveTo evaluate the efficacy and influencing factors of Biejiajianwan in the treatment of primary liver cancer based on real-world data of traditional Chinese medicine （TCM）. MethodClinical diagnosis and treatment data of patients with primary liver cancer admitted to five Grade-A tertiary hospitals in Henan Province from January 2015 to December 2020 were collected from the medical electronic database. The patients treated with Biejiajianwan for ≥30 days were assigned to the exposure group and those without treatment with Biejiajianwan or treated with Biejiajianwan for <30 days to the non-exposure group. The propensity score matching model was used to balance confounding factors between the two groups according to the 1∶1 genetic matching method. Kaplan-Meier method was used for survival analysis and survival curve plotting. Log-rank was used to test the difference in survival rate between the two groups. Univariate analysis of Biejiajianwan in the treatment of primary liver cancer was performed by Log-rank test combined with the Kaplan-Meier method. The factors with statistical significance （P<0.05） were combined with unbalanced factors by the propensity score matching model， and at the same time， clinical common sense and relevant prognostic factors by literature search were considered， which were subjected to multivariate analysis by Cox proportional hazards regression model. ResultA total of 2 207 electronic cases were collected，including 174 cases in the exposure group （Biejiajianwan group） and 2 033 cases in the non-exposure group. After propensity score matching， there were 174 cases in the exposure group and 174 cases in the non-exposure group. The Kaplan-Meier method was used for survival analysis on the matched data， and the Log-rank test results showed that the survival rate of patients with primary liver cancer in the Biejiajianwan group was higher than that in the control group （χ²=12.193， P<0.01）. Cox proportional hazards regression model analysis showed that the regression coefficient of Biejiajianwan was -0.916 4 with the hazard ratio （HR） ［95% confidence interval （CI）］=0.4 （0.239 5-0.668 0）， P<0.01， and the regression coefficient of radiofrequency ablation treatment was -0.976 5 with HR （95% CI）=0.376 6 （0.172 8-0.821 1， P<0.05）. Fibrinogen （FIB） abnormal regression coefficient was 0.481 4 with HR （95% CI）=1.618 4（1.022 0-2.562 9），P<0.05. ConclusionBiejiajianwan can prolong the survival period of patients with primary liver cancer. Radiofrequency ablation is an independent protective factor for Biejiajianwan in the treatment of primary liver cancer，while abnormal FIB are independent risk factors for Biejiajianwan in the treatment of primary liver cancer.

OBJECTIVE To evaluate the cost-effectiveness of sintilimab combined with chemotherapy than single-use chemotherapy in the first-line treatment of advanced， recurrent or metastatic esophageal squamous cell carcinoma （ESCC） from the perspective of health system of our country， and provide reference for rational use of drug in clinic. METHODS Based on ORIENT-15 study data， TreeAge Pro 2011 software was used to establish a three-state Markov model of non-progressive survival （PFS）， disease progression and death for cost-utility analysis. The model period was 3 weeks， the research time limit was 10 years， and the discount rate was 5%. The main outputs of the model were total cost， quality-adjusted life year （QALY） and incremental cost-effectiveness ratio （ICER）. The 1-3 times of China’s GDP per capita in 2021 was taken as the threshold of willing- ness to pay （WTP）. The uncertainty of the parameters was analyzed by single factor sensitivity analysis and probability sensitivity analysis， and the cost-effectiveness of the two schemes was discussed under three situations： different discount rates， comparison with other similar treatment schemes and charitable drug donation schemes. RESULTS The results of basic analysis showed that compared with chemotherapy plan alone， the ICER of sintilimab combined with chemotherapy was 64 208.75 yuan/QALY， which was less than WTP threshold. The results of single factor sensitivity analysis show that PFS state utility value， cycle cost of sintilimab and discount rate had relatively great influence on the results. Probability sensitivity analysis showed that when WTP≥120 000 yuan， the economic probability of sintilimab combined with chemotherapy plan was 100%. The results of situational analysis showed that sintilimab combined chemotherapy was more cost- effective than single-use chemotherapy. CONCLUSIONS Sintilimab combined with chemotherapy is more cost-effective than single-use chemotherapy in the first-line treatment of advanced， recurrent or metastatic ESCC.