Objective:To analyze the latent profiles of voice behavior among head nurses and to explore the influencing factors associated with different voice behavior categories.Methods:A convenience sampling method was used to recruit 527 head nurses from 104 medical institutions across 17 provinces in East, South, Central, North, Northwest, Southwest, and Northeast China between November 2023 and January 2024. Data were collected using a General Information Questionnaire, Voice Behavior Scale, Organizational Justice Scale, General Self-Efficacy Scale, and a Brief Personality Inventory. Latent profile analysis was conducted to identify subgroups of voice behavior, and multinomial Logistic regression was performed to explore influencing factors.Results:The score of head nurses' voice behavior was (45.84±6.88). Three latent profiles were identified: low-capacity fluctuating type, medium-capacity stable type, and high-capacity promoting type. Logistic regression analysis showed that openness personality trait, organizational justice, self-efficacy, and hospital grade were significant predictors of voice behavior profiles (all P<0.05) . Conclusions:The overall level of voice behavior among head nurses is above average, with evident heterogeneity. Nursing administrators should actively encourage voice behavior, provide timely feedback, and foster a fair organizational environment to promote a positive and constructive voice culture.

Objective:To analyze the latent profiles of voice behavior among head nurses and to explore the influencing factors associated with different voice behavior categories.Methods:A convenience sampling method was used to recruit 527 head nurses from 104 medical institutions across 17 provinces in East, South, Central, North, Northwest, Southwest, and Northeast China between November 2023 and January 2024. Data were collected using a General Information Questionnaire, Voice Behavior Scale, Organizational Justice Scale, General Self-Efficacy Scale, and a Brief Personality Inventory. Latent profile analysis was conducted to identify subgroups of voice behavior, and multinomial Logistic regression was performed to explore influencing factors.Results:The score of head nurses' voice behavior was (45.84±6.88). Three latent profiles were identified: low-capacity fluctuating type, medium-capacity stable type, and high-capacity promoting type. Logistic regression analysis showed that openness personality trait, organizational justice, self-efficacy, and hospital grade were significant predictors of voice behavior profiles (all P<0.05) . Conclusions:The overall level of voice behavior among head nurses is above average, with evident heterogeneity. Nursing administrators should actively encourage voice behavior, provide timely feedback, and foster a fair organizational environment to promote a positive and constructive voice culture.

Objective To establish an individual Nomgram model for predicting the risk of coronary heart disease complicated with pulmonary hypertension. Methods From January 2017 to December 2021 , 352 patients with coronary heart disease (CHD) complicated with pulmonary hypertension in our hospital were selected, and 352 patients with coronary heart disease but without pulmonary hypertension were selected as the control group. The clinical baseline data of the two groups were analyzed first, and then logistics multivariate analysis was performed. To explore the risk factors of coronary heart disease complicated with pulmonary hypertension, the Nomgram model was established to predict the risk, and the predictive value of the model was tested by receiver characteristic curve (ROC). Results Logistics multivariate analysis showed that alcoholism, smoking, stroke history, hypertension course, CHD course, PASP, HCT, PaCO₂, D-dimer, NIHSS score and low PaO₂ were all independent risk factors for CHD complicated with pulmonary hypertension. Nomgram model prediction results for patients with coronary heart disease showed that Alcohol abuse, smoking, stroke history, duration of hypertension (5.66 years), duration of coronary heart disease (2.12 years), NIHSS (12.33 points), PASP (75.22mmHg), HCT (33.22%), PaCO₂ (56.11mmHg), D-dimer (255.12μg/L), PaO2 (56.22mmHg) is a risk factor for coronary heart disease complicated with pulmonary hypertension. ROC curve showed that the area under the prediction curve of Nomgram model for coronary heart disease complicated with pulmonary hypertension was 0.675. Conclusion Nomgram model can predict pulmonary hypertension in patients with coronary heart disease to a certain extent.

Objective This study aimed to evaluate the bone integration performance of antibacterial carbon dot(CD)-modified polyether ether ketone(PEEK)in infectious bone defect environments.Methods Guanidine-based CDs(G-CDs)prepared by the melting method combined with dialysis purification were used to modify PEEK implants using polyvinyl butyraldehyde(PVB)by the soaking-drying method(PEEK/PVB-G-CDs).SD rats were divided into the following groups:(1)PEEK-implanted uninfected(PEEK(-)),(2)PEEK/PVB-G-CDs-implanted uninfected(PEEK/PVB-G-CDs(-)),(3)PEEK-implanted infected(PEEK(+)),and(4)PEEK/PVB-G-CDs-implanted infected(PEEK/PVB-G-CDs(+)).A hole(diameter 2 mm,depth 5 mm)was drilled at the lateral condyle of the vertical femur in all rats to simulate a bone defect.Rats in the PEEK(-)and PEEK/PVB-G-CDs(-)groups without infection were injected with 30 μL physiological saline into the bone marrow cavity,and rats in the PEEK(+)and PEEK/PVB-G-CDs(+)groups with infection were injected with 30 μL MRSA bacterial suspension(1.5 × 104 colony-forming units/mL)into the bone marrow cavity.The implantation site was observed using animal-specific X-ray examination at 0,2,and 4 weeks after implantation,and the bone tissue characteristics of the implantation site were evaluated by micro computed tomography(CT)at 6 weeks after surgery.The bone implantation sites in each group of rats were examined by bacterial culture of bone marrow and hematoxylin and eosin staining,Toluidine blue,Goldner trichrome,and immunohistochemical staining.Results X-ray,Micro-CT,bacterial culture of bone marrow,and histopathological analysis confirmed no signs of infection in the PEEK(-)and PEEK/PVB-G-CDs(-)groups and the implants were integrated with the bone defects.Rats in the PEEK/PVB-G-CDs(+)group showed signs of antibacterial activity that effectively controlled the osteomyelitis caused by MRSA and achieved bone integration,while rats in the PEEK(+)group failed to achieve bone integration because of persistent infection.Immunohistochemical staining confirmed lower levels of anti-inflammatory factors such as IL-4 and IL-10 in the PEEK(+)group,and stronger expression of pro-inflammatory factors such as IL-6 and TNF-α compared with the other three groups,indicating that G-CD-modified PEEK inhibited MRSA infection,regulated inflammation levels in the local microenvironment,and promoted bone integration at the site of bone defects.Conclusions Antibacterial G-CDs modified PEEK exhibits excellent bone integration performance,providing a candidate strategy for future clinical treatment of infectious bone defects.

Objective This study aimed to evaluate the bone integration performance of antibacterial carbon dot(CD)-modified polyether ether ketone(PEEK)in infectious bone defect environments.Methods Guanidine-based CDs(G-CDs)prepared by the melting method combined with dialysis purification were used to modify PEEK implants using polyvinyl butyraldehyde(PVB)by the soaking-drying method(PEEK/PVB-G-CDs).SD rats were divided into the following groups:(1)PEEK-implanted uninfected(PEEK(-)),(2)PEEK/PVB-G-CDs-implanted uninfected(PEEK/PVB-G-CDs(-)),(3)PEEK-implanted infected(PEEK(+)),and(4)PEEK/PVB-G-CDs-implanted infected(PEEK/PVB-G-CDs(+)).A hole(diameter 2 mm,depth 5 mm)was drilled at the lateral condyle of the vertical femur in all rats to simulate a bone defect.Rats in the PEEK(-)and PEEK/PVB-G-CDs(-)groups without infection were injected with 30 μL physiological saline into the bone marrow cavity,and rats in the PEEK(+)and PEEK/PVB-G-CDs(+)groups with infection were injected with 30 μL MRSA bacterial suspension(1.5 × 104 colony-forming units/mL)into the bone marrow cavity.The implantation site was observed using animal-specific X-ray examination at 0,2,and 4 weeks after implantation,and the bone tissue characteristics of the implantation site were evaluated by micro computed tomography(CT)at 6 weeks after surgery.The bone implantation sites in each group of rats were examined by bacterial culture of bone marrow and hematoxylin and eosin staining,Toluidine blue,Goldner trichrome,and immunohistochemical staining.Results X-ray,Micro-CT,bacterial culture of bone marrow,and histopathological analysis confirmed no signs of infection in the PEEK(-)and PEEK/PVB-G-CDs(-)groups and the implants were integrated with the bone defects.Rats in the PEEK/PVB-G-CDs(+)group showed signs of antibacterial activity that effectively controlled the osteomyelitis caused by MRSA and achieved bone integration,while rats in the PEEK(+)group failed to achieve bone integration because of persistent infection.Immunohistochemical staining confirmed lower levels of anti-inflammatory factors such as IL-4 and IL-10 in the PEEK(+)group,and stronger expression of pro-inflammatory factors such as IL-6 and TNF-α compared with the other three groups,indicating that G-CD-modified PEEK inhibited MRSA infection,regulated inflammation levels in the local microenvironment,and promoted bone integration at the site of bone defects.Conclusions Antibacterial G-CDs modified PEEK exhibits excellent bone integration performance,providing a candidate strategy for future clinical treatment of infectious bone defects.

OBJECTIVE: To explore the genetic basis for a child with Rothmund-Thomson syndrome (RTS). METHODS: The child has featured poikeloderma, short stature, cataract, sparse hair and skeletal malformation. Peripheral blood samples of the child and her family members were collected and subjected to whole exome sequencing. Candidate variants were verified by Sanger sequencing. RESULTS: The child was found to harbor compound heterozygous variants of the RECQL4 gene, namely c.1048_1049delAG and c.2886-1G>A, among which c.2886-1G>A was unreported previously. According to the ACMG guidelines, the c.1048_1049delAG was predicted to be pathogenic (PVS1+PM3_Strong+PM2), while the c.2886-1G>A was predicted to be likely pathogenic (PVS1+PM2). CONCLUSION The compound heterozygous variants of the RECQL4 gene probably underlay the pathogenesis of RTS in this patient. Above finding has enriched the mutational spectrum of the RECQL4 gene.
Child ; Family ; Female ; Humans ; Mutation ; RecQ Helicases/genetics* ; Rothmund-Thomson Syndrome/genetics* ; Whole Exome Sequencing

Objective To establish the HPLC fingerprints of petroleum ether parts from five traditional medicine (Alpinia officinarum Hance, Alpinia galangal ( L.) Wild, Alpinia galanga Will., Alpinia katsumadai Hayata, and Alpinia oxyphylla Miq), and to explore the similarities and differences of chemical composition,as well as the correlation between the genetic relationship and the chemical composition. Methods HPLC method was used to analysis the five traditional medicines. The data were evaluated by using the"similarity evaluation system for chromatographic fingerprint of TCM" software. Results The similarity chemical composition from Alpinia officinarum Hance,Alpinia galangal(L.) Wild,Alpinia galanga Will.,Alpinia katsumadai Hayata,and Alpinia oxyphylla Miq in ethyl acetate were 0.741,0.855,0.610,0.510, 0.680,respectively. Conclusion Though there were differences of fingerprint peak of petroleum ether parts between five the traditional Chinese medicines, similarities were also observed among them.