Methods: Cervical radiographs were analyzed. EOP hyperplasia was classified into three subtypes with standardized length measurements. Variables encompassed demographics, ONL-related indices, and sagittal parameters. Subtype comparisons and multivariate regression analyses (with EOP length as dependent variable) were conducted. Results: Analysis of 187 CSM patients (64.2% male) identified gender-specific patterns: males exhibited greater EOP length (9.4±6.8 mm vs. 4.6±3.4 mm, p<0.001). Type III EOP demonstrated male predominance (82.4% vs. type I 31.8%, type II 51.4%; p<0.001), with associated longer hyperplasia length (11.6±6.6 mm vs. type II 5.1±1.9 mm, p<0.001). Type III EOP was associated with higher ONL prevalence (type III 64.8% vs. type I 45.5%, type II 41.9%; p=0.010) and longer ONL osteophyte length (type III 18.8±9.8 mm vs. type I 14.2±8.1 mm, type II 14.2±9.4 mm; p=0.046). Multivariate regression confirmed male sex (β=–3.82, p=0.009), ONL osteophyte length (β=0.16, p=0.017), T1 slope (β=0.27, p=0.041), and spino-cranial angle (β=–0.19, p=0.009) as factors independently associated with EOP length (adjusted R²=0.382). Conclusions Severe EOP hyperplasia exhibits a male-predominant distribution pattern and demonstrates significant radiological associations with ONL and cervical sagittal imbalance in CSM patients. These findings advocate for EOP evaluation in clinical evaluations to identify high-risk biomechanical profiles.

Methods: From March 2020 to March 2023, 100 inpatients with DS were classified into groups A, B, C, and D based on the CARDS classification system. Preoperative radiological data were analyzed to measure the severity of central canal stenosis, facet joint arthropathy, intervertebral disc herniation, and spinal epidural lipomatosis, osteophyte formation, range of motion (ROM), and computed tomography value of the vertebral bodies. The radiological characteristics and clinical contraindications for OLIF were compared among the groups. Results: Of the 100 patients, 51% had clinical contraindications for OLIF, which included 85%, 25%, 62.5%, and 20% of patients in groups A, B, C, and D, respectively. Compared with group B, group A demonstrated greater severity of central canal stenosis, whereas group C showed a higher degree of facet joint arthropathy. More patients in groups A and C had severe central canal stenosis. Regarding the ROM results, group A had segmental stiffness, whereas group D presented relatively unstable slip segments. Conclusions Patients with different DS subtypes have varied radiological characteristics. Groups B and D are suitable candidates for OLIF. Most patients in group A are unsuitable for OLIF because of bony hyperplasia, severe spinal stenosis, and segmental stiffness.

As the "main force" for providing health services, there has been a constant increase in the number of health service and management graduates in recent years, but with a lack of satisfactory quality. The concept of outcome-based education (OBE) takes the needs of all parties as the starting point and foothold for practice, which can ensure the consistency between the goal of talent training and the learning achievements of students to the greatest extent. This article proposes to integrate the educational concept of OBE into the training path of health service and management talents, clarify talent training objectives by understanding the needs of all parties, optimize the curriculum system according to training objectives, and construct a diversified evaluation system with the organic combination of process evaluation and summative assessment, in order to continuously optimize the training path of health service and management talents and cultivate applied health management talents with knowledge, ability, and quality.

Objective:To analyze the clinical characteristics and nutritional treatment of malnutrition in infants with botulism.Methods:A retrospective analysis was conducted on 25 infant botulism patients admitted to Beijing Children's Hospital Affiliated to Capital Medical University，from May 1，2019 to October 31，2024.The nutritional risk and malnutrition incidence were assessed，nutritional therapy methods，formulations，tolerance status, energy intake rate, secondary infections and prognosis were analyzed.Results:A total of 25 pediatric patients were included, 19 males and 6 females, with a median age of 5(4,6) months. Twenty-five cases (100%) showed reduced food intake, with a weight of 7.3 (7.0, 9.0) kg upon admission. Twenty-four cases (96%) were assessed as high-risk for nutrition screening, and one case was diagnosed with malnutrition. Twenty-four cases (96%) received nasogastric tube feeding, with an early enteral nutrition implementation rate of 84% (21 cases) and intermittent infusion in 25 cases (100%). Fourteen cases used whole protein formula milk,eight cases used hydrolyzed protein formula milk and three cases were given 5% sugar solution. Nine cases were treated with intravenous nutrition, with a duration of 9 (5, 12) days. Five cases (20%) developed enteral feeding intolerance, and all five cases had secondary infections and were treated with parenteral nutrition. All 25 patients had good prognosis. At discharge, 17 cases (68%) were fed orally, and eight cases (32%) were fed through nasogastric tubes, with a median weight of 7.5 (7.0, 9.0) kg. Fifteen patients (60%) had weight gain, and the nutritional screening assessment was all low-risk.Conclusion:Infants with botulism are mostly in a state of high nutritional risk when they are admitted to hospital. Early enteral nutrition through a gastric tube has a high implementation rate. Some children may experience feeding intolerance,combined with timely use of parenteral nutrition replacement and symptomatic treatment can improve prognosis.

Methods: From March 2020 to March 2023, 100 inpatients with DS were classified into groups A, B, C, and D based on the CARDS classification system. Preoperative radiological data were analyzed to measure the severity of central canal stenosis, facet joint arthropathy, intervertebral disc herniation, and spinal epidural lipomatosis, osteophyte formation, range of motion (ROM), and computed tomography value of the vertebral bodies. The radiological characteristics and clinical contraindications for OLIF were compared among the groups. Results: Of the 100 patients, 51% had clinical contraindications for OLIF, which included 85%, 25%, 62.5%, and 20% of patients in groups A, B, C, and D, respectively. Compared with group B, group A demonstrated greater severity of central canal stenosis, whereas group C showed a higher degree of facet joint arthropathy. More patients in groups A and C had severe central canal stenosis. Regarding the ROM results, group A had segmental stiffness, whereas group D presented relatively unstable slip segments. Conclusions Patients with different DS subtypes have varied radiological characteristics. Groups B and D are suitable candidates for OLIF. Most patients in group A are unsuitable for OLIF because of bony hyperplasia, severe spinal stenosis, and segmental stiffness.

Methods: From March 2020 to March 2023, 100 inpatients with DS were classified into groups A, B, C, and D based on the CARDS classification system. Preoperative radiological data were analyzed to measure the severity of central canal stenosis, facet joint arthropathy, intervertebral disc herniation, and spinal epidural lipomatosis, osteophyte formation, range of motion (ROM), and computed tomography value of the vertebral bodies. The radiological characteristics and clinical contraindications for OLIF were compared among the groups. Results: Of the 100 patients, 51% had clinical contraindications for OLIF, which included 85%, 25%, 62.5%, and 20% of patients in groups A, B, C, and D, respectively. Compared with group B, group A demonstrated greater severity of central canal stenosis, whereas group C showed a higher degree of facet joint arthropathy. More patients in groups A and C had severe central canal stenosis. Regarding the ROM results, group A had segmental stiffness, whereas group D presented relatively unstable slip segments. Conclusions Patients with different DS subtypes have varied radiological characteristics. Groups B and D are suitable candidates for OLIF. Most patients in group A are unsuitable for OLIF because of bony hyperplasia, severe spinal stenosis, and segmental stiffness.

Objective:To explore the correlation between serum ferritin (SF) and risk of lean non-alcoholic fatty liver disease (NAFLD), so as to provide the basis for the prevention and treatment of lean NAFLD.Methods:A total of 7 187 people without NAFLD at baseline who took at least 2 physical examinations in the Health Management Center of the Second Hospital of Dalian Medical University from January 2014 to December 2023 and met the selection criteria were selected as the research subjects, and all the subjects had no NAFLD at baseline. Subjects were divided into four groups according to baseline SF quartiles: 1 797 cases in the first quartile ( Q1) group, 1 797 cases in the second quartile ( Q2) group, 1 797 cases in the third quartile ( Q3) group, and 1 796 cases in the fourth quartile ( Q4) group. The incidence of lean NAFLD in each group were observed. Kaplan-Meier curve was plotted to calculate the cumulative incidence of lean NAFLD which compared by log-rank test. Cox proportional hazard regression model was used to analyze the correlation between SF and new-onset lean NAFLD, Q1, Q2, Q3 and Q4 of SF were taken as continuous variables into the model for trend test.The stability of the results was verified by two item sensitivity analyses. Time-dependent receiver operating characteristic curve (ROC) was plotted to evaluate the predictive value of SF for the onset of lean NAFLD. Results:The cumulative follow-up were 25 076 person-years. There were 230 new cases of lean NAFLD, and the incidence density was 9.172/1 000 person-years. The incidence densities of lean NAFLD in Q1, Q2, Q3 and Q4 groups were 6.915/1 000 person-years, 8.552/1 000 person-years, 9.641/1 000 person-years, 12.003/1 000 person-years, respectively. Kaplan-Meier curve indicated that the incidence of lean NAFLD was increased with the increment of SF, and the difference was statistically significant (log-rank test, χ2=9.92, P=0.019). Cox proportional hazard regression model results showed that the risk of developing lean NAFLD in Q4 group increased by 72.8% ( HR=1.728, 95% confidence interval (95% CI): 1.059 to 2.820) compared with Q1 group. Trend analysis revealed that the risk of lean NAFLD increased by 18.9% for each one-quartile increase of SF( HR=1.189, 95% CI: 1.012 to 1.396). Two sensitivity analyses indicated that the risk of NAFLD in Q4 group was 1.795 times ( HR=1.795, 95% CI: 1.083 to 2.975) or 1.654 times ( HR=1.654, 95% CI: 1.022 to 2.678) higher than that in Q1 group. The area under the curve (95% CI) of SF for predicting the incidence of lean NAFLD at 2-, 3-, 7- and 8-year follow-up based on time-dependent ROC were 0.645 (0.593 to 0.698), 0.652 (0.603 to 0.700), 0.605 (0.539 to 0.672) and 0.716 (0.597 to 0.836), respectively. Conclusion:SF is an independent risk factor for lean NAFLD and has predictive value for the new-onset of lean NAFLD.

Objective:To explore the relationship between thyroid hormone sensitivity and metabolic dysfunction-associated steatotic liver disease(MASLD) in a population with normal thyroid function, with a particular focus on sex-specific differences.Methods:This retrospective study included 41 355 euthyroid cases who underwent routine health examinations at the Health Management Centre of the Second Affiliated Hospital of Dalian Medical University from January 2014 to December 2023 were included. The free triiodothyronine(FT 3) to free thyroxine(FT 4) ratio(FT 3/FT 4) was calculated in order to reflect the peripheral sensitivity of the thyroid gland. Similarly, thyroid feedback quantile-based index(TFQI), thyrotrophic thyroxine resistance index(TT 4RI), and the FT 3-based TFQI-derived index(TFQI-FT 3) were calculated in order to reflect the central sensitivity of the thyroid gland. A Logistic regression was employed to analyse the effect of sex-specific thyroid hormone sensitivity indices on the prevalence of MASLD. The restricted cubic spline was used to analyse the non-linear relationship between the thyroid sensitivity hormone indices and MASLD. Furthermore, the correlation between the thyroid hormone sensitivity indices and MASLD in different subgroups was also analysed. Results:The prevalence of MASLD in the study population was 28.8%. After adjusting the model for confounders, the risk of MASLD increased by 7%, 3%, 10%, and 5% for each standard deviation increase in FT 3/FT 4, TFQI, TFQI-FT 3, and TT 4RI in the total population, respectively. The risk of MASLD increased by 6% and 5% for each standard deviation increase in FT 3/FT 4 and TFQI-FT 3 in men, respectively. For each standard deviation increase in FT 3/FT 4, TFQI, TFQI-FT 3, and TT 4RI in women, the risk of MASLD increased by 6%, 5%, 11%, and 5%, respectively. Higher FT 3/FT 4 and TFQI-FT 3 were positively associated with the risk of developing MASLD in men, and higher FT 3/FT 4, TFQI, TFQI-FT 3, and TT 4RI were positively associated with the risk of developing MASLD in women. There was a non-linear, inverted U-shaped relationship between TFQI and risk of MASLD in women. Subgroup analyses showed positive associations between FT 3/FT 4, TFQI, TFQI-FT 3, and MASLD. Conclusions:The thyroid hormone sensitivity indices may provide a basis for clinical prevention and management of MASLD in individuals with normal thyroid function. Additionally, FT 3/FT 4 and TFQI-FT 3 may indicate the risk of MASLD in the general population, while TFQI and TT 4RI are more suitable for assessing the risk of MASLD in women.

Objective:To understand the knowledge, attitudes, and behaviors of residents in areas endemic for severe fever with thrombocytopenia syndrome (SFTS) and the factors influencing these aspects, to provide a scientific basis for the prevention and control of SFTS among residents in endemic areas.Methods:A multi-stage sampling method was used to select subjects for a questionnaire survey, and the collected data were analyzed and compared.Results:The awareness rate of SFTS-related knowledge among residents in the endemic areas of Qingdao was 14.38%, while the awareness rate of tick-related knowledge was 69.78%. The mean score for protective attitudes among residents in the endemic areas was 24.50±4.09, and the mean score for protective behaviors was 11.20±2.76. Among residents of different ages, occupations, and educational levels, comparisons of SFTS-related knowledge awareness rates ( χ2=293.553, P<0.001; χ2=495.216, P<0.001; χ2=677.272, P<0.001), tick-related knowledge awareness rates ( χ2=29.986, P<0.001; χ2=23.239, P=0.002; χ2=41.003, P<0.001), protective attitude scores ( H=52.094, P<0.001; H=33.446, P<0.001; H=81.715, P<0.001), and protective behavior scores ( H=52.344, P<0.001; H=28.465, P<0.001; H=67.061, P<0.001) showed statistically significant differences. Comparisons of these same factors among residents of different genders showed no statistically significant differences ( χ2=1.159, P=0.282; χ2=0.298, P=0.585; t=-0.808, P=0.419; t=-1.229, P=0.219). Comparisons of tick-related knowledge awareness rates among residents with different frequencies of outdoor work showed no statistically significant differences ( χ2=5.367, P=0.147); however, comparisons of SFTS-related knowledge awareness rates, protective attitude scores, and protective behavior scores among residents with different frequencies of outdoor work showed statistically significant differences ( χ2=117.010, P<0.001; F=4.127, P=0.006; H=56.280, P<0.001). Multivariate linear regression analysis revealed that older age, lower educational level, and less frequent outdoor work were associated with lower protective behavior scores ( t=-3.479, P<0.001; t=4.861, P<0.001; t=-7.753, P<0.001). Conclusions:Residents in the epidemic areas of SFTS have a low level of knowledge, attitude and practice. Factors influencing protective behaviors include age, occupation, educational level, and frequency of outdoor work. Farmers are a group that requires particular attention.

Objective To systematically review and quantify the content and structure of the non-accompanied wards policy texts at the provincial level in China from the perspective of policy tools,providing references and insights for optimizing and implementing future policies.Methods Using the policy analysis tools as framework,it applies content ana lysis to construct a two-dimensional analytical framework with the X-dimension and Y-dimension.A total of 19 policy texts related to non-accompanied ward issued by provincial governments in China from January 2000 to August 2024 were coded and analyzed.Results A total of 141 entries were coded.In the X-dimension,supply-oriented,demand-oriented,and environment-oriented policy tools accounted for 21.28%,19.86%,and 58.86%,respectively,indicating a greater reliance on environmental-oriented policy tools;In the Y-dimension,policies from the"12th Five-Year Plan"(16.31%),"13th Five-Year Plan"(14.89%),and"14th Five-Year Plan"(68.80%)phases were analyzed.The number of policies in the"14th Five-Year Plan"phase was the highest among the three periods.Conclusion The policy framework for non-accompanied wards in China is still in its initial exploration phase and has room for improvement.It is recommended that future policies optimize the use of policy tools,strengthen coordination among them,and support the development of non-accompanied wards.