The perioperative nursing quality of patients with trigeminal neuralgia(TN)treated with percutaneous balloon compression(PBC)directly affects the efficacy and prognosis of the surgery.In view of this,the Chinese Physician Association Interventional Physician Branch has invited 37 experts in the fields of neural intervention,pain diagnosis,treatment,and nursing to develop this expert consensus.The systematic search of relevant guidelines,expert consensus,best evidence-based proofs,and clinical trial research results from the past 10 years at home and abroad,and the summary of the relevant research hotspots and clinical experiences in China are performed,based on which,two rounds of improved Delphi method expert inquiry and demonstration are conducted[expert authority coefficient(Cr)is 0.884 for both],and the quality level of relevant proofs and recommended opinions are extracted.The expert group has finally formulated this consensus.This consensus includes the following contents:preoperative evaluation and nursing,intraoperative monitoring and cooperation,postoperative nursing,complication warning and management,continuity of care,etc.,aiming to provide professional and scientific reference and guidance for optimizing the perioperative nursing way of PBC and reducing surgery-related risks.

Objective:To evaluate the diagnostic efficacy and practicality of the Jaundice color card (JCard) as a screening tool for neonatal jaundice.Methods:Following the standards for reporting of diagnostic accuracy studies (STARD) statement, a multicenter prospective study was conducted in 9 hospitals in China from October 2019 to September 2021. A total of 845 newborns who were admitted to the hospital or outpatient department for liver function testing due to their own diseases. The inclusion criteria were a gestational age of ≥35 weeks, a birth weight of ≥2 000 g, and an age of ≤28 days. The neonate′s parents used the JCard to measure jaundice at the neonate′s cheek. Within 2 hours of the JCard measurement, transcutaneous bilirubin (TcB) was measured with a JH20-1B device and total serum bilirubin (TSB) was detected. The Pearson′s correlation analysis, Bland-Altman plots and the receiver operating characteristic (ROC) curve were used for statistic analysis.Results:Out of the 854 newborns, 445 were male and 409 were female; 46 were born at 35-36 weeks of gestational age and 808 were born at ≥37 weeks of gestational age. Additionally, 432 cases were aged 0-3 days, 236 cases were aged 4-7 days, and 186 cases were aged 8-28 days. The TSB level was (227.4±89.6) μmol/L, with a range of 23.7-717.0 μmol/L. The JCard level was (221.4±77.0) μmol/L and the TcB level was (252.5±76.0) μmol/L. Both the JCard and TcB values showed good correlation ( r=0.77 and 0.80, respectively) and agreements (96.0% (820/854) and 95.2% (813/854) of samples fell within the 95% limits of agreement, respectively) with TSB. The JCard value of 12 had a sensitivity of 0.93 and specificity of 0.75 for identifying a TSB ≥205.2?μmol/L, and a sensitivity of 1.00 and specificity of 0.35 for identifying a TSB ≥342.0?μmol/L. The TcB value of 205.2?μmol/L had a sensitivity of 0.97 and specificity of 0.60 for identifying TSB levels of 205.2 μmol/L, and a sensitivity of 1.00 and specificity of 0.26 for identifying TSB levels of 342.0 μmol/L. The areas under the ROC curve (AUC) of JCard for identifying TSB levels of 153.9, 205.2, 256.5, and 342.0 μmol/L were 0.96, 0.92, 0.83, and 0.83, respectively. The AUC of TcB were 0.94, 0.91, 0.86, and 0.87, respectively. There were both no significant differences between the AUC of JCard and TcB in identifying TSB levels of 153.9 and 205.2 μmol/L (both P>0.05). However, the AUC of JCard were both lower than those of TcB in identifying TSB levels of 256.5 and 342.0 μmol/L (both P<0.05). Conclusions:JCard can be used to classify different levels of bilirubin, but its diagnostic efficacy decreases with increasing bilirubin levels. When TSB level are ≤205.2 μmol/L, its diagnostic efficacy is equivalent to that of the JH20-1B. To prevent the misdiagnosis of severe jaundice, it is recommended that parents use a low JCard score, such as 12, to identify severe hyperbilirubinemia (TSB ≥342.0 μmol/L).

Objective:To study the clinical efficacy of roxadustat capsule combined with recombinant human erythropoietin (rhEPO) in the treatment of chronic kidney failure (CKD).Methods:A total of 105 patients with CKD complicated with renal anemia who received treatment in Yiwu Fuyuan Hospital from October 2019 to October 2022 were prospectively selected and divided into observation group (53 cases) and control group (52 cases) according to random number table method. Both groups received maintenance hemodialysis treatment, while the control group received rhEPO intravenous injection treatment. On the basis of the control group, the observation group received roxadustat oral treatment. After 8 weeks of continuous treatment, the clinical efficacy of both groups was determined, and the anemia indicators, micro inflammatory factors and iron metabolism indicators were compared.Results:The total effective rate in the observation group was higher than that in the control group: 96.23%(51/53) vs. 80.77% (42/52), there was statistical difference ( χ2 = 4.46, P<0.05). After treatment, the levels of hemoglobin (Hb), red blood cell (RBC) and hematocrit (Hct) in the observation group were higher than those in the control group: (102.54 ± 9.37) g/L vs. (91.82 ± 10.20) g/L, (3.62 ± 0.59) × 10 12/L vs. (2.77 ± 0.63) × 10 12/L, 0.369 ± 0.068 vs. 0.288 ± 0.056, there were statistical differences ( P<0.05). After treatment, the levels of tumor necrosis factor-α, C-reactive protein and interleukin-6 in the observation group were lower those in the control group: (2.14 ± 0.56) μg/L vs. (3.26 ± 0.72) μg/L, (8.17 ± 2.44) mg/L vs. (10.73 ± 3.05) mg/L, (101.27 ± 14.95) μg/L vs. (123.74 ± 18.38) μg/L, there were statistical differences ( P<0.05). After treatment, The levels of ferritin, transferrin, transferrin saturation in the observation group were higher than those in the control group and hemodulin was lower than that in the control group: (288.47 ± 26.65) μg/L vs.(259.66 ± 24.80) μg/L, (2.81 ± 0.31) g/L vs. (2.43 ± 0.35) g/L, 0.351 ± 0.051 vs. 0.299 ± 0.053, (95.17 ± 17.56) μg/L vs. (106.49 ± 19.28) μg/L, there were statistical differences ( P<0.05). Conclusions:Roxadustat combined with rhEPO has a significant therapeutic effect on CKD complicated with renal anemia, which can effectively improve the patient′s micro inflammatory state and iron metabolism, alleviate anemia symptoms.

In traditional clinical teaching of impacted tooth extraction, there are problems including limited observation fields for students, insufficient doctor-patient communication training, inadequate clinical thinking development, and low levels of clinical participation. Based on the core elements of visualizing jaw structure with perspective, formulating clinical strategy, immersing in clinical participation, and cultivating the spirit of caregiving, we developed a virtual reality simulation teaching platform for the clinical decision analysis of impacted tooth extraction. The virtual simulation-based platform can create three different impacted tooth scenarios in 3D, which demonstrates the process of clinical decision analysis of impacted tooth extraction through virtuality-reality interaction, allowing students to immerse in the discovery, analysis, and resolution of the medical and humanistic problems in the process of impacted tooth extraction. The questionnaire survey showed that 81.36% (48/59) of the students believed that the software could improve their clinical thinking ability; 76.27% (45/59) of the students believed that it could help them master the basic process of impacted tooth extraction; and 62.71% (37/59) of the students believed that it could improve their skills of impacted tooth extraction. By providing immersive learning experience, constructive teaching design, and multi-dimensional teaching evaluation, the software achieved the goals of cultivating students' clinical thinking ability and professional literacy in oral and maxillofacial surgery.

Objective To explore the safety and efficacy of"fishing-style"uterine suspension and vaginal purse-string suture encapsulation of the cervix in modified laparoscopic radical hysterectomy.Methods Clinical data of 82 patients with cervical cancer who underwent QM-C2 radical hysterectomy in our hospital from October 2021 to August 2023 were retrospectively analyzed.There were 36 cases in laparoscopic group(LRH)and 46 cases in abdominal group(ARH).In the laparoscopic group,the"fishing-style"uterine suspension,rather than a uterine manipulator,was used to manipulate the uterus,followed by vaginal purse-string suture encapsulation of the cervix before copotomy.The operation time,intraoperative bleeding,complications,positive rate of pathological margins,and recurrence rate were compared between the two groups.Results The LRH group showed less intraoperative bleeding and shorter postoperative hospital stay than the ARH group[40(30-130)ml vs.80(20-300)ml,Z=-4.057,P=0.000;8.5(5-24)d vs.10(5-26)d,Z=-2.975,P=0.003].There were no significant differences in operation time,complications,the number of lymph node dissected,cutting edge positivity rate,and recurrence rate(P>0.05).Conclusion The modified laparoscopic radical hysterectomy with"fishing-style"uterine suspension and vaginal purse-string suture encapsulation of the cervix is safe and feasible.

As the most important source of nutrients for newborns，breast milk is not only rich in protein，fat，carbohydrates，vitamins，minerals and other nutrients，but also contains hundreds of bioactive factors，such as hormones，cytokines，white blood cells，immunoglobulins，lactoferrin，lysozyme，stem cells，breast milk oligosaccharides，micropopulation and microRNA.The comprehensive action of all components of breast milk can regulate the development of neonatal immune system.Various microorganisms in breast milk interact with each other to form a breast milk microecosystem.More and more attention has been paid to the role of breast milk microflora in promoting the development of neonatal immune system.This article reviews the relationship between breast milk microecology and neonatal immune function.

Objective To investigate the current demand for extended nursing services for newborns after discharge.Methods A survey was conducted on the demand for extended nursing services after discharge of newborns using the"Survey Form for Demand for Extended Nursing Services after Discharge of Newborns",and the results were analyzed.Results 62.30％of the data for this survey was provided by the father,possibly due to a Chinese tradition where mothers were confined at home during confinement after their child's discharge,making it inconvenient for them to go out.The educational level of parents was mainly undergraduate or above,with an age of 30.55±5.07 years old,mainly middle-aged and young;The top 5 scores for continuity of care content requirements were:reminder for follow-up visits(4.39±0.08)points,discharge medication guidance(4.35±0.92)points,health assessment(4.29±0.94)points,disease-related knowledge education(4.28±0.95)points,specialized nursing(4.17±1.05)points and basic nursing guidance(4.17±1.04)points;The top four scores of parents'demands for extended nursing channels were:telephone follow-up 2673(85.45％),discharge education 2529(80.85％),community two-way referral 2390(76.41％),and health education network platform 2271(72.60％)(such as WeChat official account,forum,Tiktok live broadcast);Family members hope that 2340 doctors(74.81％)and 1 764 hospital nurses(56.39％)were still the main executors of extended services provided by the hospital;After discharge,if necessary due to the condition,medical staff would come to your doorstep to provide corresponding medical care services.Patients agreed to pay 2759 cases(88.20％)according to the price standard,with the majority agreeing to pay 2 189 cases(69.98％)for consultation fees,2057 cases(65.76％)for material fees and 1 997 cases(63.84％)for diagnosis,treatment,and nursing fees.Conclusion Providing continuous extended care services during and after the discharge of newborns can reduce their readmission rate,promote physical development,and reduce complications.With the development of medical technology and information technology,parents of newborns have an increasing demand for extended care services,and it is imperative to carry out extended care services.

Objective To investigate the effect of ursodeoxycholic acid(UDCA)on the symptoms after severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection in patients with primary biliary cholangitis(PBC)and their family member.Methods A questionnaire survey was conducted to collect related information from 171 PBC patients who attended The First Affiliated Hospital of Air Force Medical University before March 22,2023 and 128 family members,including demographic information,comorbidities,UDCA administration,SARS-CoV-2 infection,vaccination,symptoms,therapeutic medication,and the changes in liver disease-related symptoms.The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups,and the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups.Results The median age was 51 years in the PBC patients and 49 years in the family members,with no significant difference between the two groups(P>0.05).Compared with the family member group,the PBC group had significantly lower body mass index(22.2±2.4 kg/m2 vs 23.3±2.9 kg/m2,P<0.001)and proportion of male individuals(10%vs 55%,P<0.001).All PBC patients received UDCA at a dose of 13—15 mg/kg,and SARS-CoV-2 infection rate was 100%in both groups.The family members had a significantly higher SARS-CoV-2 vaccination rate than the PBC patients(91%vs 57%,P<0.001).Compared with the family members,the PBC patients had significantly milder symptoms of sneezing,nasal obstruction,chest pain,and abnormal taste(P<0.05).Compared with the family members,the PBC patients had significantly lower rates of use of compound cold medicine(11%vs 20%,P<0.05)and Lianhua Qingwen capsules(12%vs 21%,P<0.05).For the PBC patients after SARS-CoV-2 infection,the liver disease-related symptoms such as fatigue,abdominal distension,dry mouth and dry eyes,pruritus,and yellow skin were aggravated by 37%,2%,27%,10%,and 3%,respectively.Conclusion Compared with the immediate family members of PBC patients who do not take UDCA,the PBC patients receiving UDCA do not show a reduction in SARS-CoV-2 infection rate,but UDCA may have a certain effect on alleviating infection-related symptoms in such patients.PBC patients may still experience the aggravation of liver disease-related symptoms after SARS-CoV-2 infection,and the long-term effect on PBC patients after SARS-CoV-2 infection should be taken seriously in clinical practice.

Objective To investigate the impacts of wogonin(WG)on Th17/Treg cell balance in autoimmune hep-atitis(AIH)rats.Methods A total of 10 rats were randomly selected as the control group.The remaining rats were injected with concanavalin A(ConA,12.5 mg/kg)solution via tail vein to construct AIH model rat,which were ran-domly divided into AIH group,L-WG group(10 mg/kg),M-WG group(20 mg/kg),H-WG group(30 mg/kg),H-WG+VPA group(30 mg/kg WG+300 mg/kg Notch signal pathway activator VPA),10 rats in each group and administered once a day for 10 days.Serum inflammatory factors and liver function indexes were detected by ELISA;HE staining was used to observe the pathological morphology of liver tissue;the level of spleen Th17/Treg cells was detected by flow cytometry;Western blot was used to detect the expression of spleen retinoid acid related orphan receptor γ t(RORγt),fork head box protein P3(Foxp3)and liver Notch signal pathway proteins.Results The liver tissue structure of control group was normal and the staining was clear;In AIH group,the cells of liver tis-sue showed edema,the increase of cell volume led to the compression and narrowing of liver sinuses,and a large number of inflammatory cell infiltration and a small amount of necrosis occurred.The contents of alanine aminotrans-ferase(ALT),aspartate aminotransferase(AST),interleukin(IL)-17 and IL-23,level of Th17 cells,Th17/Treg,the expression of RORγt,Notch,hes family bHLH transcription factor 1 gene(HES1)and hes related family bHLH transcription factor with YRPW motif 1(HEY1)protein in AIH group were greatly higher than those in control group(P＜0.05),the contents of IL-10 and TNF-β,level of Treg cells,and level of Foxp3 protein were greatly lower(P＜0.05);Compared with AIH group,the liver injury in L-WG group,M-WG group and H-WG group was im-proved,the contents of ALT,AST,IL-17 and IL-23,level of Th17 cells,Th17/Treg,the expression of RORγt,Notch,HES1 and HEY1 protein were greatly lower(P＜0.05),the contents of IL-10 and TNF-β,level of Treg cells,and level of Foxp3 protein were greatly higher(P＜0.05);VPA reversed the improvement effect of H-WG on AIH rats.Conclusions WG could promote Th17/Treg cell balance in AIH rats by down-regulating Notch signal pathway.