ObjectiveTo investigate the risk factors for rebleeding after endoscopic therapy for esophageal and gastric varices in liver cirrhosis patients， to construct a clinical predictive model， and to provide a reference for predicting rebleeding in the early stage， reducing the incidence rate of rebleeding， and improving the clinical outcome of patients. MethodsA retrospective analysis was performed for the clinical data of 194 liver cirrhosis patients with gastroesophageal variceal bleeding who received initial endoscopic therapy at Department of Gastroenterology， The Second People’s Hospital of Lanzhou， from January 1， 2021 to May 31， 2025. According to whether rebleeding occurred within 1 year after endoscopic therapy， the patients were divided into rebleeding group and non-rebleeding group. 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. The patients enrolled were randomly divided into a training set and a validation set at a ratio of 7∶3. In the training set， the Lasso regression analysis was used to obtain optimal predictive variables， and the factors that might affect prognosis were included in the univariate and multivariate Logistic regression analyses to identify independent predictive factors for rebleeding after endoscopic therapy for esophageal and gastric varices in liver cirrhosis patients， which were used to construct a nomogram model. In both the training set and the validation set， the receiver operating characteristic （ROC） curve and the calibration curve were used to assess the discriminatory ability and calibration of the model， and decision curve analysis and the clinical impact curve were used to assess the clinical practicability of the model. ResultsAmong the 194 liver cirrhosis patients with esophageal and gastric varices， 116 （59.79%） experienced rebleeding within 1 year after endoscopic therapy， with 76 patients in the training set and 40 patients in the validation set. In the training set， the Lasso regression analysis and the univariate and multivariate Logistic regression analyses showed that etiology of liver cirrhosis （odds ratio ［OR］=3.540， 95% confidence interval ［CI］： 1.520 — 7.150， P<0.001）， Child-Pugh class （OR=3.560， 95%CI： 1.380 — 9.500， P=0.019）， severity of esophageal and gastric varices （OR=8.190， 95%CI： 3.568 — 17.850， P=0.026）， and main portal vein diameter （OR=2.954， 95%CI： 1.349 — 15.030， P=0.044） were independent predictive factors for rebleeding of esophageal and gastric varices in liver cirrhosis patients. A nomogram model was constructed based on the above independent predictive factors. The ROC curve analysis showed that this model had an area under the ROC curve of 0.845 （95%CI： 0.778 — 0.912） in the training set and 0.801 （95%CI： 0.798 — 0.868） in the validation set. The model had an index of concordance of 0.832 in the training set and 0.820 in the validation set， suggesting that the model had a good discriminatory ability. The Hosmer-Lemeshow test showed P values of 0.320 and 0.550 in the training set and validation set， respectively， the calibration curve indicated that the predicted probabilities of the nomogram model were in good concordance with the actual observed probabilities， suggesting that the model had good calibration. The decision curve analysis and the clinical impact curve showed that the model had good clinical utility. ConclusionThe nomogram model based on etiology of liver cirrhosis， Child-Pugh class， severity of esophageal and gastric varices， and main portal vein diameter has a certain clinical value in predicting the risk of rebleeding from esophageal and gastric varices in liver cirrhosis.

Objective To describe and evaluate the clinical studies of postoperative pain sensitization caused by sleep deprivation through the evidence map system,understand the distribution of evidence in this field,and provide reference for subsequent evidence research.Methods A computer-based search of PubMed,EMBASE,Cochrane library,Web of Science,CNKI,Wanfang Data,VIP and Chinese Biomedical Literature Database from inception to August 2023 was conducted to obtain intervent ion studies,observational studies and systematic reviews/Meta-analysis of postoperative pain sensitization caused by sleep deprivation.The research characteristics and methodological quality were analyzed and evaluated.The Cochrane Handbook for Systematic Reviews,the Newcastle-Ottawa Scale(NOS)and the AMSTAR-2 scale were used to evaluate the quality of the included studies,and the evidence was comprehensively analyzed and displayed by means of bubble chart,table and text.Results A total of 35 observational studies(31 cohort studies and 4 case-control studies),15 randomized controlled trials and 4 systematic reviews/Meta-analyses were included.The number of publications increased rapidly after 2018 and peaked in 2022,and clinical studies in this field mainly fo-cused on cohort studies,with fewer randomized controlled trials and systematic reviews/Meta-analysis studies.The results of the evidence map showed that in terms of quality,22 studies were'high quality',24 studies were'medium quality',and 8 studies were'low quality'.Thirty studies showed that sleep deprivation could induce postoperative pain sensitization.Only 2 studies suggested that sleep disorders were not significantly asso-ciated with postoperative pain sensitization,and ten studies were uncertain whether sleep deprivation could in-duce postoperative pain sensitization.Conclusions Overall evidence shows that sleep deprivation can induce postoperative pain sensitization,but the evaluation dimensions are limited and the methodological quality of the included literature needs to be improved.More high-quality,large-sample and standardized clinical studies should be carried out in the future to provide better scientific basis for clinical work.

Objective:To explore the effect of multidisciplinary comprehensive nursing under the Green Intensive Nursing Model on the clinical outcomes of patients with post-traumatic epilepsy (PTE) .Methods:A convenience sampling method was used to select 120 patients with PTE admitted to the Department of Neurosurgery, Zhumadian Central Hospital, from January 2022 to May 2024. Patients were randomly divided into an intervention group ( n=60) and a control group ( n=60) using a computer-generated random number table. The control group received routine neurosurgical nursing, while the intervention group received multidisciplinary comprehensive nursing under the Green Intensive Nursing Model in addition to routine nursing. The Quality of Life in Epilepsy Inventory-31 (QOLIE-31), Hospital Anxiety and Depression Scale (HADS), Barthel Index, and Montreal Cognitive Assessment (MoCA) were used for evaluation. Seizure frequency, quality of life, anxiety and depression, activities of daily living, and cognitive-behavioral function were compared between the two groups after intervention. Results:At the 3-month follow-up, the intervention group had fewer seizures than the control group, and the difference was statistically significant ( P<0.05). After the intervention, the QOLIE-31 scores, Barthel Index, and MoCA scores of the intervention group were higher than those of the control group, while the HADS scores were lower, the differences were statistically significant ( P<0.05) . Conclusions:Multidisciplinary comprehensive nursing under the Green Intensive Nursing Model can reduce seizure frequency in PTE patients, improve their quality of life, decrease anxiety and depression, enhance daily living ability, and improve cognitive-behavioral function.

Getah virus(GETV)is an arbovirus capable of infecting humans and vertebrates such as horses and pigs via blood-sucking mosquitoes,which is extremely harmful to the livestock indus-try.Current monitoring methods are time-consuming,costly,and dependent on specialized instru-ments.These characteristics hinder rapid detection in clinical samples.Therefore,the development of a simple,rapid,specific,and sensitive method for detecting GETV antigen is crucial for the pre-vention and control of GETV.In this study,a GETV E1 monoclonal antibody strain SD17/09-E1-mAb was prepared by a prokaryotic expression system for GETV E1 protein expression,and a col-loidal gold double-antibody sandwich assay encapsulating two strains of GETV E1 monoclonal an-tibody wasestablished.The results showed that the prepared colloidal gold test strips had good sen-sitivity and did not cross-react with other common porcine virus-positive tissue samples;the test strips had a high compliance rate with the IFA assay for GETV,and could be stored at 37 ℃ for one month and at room temperature for at least three months.In this study,a colloidal gold anti-surveillance test strip for rapid detection of GETV was successfully prepared,which provides a powerful tool for GETV detection.

Getah virus(GETV)is an arbovirus capable of infecting humans and vertebrates such as horses and pigs via blood-sucking mosquitoes,which is extremely harmful to the livestock indus-try.Current monitoring methods are time-consuming,costly,and dependent on specialized instru-ments.These characteristics hinder rapid detection in clinical samples.Therefore,the development of a simple,rapid,specific,and sensitive method for detecting GETV antigen is crucial for the pre-vention and control of GETV.In this study,a GETV E1 monoclonal antibody strain SD17/09-E1-mAb was prepared by a prokaryotic expression system for GETV E1 protein expression,and a col-loidal gold double-antibody sandwich assay encapsulating two strains of GETV E1 monoclonal an-tibody wasestablished.The results showed that the prepared colloidal gold test strips had good sen-sitivity and did not cross-react with other common porcine virus-positive tissue samples;the test strips had a high compliance rate with the IFA assay for GETV,and could be stored at 37 ℃ for one month and at room temperature for at least three months.In this study,a colloidal gold anti-surveillance test strip for rapid detection of GETV was successfully prepared,which provides a powerful tool for GETV detection.

Objective:To explore the effect of multidisciplinary comprehensive nursing under the Green Intensive Nursing Model on the clinical outcomes of patients with post-traumatic epilepsy (PTE) .Methods:A convenience sampling method was used to select 120 patients with PTE admitted to the Department of Neurosurgery, Zhumadian Central Hospital, from January 2022 to May 2024. Patients were randomly divided into an intervention group ( n=60) and a control group ( n=60) using a computer-generated random number table. The control group received routine neurosurgical nursing, while the intervention group received multidisciplinary comprehensive nursing under the Green Intensive Nursing Model in addition to routine nursing. The Quality of Life in Epilepsy Inventory-31 (QOLIE-31), Hospital Anxiety and Depression Scale (HADS), Barthel Index, and Montreal Cognitive Assessment (MoCA) were used for evaluation. Seizure frequency, quality of life, anxiety and depression, activities of daily living, and cognitive-behavioral function were compared between the two groups after intervention. Results:At the 3-month follow-up, the intervention group had fewer seizures than the control group, and the difference was statistically significant ( P<0.05). After the intervention, the QOLIE-31 scores, Barthel Index, and MoCA scores of the intervention group were higher than those of the control group, while the HADS scores were lower, the differences were statistically significant ( P<0.05) . Conclusions:Multidisciplinary comprehensive nursing under the Green Intensive Nursing Model can reduce seizure frequency in PTE patients, improve their quality of life, decrease anxiety and depression, enhance daily living ability, and improve cognitive-behavioral function.

To describe and evaluate the clinical studies of postoperative pain sensitization caused by sleep deprivation through the evidence map system, understand the distribution of evidence in this field, and provide reference for subsequent evidence research.

Objective:To investigate the risk factors of lower extremity deep venous thrombosis (LEDVT) in patients with sepsis during hospitalization in intensive care unit (ICU), and to construct a nomogram prediction model of LEDVT in sepsis patients in the ICU based on the critical care scores combined with inflammatory markers, and to validate its effectiveness in early prediction.Methods:726 sepsis patients admitted to the ICU of the Affiliated Hospital of Jining Medical University from January 2015 to December 2021 were retrospectively included as the training set to construct the prediction model. In addition, 213 sepsis patients admitted to the ICU of the Affiliated Hospital of Jining Medical University from January 2022 to June 2023 were retrospectively included as the validation set to verify the performance of the prediction model. Clinical data of patients were collected, such as demographic information, vital signs at the time of admission to the ICU, underlying diseases, past history, various types of scores within 24 hours of admission to the ICU, the first laboratory indexes of admission to the ICU, lower extremity venous ultrasound results, treatment, and prognostic indexes. Lasso regression analysis was used to screen the influencing factors for the occurrence of LEDVT in sepsis patients, and the results of Logistic regression analysis were synthesized to construct a nomogram model. The nomogram model was evaluated by receiver operator characteristic curve (ROC curve), calibration curve, clinical impact curve (CIC) and decision curve analysis (DCA).Results:The incidence of LEDVT after ICU admission was 21.5% (156/726) in the training set of sepsis patients and 21.6% (46/213) in the validation set of sepsis patients. The baseline data of patients in both training and validation sets were comparable. Lasso regression analysis showed that seven independent variables were screened from 67 parameters to be associated with the occurrence of LEDVT in patients with sepsis. Logistic regression analysis showed that the age [odds ratio ( OR) = 1.03, 95% confidence interval (95% CI) was 1.01 to 1.04, P < 0.001], body mass index (BMI: OR = 1.05, 95% CI was 1.01 to 1.09, P = 0.009), venous thromboembolism (VTE) score ( OR = 1.20, 95% CI was 1.11 to 1.29, P < 0.001), activated partial thromboplastin time (APTT: OR = 0.98, 95% CI was 0.97 to 0.99, P = 0.009), D-dimer ( OR = 1.03, 95% CI was 1.01 to 1.04, P < 0.001), skin or soft-tissue infection ( OR = 2.53, 95% CI was 1.29 to 4.98, P = 0.007), and femoral venous cannulation ( OR = 3.72, 95% CI was 2.50 to 5.54, P < 0.001) were the independent influences on the occurrence of LEDVT in patients with sepsis. The nomogram model was constructed by combining the above variables, and the ROC curve analysis showed that the area under the curve (AUC) of the nomogram model for predicting the occurrence of LEDVT in patients with sepsis was 0.793 (95% CI was 0.746 to 0.841), and the AUC in the validation set was 0.844 (95% CI was 0.786 to 0.901). The calibration curve showed that its predicted probability was in good agreement with the actual probabilities were in good agreement, and both CIC and DCA curves suggested a favorable net clinical benefit. Conclusion:The nomogram model based on the critical illness scores combined with inflammatory markers can be used for early prediction of LEDVT in ICU sepsis patients, which helps clinicians to identify the risk factors for LEDVT in sepsis patients earlier, so as to achieve early treatment.

Objective:To investigate the value of electronic nasolaryngoscope combined with nasopharyngeal three dimensional computed tomography(3D-CT)in postoperative assessment for the surgery of pediatric tonsil adenoid.Methods:A total of 106 pediatric patients with tonsil adenoid admitted to the Affiliated Hospital of Weifang Medical College from January 2021 to January 2024 were selected,and all of them underwent electronic nasal laryngoscopy combined with nasopharyngeal 3D-CT before and after surgery.According to different assessment methods,pediatric patients who underwent the assessment of electronic nasolaryngoscope combined with nasopharyngeal 3D-CT were included in the combined assessment group(42 patients),and pediatric patients who underwent the assessment of electronic nasolaryngoscope were included in the electronic nasolaryngoscope assessment group(30 patients),and pediatric patients who underwent the assessment of nasopharyngeal 3D-CT were included in the nasopharyngeal 3D-CT assessment group(34 patients).Descriptive statistics was conducted on the basic characteristics of the three groups.The accuracies of nasopharyngeal 3D-CT combined with electronic nasolaryngoscope,the single electronic nasolaryngoscope,and the single nasopharyngeal 3D-CT in the postoperative assessment were calculated and compared.Results:In assessment effect of 42 pediatric patients of the combined assessment group,20 cases were effective,and 22 cases were ineffective,and the effective rate of assessment was 47.62%(20/42).In assessment effect of 30 pediatric patients of the electronic nasolaryngoscope assessment group,5 cases were effective,and 25 cases were ineffective,and effective rate of assessment was 16.67%(5/30).In assessment effect of 34 pediatric patients of the nasopharyngeal 3D-CT assessment group,13 cases were effective and 21 cases were ineffective,and the effective rate of assessment was 38.24%(13/34).The effective rate of the assessment of the combined assessment group was significantly higher than that of each single assessment group,and the difference was statistically significant(x2=7.414,P<0.05).The sensitivity,specificity,accuracy,positively predictive value and negatively predictive value of the combined assessment were respectively 47.60%,83.30%,55.60%,80.00%and 53.60%.These indicators of single electronic nasolaryngoscope assessment were respectively 16.70%,47.60%,35.70%,18.20%and 44.40%.These indicators of single nasopharyngeal 3D-CT assessment were respectively 38.20%,83.30%,50.00%,72.20%and 54.30%.Conclusion:The combined application of nasopharyngeal 3D-CT and electronic nasolaryngoscope can improve the accuracy of postoperative assessment for the surgery of pediatric tonsil adenoid,and it is helpful to timely find and deal with postoperative problems,and improve the treatment effect.

Microglia, originating from primitive macrophages in the yolk sac, serves as both immune system defenders and regulators of homeostasis. These cells exhibit two primary polarization states: conventionally activated(M1)and alternatively activated(M2). The polarization of microglia plays a crucial role in influencing inflammatory disorders, metabolic imbalances, and neural degeneration. This process is implicated in various aspects of ocular diseases, especially age-related macular degeneration(AMD), including inflammation, oxidative stress and pathological angiogenesis. The distinct functional phenotypes of microglia impact disease progression and prognosis. Thus, regulating the polarization or functional phenotype of microglia at different stages of AMD holds promise for personalized therapeutic approaches. This comprehensive review outlines the involvement of microglia polarization in both physiological and pathological conditions, emphasizing its relevance in AMD. The discussion underscores the potential of polarization as a foundation for personalized treatment strategies for AMD.