Objective:To explore the current status and correlation of occupational stress and burnout among pediatric nurses.Methods:From April 2023 to January 2024, convenience sampling was used to select 150 pediatric nurses from Taizhou Hospital of Zhejiang Province, East Campus of Taizhou Hospital of Zhejiang Province, and Taizhou Enze Medical Center as research subjects. The survey was conducted using the General Information Questionnaire, Chinese version of the Maslach Burnout Inventory General Survey, and Nurse Job Stressors Scale.Results:A total of 150 nurses were surveyed, and 149 valid questionnaires were collected, with a valid response rate of 99.33%. Pediatric nurses had high scores in emotional exhaustion and depersonalization dimensions in occupational burnout. The job stressors for pediatric nurses were ranked in order of their scores in each dimension, including workload and time management, work environment and resources, nursing profession and work, management and interpersonal relationships, and patient nursing. There were correlations between occupational burnout and occupational stress among pediatric nurses in multiple dimensions (all P<0.05) . Conclusions:Pediatric nurses have a relatively high level of occupational burnout and often face significant occupational stress. In the development of the healthcare system, attention should be paid to the occupational burnout and stress of pediatric nurses. The physical and mental health of pediatric nursing staff can be promoted and work efficiency can be improved by reducing the overloaded work of pediatric nurses, optimizing personnel allocation, and improving social support.

Objective:To explore the white matter structural characteristics in patients with bipolar disorder(BD)using diffusion tensor imaging(DTI)and investigate their relationship with cognitive function.Methods:A total of 15 patients with BD type Ⅰ and 26 patients with BD type Ⅱ who met the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition(DSM-Ⅳ)diagnostic criteria and 37 normal controls were included.Cognitive function was assessed with the Trail Making Test(TMT)and Repeatable Battery for the Assessment of Neuropsy-chological Status(RBANS).The tract-based spatial statistics(TBSS)method was used to explore the differences in fractional anisotropy(FA)and mean diffusivity(MD)among the three groups and perform correlation analyses with cognitive function.Results:Patients with BD Ⅰ and BD Ⅱ had lower scores in attention(P＜0.001),delayed memory(P＜0.01),and total scores(P＜0.001)on the RBANS compared to the normal control group.They also exhibited lower FA values in the corpus callosum and right superior corona radiata compared to the normal control group(P＜0.05).In the BD Ⅰ group,there was a positive correlation between FA values in the genu of corpus cal-losum and visuospatial/constructional scores(r=0.74,P＜0.05),while in the BD Ⅱ group,a positive correlation was found between FA values in the same region and language function scores(r=0.55,P＜0.05).Conclusion:It suggests that patients with bipolar disorder may have impaired white matter integrity in the corpus callosum and right superior corona radiata,which may be associated with cognitive impairment.

Objective:To study the clinical effects of QingxinWendan decoction in the treatment of bipolar disorder (BD) manic episode.Methods:60 patients with BD manic episode treated in Hunan Brain Hospital from February 2020 to December 2020 were prospectively selected. They were included in the control group and the observation group according to the random alphabet method, with 30 cases in each group. The control group was treated with magnesium valproate sustained-release tablets, and the observation group was treated with Qingxin Wendan decoction combined with magnesium valproate sustained-release tablets. The curative effect was evaluated after 4 weeks of continuous treatment. The degree of mania before and after treatment was evaluated by Beck-Rafaelsen mania scale (BRMS); the cognitive function before and after treatment was evaluated by Wechsler Adult Intelligence Scale (WAIS-RC) and Wechsler Memory Scale (WMS); The levels of interleukin (IL)-1β, tumor necrosis factor-α (TNF-α), neuron specific enolase (NSE) and amyloid β protein (Aβ) levels were measured by enzyme linked immunosorbent assay (ELISA) before and after treatment. Spearman correlation analysis was used to analyze the correlation between serum NSE and Aβ levels and WAIS-RC and WMS scores in the two groups.Results:The curative effect of the observation group was better than that of the control group, with statistically significant difference ( P<0.05). After treatment, the BRMS scores of the control group and the observation group decreased (all P<0.05), and the BRMS scores of the observation group were lower than those of the control group ( P<0.05); After treatment, the WAIS-RC and WMS scores of the control group and the observation group increased (all P<0.05), and the WAIS-RC and WMS scores of the observation group were higher than those of the control group (all P<0.05). After treatment, the serum levels of IL-1β, TNF-α, NSE and Aβ in two groups were decreased (all P<0.05), and the levels of IL-1β, TNF-α, NSE and Aβ in the observation group were lower than those in the control group (all P<0.05). NSE and Aβ levels were negatively correlated with WAIS-RC and WMS scores (all P<0.05). Conclusions:Magnesium valproate sustained-release tablets combined with Qingxin Wendan decoction in the treatment of patients with BD manic episode were superior to magnesium valproate sustained-release tablets alone in reducing manic score, IL-1β, TNF-α, NSE and Aβ levels, and improving the cognitive function of patients. The use of QingxinWendan decoction on top of valproate extended-release tablet treatment for BD manic episode was superior to treatment with valproate extended-release tablets alone in reducing mania scores, IL-1β, TNF-α, NSE and Aβ levels, as well as improving patients' cognitive function.

Objective:To summarize the clinical and imaging features of pediatric neuroglial heterotopia (NGH) in different locations.Methods:The clinical and preoperative imaging data of 9 patients (6 boys and 3 girls, median age 3 months, range from 1 to13 months) with NGH confirmed by pathology were retrospectively reviewed in Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science and Technology from October 2009 to December 2020. All patients underwent preoperative CT or/and MR examination. Follow-up was performed in 12 to 60 months after operation, with a median follow-up time of 24 months. The location, range, size, density/signal intensity of the lesions were reviewed.Results:Of all 9 cases, three cases were located in nose (2 extranasal type and 1 mixed type), with the maximum diameter of 13, 13 and 15 mm; there were 3 lesions in tongue, all of which were located on the dorsum of tongue, with the maximum diameter of 13, 18 and 23 mm; there were also 2 cases located in nasopharynx, maximum diameter of 15 and 22 mm, respectively. One case was in sacrococcygeal area, with the maximum diameter as 18 mm. All lesions presented as solid masses with well-defined margins, displaying slightly low density compared to grey matter. The CT value ranged from 25 to 47 HU. Compared to grey matter or spinal cord, MRI demonstrated isointense or slight hypointense on T 1WI and slight hyperintense on T 2WI. All masses presented homogenous density or signal intensity, with mild homogenous enhancement. During postoperative follow-up, no recurrence was found in 8 cases. One case of nasal NGH with gradeⅡcleft lip recurred at 1 month follow-up after surgery, and no recurrence was found after the second surgery. Conclusions:The NGH in children has typical imaging features, and is mostly located at the extracranial midline structure.It presents as solid mass, with quasi-circular morphology, well-defined margins and homogeneous density or signal intensity similar to gray matter or spinal cord. The postoperative recurrence rate is low.

Objective To investigate the effect of naringenin on the killing rate of natural killer (NK) cells and related mechanism by amplification of human peripheral blood mononuclear cells into NK cells in vitro and co-culture with hepatocellular carcinoma (HCC) CLC5 cells at a ratio of 1∶ 1. Methods A lymphocyte separation medium was used to isolate human peripheral blood mononuclear cells, which were induced with recombinant human interleukin-2 in vitro to culture NK cells. CCK-8 assay was used to measure the proliferation of HCC cells after human HCC cells were treated with naringenin (0, 3.125, 6.25, 12.5, 25, and 50 μmol/L) for 0, 24, and 48 hours, and after human NK cells were treated with different concentrations of naringenin for 24 hours, CCK-8 assay was used to measure the proliferation of NK cells. CellTiter-LumiTM was used to measure the killing rate of NK cells after the NK-HCC cell co-culture system at the ratio of 1∶ 1 was treated with naringenin for 24 hours. Quantitative real-time PCR was used to measure the gene expression of the activating receptor NKG2D in NK cells and NKG2D ligands in HCC cells. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t -test was used for further comparison between two groups. Results After being induced and cultured by recombinant human interleukin-2, NK cells were amplified to 82.33%±0.70% of human peripheral blood mononuclear cells. After naringenin treatment for 24 hours, there was no significant difference in the proliferation rate of HCC CLC5 cells between all mass concentration groups (all P > 0.05), and in the 25 and 50 μmol/L mass concentration groups, naringenin significantly promoted the proliferation of NK cells (both P < 0.000 1). After the NK-HCC cell co-culture system at the ratio of 1∶ 1 was treated with naringenin for 24 hours, there was a significant increase in the killing rate of NK cells in the 25 and 50 μmol/L mass concentration groups (both P < 0.000 1). After the co-culture system was treated with naringenin for 24 hours, naringenin had no effect on the expression of NKG2D in NK cells in the 25 and 50 μmol/L mass concentration groups, and it also had no effect on the expression of MICB and ULBP2 in HCC cells (all P > 0.05); it significantly upregulated the expression of the NKG2D ligands such as ULBP1 and ULBP3 in HCC cells (all P < 0.001). Conclusion Naringenin may increase the killing activity of NK cells by upregulating the expression of NKG2D ligands in HCC cells.

Objective:To explore the changes in serum neuron-specific enolase（NSE）in patients with moderately severe to profound idiopathic sudden sensorineural hearing loss（ISSHL）and the effect of hyperbaric oxygen（HBO）therapy on NSE，and to analyze the relationship between hearing recovery and serum NSE levels.Methods:Using convenient sampling，a total of 90 inpatients with unilateral moderately severe to profound ISSHL were selected as the research subjects，and they were divided into observation group and control group according to the random number table method，with 45 cases in each group. The control group received hormones，Ginkgo biloba injection，and neurotropic drugs，and the observation group was treated with HBO based on the treatment of the control group. Pure tone audiometry was performed before and after treatment to test hearing levels，and serum NSE was determined by ELISA. After 20 days of treatment，the effective rates and the changes of NSE of the two groups were compared，and the relation between NSE level and hearing change were analyzed.Results:The serum NSE levels of ISSHL patients in both groups were significantly higher than those of the control group，and it was correlated with the severity of hearing loss（ P<0.01）. The serum NSE levels of profound ISSHL patients were significantly higher than those of moderately severe and severe ISSHL patients（ P<0.01）. After treatment，the clinical effective rate of the observation group（82.2%）was significantly higher than that of the control group（60.0%）（ P<0.05）；the hearings of the patients in both groups were significantly improved compared with those before treatment；the pure tone average of the observation group was lower than that of the control group（ P<0.05）；and the hearing threshold gain of the observation group was significantly higher than that of the control group（ P<0.01）. After treatment，the NSE levels of the patients in the two groups decreased after treatment；the NSE level of the observation group was significantly lower than that of the control group（ P<0.05）；and the decrease of NSE level in the observation group was significantly greater than that of the control group（ P<0.01）. The decreases of serum NSE in the two groups were positively correlated with the gains of the auditory domain（ r=0.686， P<0.01 in the observation group； r=0.418， P<0.01 in the control group）. Conclusion:The serum NSE level of patients with moderately severe to profound ISSHL is increased，which is related to the severity of hearing loss. Additionally adopting HBO therapy could improve the hearing of patients，increase the effective rate，and reduce the NSE level of ISSHL patients.

Objective:To explore the changes in serum neuron-specific enolase（NSE）in patients with moderately severe to profound idiopathic sudden sensorineural hearing loss（ISSHL）and the effect of hyperbaric oxygen（HBO）therapy on NSE，and to analyze the relationship between hearing recovery and serum NSE levels.Methods:Using convenient sampling，a total of 90 inpatients with unilateral moderately severe to profound ISSHL were selected as the research subjects，and they were divided into observation group and control group according to the random number table method，with 45 cases in each group. The control group received hormones，Ginkgo biloba injection，and neurotropic drugs，and the observation group was treated with HBO based on the treatment of the control group. Pure tone audiometry was performed before and after treatment to test hearing levels，and serum NSE was determined by ELISA. After 20 days of treatment，the effective rates and the changes of NSE of the two groups were compared，and the relation between NSE level and hearing change were analyzed.Results:The serum NSE levels of ISSHL patients in both groups were significantly higher than those of the control group，and it was correlated with the severity of hearing loss（ P<0.01）. The serum NSE levels of profound ISSHL patients were significantly higher than those of moderately severe and severe ISSHL patients（ P<0.01）. After treatment，the clinical effective rate of the observation group（82.2%）was significantly higher than that of the control group（60.0%）（ P<0.05）；the hearings of the patients in both groups were significantly improved compared with those before treatment；the pure tone average of the observation group was lower than that of the control group（ P<0.05）；and the hearing threshold gain of the observation group was significantly higher than that of the control group（ P<0.01）. After treatment，the NSE levels of the patients in the two groups decreased after treatment；the NSE level of the observation group was significantly lower than that of the control group（ P<0.05）；and the decrease of NSE level in the observation group was significantly greater than that of the control group（ P<0.01）. The decreases of serum NSE in the two groups were positively correlated with the gains of the auditory domain（ r=0.686， P<0.01 in the observation group； r=0.418， P<0.01 in the control group）. Conclusion:The serum NSE level of patients with moderately severe to profound ISSHL is increased，which is related to the severity of hearing loss. Additionally adopting HBO therapy could improve the hearing of patients，increase the effective rate，and reduce the NSE level of ISSHL patients.

The aim of this paper is to explore the practical measures of integrating “ideological and political course” into “Psychiatry”. “Ideological and political course” is a key measure to foster character and civic virtue in colleges and universities， and a crucial link of “three -full education”. Based on the characteristics of the course “Psychiatry” and the practical experience of the course “ideological and political work” in the faculty of mental health， North Sichuan Medical College， this paper puts forward the strategies of implementing “ideological and political course” from four aspects： improving teachers’ understanding and practical ability of “ideological and political course”， constructing the integration point of ideological and political course in “Psychiatry”， choosing the teaching methods of “ideological and political course” and evaluating the teaching effect， thus providing references for the implementation of “ideological and political course” in the follow-up professional courses.

Objective:To explore the clinical characteristics and risk factors of the severe delayed encephalopathy after acute carbon monoxide poisoning (s-DEACMP).Methods:A retrospective analysis of 170 acute carbon monoxide poisoning (ACMP) patients treated in the Hyperbaric Oxygen (HBO) Department of Beijing Chao-yang Hospital, Capital Medical University from January 1st, 2017 to December 31st, 2020 was conducted. According to the occurrence of delayed encephalopathy, the ACMP patients were divided into DEACMP group and non-DEACMP (n-DEACMP) group. The DEACMP patients were stratified by the activities of daily living scale when they were most severely ill. The patients with total score≤60 were classified as s-DEACMP and the patients with total score >60 were classified as mild to moderate DEACMP (m-DEACMP). Their clinical characteristics were compared and the risk factors of s-DEACMP were analyzed.Results:There were 70 s-DEACMP patients, 49 m-DEACMP patients, and 51 n-DEACMP patients. Compared with the n-DEACMP group, the s-DEACMP group was older (average age: 59.0 vs. 49.0, P=0.005), had a higher proportion of patients over 40 years old (97.1% vs. 66.7%, P<0.001), lower Glasgow coma scale scores [(4.0±3.0) vs.(6.0±5.0), P=0.024] on admission to the hospital, longer consciousness disturbance [(32.0±31.8) h vs.(20.5±26.4) h, P=0.017], a higher proportion of patients with consciousness disturbance over 48 hours (24.3% vs. 9.8%, P=0.041), a lower proportion of patients receiving HBO therapy (70.0% vs. 86.3%, P=0.036), a higher proportion of patients with hypertension (38.6% vs. 17.6%, P=0.013), a higher proportion of patients with hyperhomocysteinemia (40.0% vs. 19.6%, P=0.017), and a higher proportion of patients with smoking index over 400 (24.3% vs. 9.8%, P=0.041). Compared with the m-DEACMP group, the s-DEACMP group had a higher proportion of patients with hyperhomocysteinemia (40.0% vs. 20.4%, P=0.024). Multivariate Logistic regression showed that age over 40 years old, consciousness disturbance over 48 hours, hypertension, and hyperhomocysteinemia were independent risk factors of s-DEACMP( P<0.05). Conclusion:The clinical characteristics of s-DEACMP patients are that the patients are older, have a deeper and longer consciousness disturbance, a lower proportion of early HBO intervention, a higher proportion of hypertension, hyperhomocysteinemia, and smoking index over 400. Among them, the age over 40 years old, disturbance consciousness over 48 hours, and hypertension were the independent risk factors of the occurrence of s-DEACMP.In additon hyperhomocysteinemia was also an idependent risk factor for s-DEAMP, which special worth attention.