Objective To discuss the perioperative anesthesia management strategy for the surgical resection of rec-tal cancer in a patient with a rare neuromuscular disease-Facioscapulohumeral Muscular Dystrophy(FSHD)compli-cated by restrictive ventilatory dysfunction.Methods Clinical data of a patient with FSHD complicated by moder-ate-to-severe restrictive ventilatory dysfunction undergoing rectal cancer surgery were retrospectively collected;the clinical manifestations,complication,preoperative evaluation,intraoperative anesthesia management and postopera-tive pain treatment were analyzed and summarized.Results FSHD is a rare genetic disorder,and preopera-tive multidisciplinary evaluation is critical.In this case,total intravenous anesthesia was employed,with invasive arterial pressure monitoring,blood gas analysis,body temperature,sufficient analgesia,close respiratory monitoring and lung protective ventilation strategy after preoperative multidisciplinary evaluation.After thorough sputum suction,lung expansion,and complete recovery of muscle strength,the patient was successfully extubated;ensuring respiratory monitoring after surgery,sufficient analgesia was administered,and transferred to the ICU for monitoring,and ultimately discharged with satisfactory treatment results.Conclusions For patients with rare neuro-muscular diseases such as FSHD,thorough preoperative evaluation and optimization are essential.Clinicians should be aware of related complications,such as restrictive ventilatory dysfunction,and develop individualized anesthesia plans.Intraoperative monitoring,particularly of the respiratory and hemodynamic systems,should aim to prevent hypoxia and carbon dioxide retention,thereby reducing the risk of complications.

With the advancement of transfusion medicine and the widespread use of platelet-related preparations, platelet transfusion has become a critical therapeutic intervention in clinics. To enhance the safety and efficacy of platelet transfusion, platelet blood group typing has been increasingly implemented in clinical practice, accompanied by the emergence of novel testing technologies and methodologies, such as flow cytometric immuno-bead array analysis, microtiter plate-based immobilized recombinant single antigen enzyme-linked immunosorbent assay and third-generation sequencing. Significant progress has been made in platelet blood group detection, including improvements in serological testing methods, integration and optimization of multi-platform detection technologies, and the development of high-throughput molecular genotyping techniques. The advancement in platelet blood group detection technology has significantly enhanced detection precision and clinical applicability, providing an important support for transfusion safety, managing platelet-related diseases, and developing antiplatelet drugs.

With the advancement of transfusion medicine and the widespread use of platelet-related preparations, platelet transfusion has become a critical therapeutic intervention in clinics. To enhance the safety and efficacy of platelet transfusion, platelet blood group typing has been increasingly implemented in clinical practice, accompanied by the emergence of novel testing technologies and methodologies, such as flow cytometric immuno-bead array analysis, microtiter plate-based immobilized recombinant single antigen enzyme-linked immunosorbent assay and third-generation sequencing. Significant progress has been made in platelet blood group detection, including improvements in serological testing methods, integration and optimization of multi-platform detection technologies, and the development of high-throughput molecular genotyping techniques. The advancement in platelet blood group detection technology has significantly enhanced detection precision and clinical applicability, providing an important support for transfusion safety, managing platelet-related diseases, and developing antiplatelet drugs.

Objective To explore the relevant relationship and specificity between the implicit and explicit loyalty of military cadets in order to provide a theoretical basis and objective indicators for a more comprehensive and objective assessment for individual loyalty.Methods E-Prime 2.0,a classic implicit association paradigm was employed to construct an implicit association loyalty test for 64 military cadets.Simultaneously,an explicit loyalty measurement was conducted using the Chinese Military Personnel Loyalty Scale.Results ① Significant implicit effect was observed in the loyalty assessment of military cadets,indicating a general tendency to perceive higher levels of personal loyalty and lower levels of loyalty to external entities.② Explicit loyalty assessment revealed that the participants had the highest loyalty score towards the Party,the Nation,and the People(4.79±0.34),followed by the loyalty score to their profession(4.38±0.53),and the relatively lower loyalty score towards the unit and leaders(4.03±0.83).Among the 3 dimensions of loyalty,the normative loyalty score ranked highest,while continuance loyalty score took lower.③ There were no correlations among the scores of loyalty to the Party,the Nation,and the People(r=-0.030,P=0.823),to the profession(r=-0.047,P=0.728),to the unit(r=0.050,P=0.710),or to the leaders(r=0.043,P=0.749).Conclusion The implicit effect in the loyalty assessment is significant in military cadets,and there is no significant correlation between explicit and implicit loyalty measurements.Thus,we cannot rely solely on explicit measurements to assess their loyalty attitudes.

Remazolam is a new ultra-short-acting benzodiazepine that produces sedation by acting on γ-aminobutyric acid type A(GABAA)receptors.Remazolam has characteristics of rapid onset of action,short half-life,high clearance,and no accumulation in the body.It also has a low incidence of injection pain and mild effects on hepatic and renal function,respiration,and haemodynamics.Additionally,it can be rapidly reversed by flumazenil.The clinical research progress on remazolam in the areas of procedural sedation,induction,and maintenance of general anesthesia were reviewed to provide references for its clinical application.

Voriconazole(VRC)is a broad-spec-trum triazole antifungal drug used for the systemic prophylaxis and treatment of invasive fungal infec-tions(IFI)in adults and children.However,VRC has a typical nonlinear pharmacokinetic profile and highly variable inter-and intra-individual variability,limiting its rational clinical use.Special populations have even greater variation due to physiologic rea-sons,especially younger pediatric patients,with less evidence and greater limitations in the use of VRC.In recent years more and more VRC popula-tion pharmacokinetic(PPK)research results have been published,identifying many covariates,which provides ideas and methods for the rational use of VRC.Based on the latest national and international research results,this article introduced the latest progress of PPK of VRC applied to special popula-tions and demonstrated how PPK could be used to adjust the dose and optimize the treatment.

Voriconazole(VRC)is a broad-spec-trum triazole antifungal drug used for the systemic prophylaxis and treatment of invasive fungal infec-tions(IFI)in adults and children.However,VRC has a typical nonlinear pharmacokinetic profile and highly variable inter-and intra-individual variability,limiting its rational clinical use.Special populations have even greater variation due to physiologic rea-sons,especially younger pediatric patients,with less evidence and greater limitations in the use of VRC.In recent years more and more VRC popula-tion pharmacokinetic(PPK)research results have been published,identifying many covariates,which provides ideas and methods for the rational use of VRC.Based on the latest national and international research results,this article introduced the latest progress of PPK of VRC applied to special popula-tions and demonstrated how PPK could be used to adjust the dose and optimize the treatment.

Objective:To investigate the changes of serum miR-210, miR-30a and miR-16 in patients with type 2 diabetes mellitus (T2DM) combined with osteoporosis (OP) and to analyze the influencing factors.Methods:Eighty patients with T2DM admitted to our hospital from May. 2019 to May. 2022 were prospectively selected for the study, and the patients were divided into 42 patients with T2DM combined with OP and 38 patients with T2DM without OP according to whether the patients were combined with OP. Another 40 cases were selected as the control group during the same period of physical examination. We compared the differences of miR-210, miR-30a and miR-16 among the groups, and analyzed the diagnostic value of miR-210, miR-30a and miR-16 on T2DM combined with OP by ROC curve, and analyzed the influencing factors of T2DM combined with OP by binary logistic regression. miR-210, miR-30a and miR-16 were analyzed by Spearman correlation. Spearman correlation analysis of miR-210, miR-30a, miR-16 and T2DM combined OP related indexes.Results:The differences of miR-210, miR-30a, and miR-16 were statistically significant between groups ( F=24.13, 62.69, 307.26, P<0.05), and the control group < T2DM uncomplicated OP group < T2DM combined OP group ( P<0.05). ROC curve analysis showed that miR-210, miR-30a, and miR-16 The AUCs for the diagnosis of T2DM combined with OP were 0.779, 0.854 and 0.973 in order, all of which had some accuracy in diagnosis. Binary logistic multi-factor regression analysis showed that the duration of T2DM disease, glycosylatedhemoglobin (HbA1c), type I collagen carboxy-terminal peptide β special series (β-CTX) were all risk factors for T2DM combined with OP ( P<0.05), body mass index (BMI. BMI, parathyroid hormone (PTH), 25-hydroxyvitamin D3monohydrate (25 (OH) D3), bone Gla protein (BGP), bone mineral density (BMD) were all risk factors for T2DM combined with OP ( P<0.05). Spearman correlation analysis showed that miR-210, miR-30a and miR-16 were negatively correlated with BGP and BMD ( r=-0.668/-0.592/-0.599, -0.671/-0.609/-0.593) and positively correlated with β-CTX ( r=0.670/0.603/0.605) . Conclusion:miR-210, miR-30a and miR-16 are highly expressed in the serum of patients with T2DM combined with OP, and the duration of T2DM, HbA1c and β-CTX were all risk factors for T2DM combined with OP, and BMI, PTH, 25 (OH) D3, BGP and BMD are all protective factors for T2DM combined with OP.

Objective:To apply CBL combined with PBL based on SMART (specific, measurable, attainable, relevant and time-based) principle in nursing practice teaching in radiotherapy.Methods:A total of 100 nurses who performed nursing practice in the Department of Radiotherapy in Guangdong Provincial Hospital of Traditional Chinese Medicine from May 2016 to May 2020 were selected as the research objects. They were divided into a control group and a study group according to their admissions, with 50 people in each group. The study group used CBL combined with PBL teaching based on SMART principle, and the control group used traditional practice teaching. After the clinical practice, the two groups were assessed on theoretical and clinical practice skills, and the two groups' teaching satisfaction and teaching effects were evaluated through seminars and questionnaire surveys. SPSS 22.0 was used for t test and chi-square test. Results:The theoretical and clinical practice performance assessment scores of the practical nurses in the study group were higher than those in the control group, with statistically significant differences ( P<0.001). The teaching satisfaction rate of the practice nurses in the control group was 62.00% (31/50), and that of the practice nurses in the study group was 96.00% (48/50), with significant differences ( P<0.001). In terms of improving independent learning ability, information acquisition and problem analysis ability, improving clinical thinking ability, mobilizing learning enthusiasm, enhancing teamwork ability, nurse-patient communication ability, and recognition of innovation ability, the teaching satisfaction of the research group was higher than that of the control group. Conclusion:The application of SMART principle in teaching has the advantages of clear goals and quantifiable evaluation. The combination of CBL and PBL based on SMART principle can help to improve the mastery of theoretical and practical skills of radiotherapy practice nurses, and achieve satisfactory teaching results.