Objective:To explore the chain mediating role of self-management efficacy and self-perceived burden between family function and decision fatigue in gastric cancer patients.Methods:Convenience sampling was used to select 219 gastric cancer inpatients in Xinxiang Central Hospital of Henan Province from June 2023 to December 2024 as study subjects. Family Assessment Device, Chinese version of the Strategies Used by People to Promote Health, Self-Perceived Burden Scale, and Decision Fatigue Scale were used to conduct the survey. The chain mediating effect were tested using Model 6 in the SPSS PROCESS program.Results:Family function, self-management efficacy, self-perceived burden and decision fatigue scores of gastric cancer patients were (73.08±8.47), (90.15±14.33), (31.64±6.55), and (19.23±3.05), respectively. Univariate analysis showed that age, education level, per capita monthly family income, tumor stage and treatment method were the influencing factors of decision fatigue in gastric cancer patients, and the difference was statistically significant ( P<0.05). Correlation analysis showed that family function was negatively correlated with self-management efficacy ( P<0.05) and positively correlated with self-perceived burden and decision fatigue ( P<0.05), and self-management efficacy was negatively correlated with self-perceived burden and decision fatigue ( P<0.05), and self-perceived burden was positively correlated with decision fatigue ( P<0.05), and the differences of the above were statistically significant. Mediating effect analysis showed that family function positively predicted decision fatigue in gastric cancer patients, with a direct effect of 0.117, accounting for 62.57% of the total effect. Self-management efficacy and self-perceived burden realized the mediating effect between family function and decision fatigue through three mediating pathways. Mediating pathway 1 was family function → self-management efficacy → decision fatigue, with an effect value of 0.032, which accounted for 17.11% of the total effect. Mediating pathway 2 was family function→ self-perceived burden → decision fatigue, with an effect value of 0.026, which accounted for 13.90% of the total effect. Mediating path 3 was family function → self-management efficacy → self-perceived burden → decision fatigue, with an effect value of 0.012, accounting for 6.42% of the total effect. The total mediating effect was 0.070, accounting for 37.43% of the total effect. Conclusions:Family function can not only directly influence decision fatigue in gastric cancer patients, but also indirectly influence decision fatigue through the mediating role of self-management efficacy and self-perceived burden. Decision fatigue of gastric cancer patients could be reduced in the future by improving family function, increasing patients' self-management efficacy, and reducing their self-perceived burden.

Objective:To explore the chain mediating role of self-management efficacy and self-perceived burden between family function and decision fatigue in gastric cancer patients.Methods:Convenience sampling was used to select 219 gastric cancer inpatients in Xinxiang Central Hospital of Henan Province from June 2023 to December 2024 as study subjects. Family Assessment Device, Chinese version of the Strategies Used by People to Promote Health, Self-Perceived Burden Scale, and Decision Fatigue Scale were used to conduct the survey. The chain mediating effect were tested using Model 6 in the SPSS PROCESS program.Results:Family function, self-management efficacy, self-perceived burden and decision fatigue scores of gastric cancer patients were (73.08±8.47), (90.15±14.33), (31.64±6.55), and (19.23±3.05), respectively. Univariate analysis showed that age, education level, per capita monthly family income, tumor stage and treatment method were the influencing factors of decision fatigue in gastric cancer patients, and the difference was statistically significant ( P<0.05). Correlation analysis showed that family function was negatively correlated with self-management efficacy ( P<0.05) and positively correlated with self-perceived burden and decision fatigue ( P<0.05), and self-management efficacy was negatively correlated with self-perceived burden and decision fatigue ( P<0.05), and self-perceived burden was positively correlated with decision fatigue ( P<0.05), and the differences of the above were statistically significant. Mediating effect analysis showed that family function positively predicted decision fatigue in gastric cancer patients, with a direct effect of 0.117, accounting for 62.57% of the total effect. Self-management efficacy and self-perceived burden realized the mediating effect between family function and decision fatigue through three mediating pathways. Mediating pathway 1 was family function → self-management efficacy → decision fatigue, with an effect value of 0.032, which accounted for 17.11% of the total effect. Mediating pathway 2 was family function→ self-perceived burden → decision fatigue, with an effect value of 0.026, which accounted for 13.90% of the total effect. Mediating path 3 was family function → self-management efficacy → self-perceived burden → decision fatigue, with an effect value of 0.012, accounting for 6.42% of the total effect. The total mediating effect was 0.070, accounting for 37.43% of the total effect. Conclusions:Family function can not only directly influence decision fatigue in gastric cancer patients, but also indirectly influence decision fatigue through the mediating role of self-management efficacy and self-perceived burden. Decision fatigue of gastric cancer patients could be reduced in the future by improving family function, increasing patients' self-management efficacy, and reducing their self-perceived burden.

Objective:To elucidate the inhibitory effect of interferon-γ(IFN-γ)on the proliferation of neuroblastoma cells and the protentral gene signature of IFN-γ and the relationship between the expression of gene signature of IFN-γ in the neuroblastoma cells and its adverse prognosis,and to clarify the effect of IFN-γ and its gene signture in the neuroblastoma.Methods:The SK-N-BE(2)(proto-oncogene N-MYC amplification type)and SH-SY5Y(proto-oncogene N-MYC non-amplification type)neuroblastoma cells were selected and treated with different concentrations(0,500,750,1 000 and 1 500 μg·L-1)of IFN-γ for 24 h,followed by cell proliferation assays using cell counting kit-8(CCK-8).Transcriptome sequencing was then performed to identify the gene signature of IFN-γ.Additionally,the tissue microarrays from 23 cases of neuroblastoma and 6 cases of normal adrenal gland samples were collected,immunohistochemistry(IHC)analysis was used to to detect the expression of gene signature of IFN-γ.Based on the expression levels of gene signature of IFN-γ,the samples were divided into SULT2B1 low and high expression groups.The correlation between the expression of gene signature of IFN-γ and poor prognosis of the patients was analyzed.Results:The CCK-8 assay results showed that as IFN-γconcentration increased,the proliferation of SK-N-BE(2)cells was significantly inhibited(P＜0.01),with inhibitory rates of SK-N-BE(2)cells in four groups were 6.73％,6.77％,7.67％,and 9.19％,respectively.In contrast,the proliferation rate of SH-SY5Y cells were significantly increased with the increase of IFN-γ concentrations(P＜0.01),and the proliferation rates of SH-SY5Y cells in four groups were 46.80％,79.19％,70.30％,and 72.33％,respectively.Transcrip tome sequencing identified hydroxysteroid sulfotransferase 2B1(SULT2B1)as a potential gene signature of IFN-γ.The IHC analysis results showed the expression amount of SULT2B1 protein in neuroblastoma tissues was increased.The clinical data analysis results revealed significant differences in age(Z=-2.618,P=0.018),lymphnode metastasis(x2=4.439,P=0.035),and distant metastasis(x2=5.856,P=0.016)between low and high SULT2B1 expression groups.Conclusion:IFN-γ can inhibit the proliferation of SK-N-BE(2)cells while promoting the proliferation of SH-SY5Y cells.SULT2B1 is a potential gene signature of IFN-γ,and its expression is upregulated in neuroblastoma tissue.SULT2B1 high expression is significantly associated with poor prognosis in the neuroblastoma patients.

Objective To explore the scheme for the deployment and withdrawal of the surgical module of the new-type tent hospital system.Methods A set of standardized scheme for deploying and withdrawing the surgical module of the new-type tent hosital system was proposed and implemented in terms of labor division,operation precedure,operation technique and precaution.The operating time,number of operational errors and number of equipment damages were recorded for each of the five deployment and withdrawal operations before and after the program was executed,and the team members'immediate heart rate,percentage of maximum heart rate(MHR)and rating of perceived exercise(RPE)at the end of the operation were recorded after the program was implemented.SPSS 26.0 software was used for statistical analysis.Results The standardized scheme had the deployment time shortened from(85.15±11.430)min to(58.23±8.513)min,withdrawal time decreased from(65.36±9.369)min to(48.92±7.129)min,with the differences being statistically significant(P＜0.05);the numbers of operatio-nal errors and equipment damages were both reduced when compared with those before the implementation of the schemce;the immediate heart rate of the team members at the end of the operation ranged from 43 to 157 beats/min,with an average value of 151.1 beats/min,the individual MHR percentages were from 75％to 87％,with an average value of 81.1％,and the RPE scores were from 14 to 17,with an average value of 15.3,which all could be categorized as moderate-operation intensity.Condusion The standardized deployment and withdrawal scheme for the surgical module meets the needs of actual combat and training assessment,and thus is worthy promoting in medical institutions equipped with the surgical module of the new-type tent hosital system.[Chinese Medical Equipment Journal,2025,46(2):74-79]

Objective To explore the scheme for the deployment and withdrawal of the surgical module of the new-type tent hospital system.Methods A set of standardized scheme for deploying and withdrawing the surgical module of the new-type tent hosital system was proposed and implemented in terms of labor division,operation precedure,operation technique and precaution.The operating time,number of operational errors and number of equipment damages were recorded for each of the five deployment and withdrawal operations before and after the program was executed,and the team members'immediate heart rate,percentage of maximum heart rate(MHR)and rating of perceived exercise(RPE)at the end of the operation were recorded after the program was implemented.SPSS 26.0 software was used for statistical analysis.Results The standardized scheme had the deployment time shortened from(85.15±11.430)min to(58.23±8.513)min,withdrawal time decreased from(65.36±9.369)min to(48.92±7.129)min,with the differences being statistically significant(P＜0.05);the numbers of operatio-nal errors and equipment damages were both reduced when compared with those before the implementation of the schemce;the immediate heart rate of the team members at the end of the operation ranged from 43 to 157 beats/min,with an average value of 151.1 beats/min,the individual MHR percentages were from 75％to 87％,with an average value of 81.1％,and the RPE scores were from 14 to 17,with an average value of 15.3,which all could be categorized as moderate-operation intensity.Condusion The standardized deployment and withdrawal scheme for the surgical module meets the needs of actual combat and training assessment,and thus is worthy promoting in medical institutions equipped with the surgical module of the new-type tent hosital system.[Chinese Medical Equipment Journal,2025,46(2):74-79]

Objective:To explore the distribution of allergen-specific IgE (sIgE) for children with atopic dermatitis in Tianjin City and provide the evidences of clinical diagnosis and treatment.Methods:A retrospective cross-sectional study was conducted to analyze the children who were suspected of atopic dermatitis and tested for serum sIgE in the Tianjin Children′s Hospital from March 2021 to February 2023. Using first detection results only, a total of 1 841 serum samples were tested for twenty common allergens. The method was the enzyme-linked immune capture assay. The allergen epidemiological characteristics were statistically analyzed by Chi square test based on the children′s characteristics and factors such as different sexes, ages and seasons by the mass data.Results:Among the 1 841 cases, the results showed that 1 247 (67.73%) were sensitized to at least 1 allergen-sIgE, comprising to 49.86% (918/1 841) to food allergen-sIgE and 47.96% (883/1 841) to aeroallergen-sIgE. The top three food allergens-sIgE were egg 32.10% (591/1 841), milk 25.91% (477/1 841) and wheat flour 14.61% (269/1 841); the top three positive rates of aeroallergens-sIgE were house dust 24.33% (448/1 841), alternaria 20.59% (379/1 841) and dermatophagoides farinae 14.83% (273/1 841). The positive rates of food allergens-sIgE were the highest in the 1-3 years old group (64.11%, 434/677) ( χ2=122.854, P<0.001), while the positive rates of aeroallergens-sIgE were higher in the 11-14 years old group (71.26%, 62/87) ( χ2=134.968, P<0.001). No seasonal difference was revealed in the overall positive rate of food allergen-sIgE and aeroallergen-sIgE ( χ2=4.047, P=0.256; χ2=7.549, P=0.056). The positive rates of soybean-sIgE and milk-sIgE were the highest in summer ( χ2=11.329, P=0.010; χ2=28.720 , P<0.001), whereas alternaria-sIgE and mugwort-sIgE were the highest in summer and autumn, respectively ( χ2=8.462, P=0.037; χ2=10.641 , P=0.014). Among the 1 841 cases, 32.21% were sensitized to three or more allergens-sIgE. The sIgE concentration levels of egg, milk and house dust were mainly level 1 to 2, and the proportions of level 3 and above were all under 15%; although the positive rates of crab, shrimp, and peanut were low, the proportions of grade 3 and above were all beyond 30%. Children sensitized to alternaria, dermatophagoides farinae, mugwort, and cat dander had higher sIgE concentration levels, which were 68.07%, 49.45%, 56.57% and 47.83% respectively. Conclusions:This study can reflect the epidemic characteristics of allergen-sIgE in children with atopic dermatitis in Tianjin region to a certain extent. Allergen-sIgE positivity in patients differed by age, and there were seasonal differences and grade distribution differences in the positive rates of some allergens-sIgE. It is necessary to reasonably avoid the high-risk allergens according to the epidemiological characteristics and clinical symptoms, which provide valuable information for the prevention, diagnosis and treatment of atopic dermatitis.

A case of a patient with severe pneumonia was detected Staphylococcus aureus(carrying the mecA gene)by both blood and sputum metagenomic next-generation sequencing.The initial treatment regimen was vancomycin 1 g,q12 h,intravenous infusion,which failed to achieve the desired therapeutic effect,steady state trough vancomycin serum concentration was 1 μg·mL-1.After consultation with a clinical pharmacist,it was considered that the patient's augmented renal clearance led to increased drug clearance,resulting in a low blood concentration of vancomycin at conventional doses.After elevating the dosage to 1 g q6 h,the patient achieved target serum concentrations and marked clinical improvement.Continuous monitoring of serum vancomycin concentration and optimization of dosing regimen were performed.Ultimately,the patient's condition improved significantly and was discharged from the hospital.

Objective:To explore the distribution of allergen-specific IgE (sIgE) for children with atopic dermatitis in Tianjin City and provide the evidences of clinical diagnosis and treatment.Methods:A retrospective cross-sectional study was conducted to analyze the children who were suspected of atopic dermatitis and tested for serum sIgE in the Tianjin Children′s Hospital from March 2021 to February 2023. Using first detection results only, a total of 1 841 serum samples were tested for twenty common allergens. The method was the enzyme-linked immune capture assay. The allergen epidemiological characteristics were statistically analyzed by Chi square test based on the children′s characteristics and factors such as different sexes, ages and seasons by the mass data.Results:Among the 1 841 cases, the results showed that 1 247 (67.73%) were sensitized to at least 1 allergen-sIgE, comprising to 49.86% (918/1 841) to food allergen-sIgE and 47.96% (883/1 841) to aeroallergen-sIgE. The top three food allergens-sIgE were egg 32.10% (591/1 841), milk 25.91% (477/1 841) and wheat flour 14.61% (269/1 841); the top three positive rates of aeroallergens-sIgE were house dust 24.33% (448/1 841), alternaria 20.59% (379/1 841) and dermatophagoides farinae 14.83% (273/1 841). The positive rates of food allergens-sIgE were the highest in the 1-3 years old group (64.11%, 434/677) ( χ2=122.854, P<0.001), while the positive rates of aeroallergens-sIgE were higher in the 11-14 years old group (71.26%, 62/87) ( χ2=134.968, P<0.001). No seasonal difference was revealed in the overall positive rate of food allergen-sIgE and aeroallergen-sIgE ( χ2=4.047, P=0.256; χ2=7.549, P=0.056). The positive rates of soybean-sIgE and milk-sIgE were the highest in summer ( χ2=11.329, P=0.010; χ2=28.720 , P<0.001), whereas alternaria-sIgE and mugwort-sIgE were the highest in summer and autumn, respectively ( χ2=8.462, P=0.037; χ2=10.641 , P=0.014). Among the 1 841 cases, 32.21% were sensitized to three or more allergens-sIgE. The sIgE concentration levels of egg, milk and house dust were mainly level 1 to 2, and the proportions of level 3 and above were all under 15%; although the positive rates of crab, shrimp, and peanut were low, the proportions of grade 3 and above were all beyond 30%. Children sensitized to alternaria, dermatophagoides farinae, mugwort, and cat dander had higher sIgE concentration levels, which were 68.07%, 49.45%, 56.57% and 47.83% respectively. Conclusions:This study can reflect the epidemic characteristics of allergen-sIgE in children with atopic dermatitis in Tianjin region to a certain extent. Allergen-sIgE positivity in patients differed by age, and there were seasonal differences and grade distribution differences in the positive rates of some allergens-sIgE. It is necessary to reasonably avoid the high-risk allergens according to the epidemiological characteristics and clinical symptoms, which provide valuable information for the prevention, diagnosis and treatment of atopic dermatitis.

Objective:To construct a new thrombus risk assessment model and evaluate its predictive ability for venous thromboembolism(VTE)in the patients with malignant tumors,and to provide the basis for the early predition of the malignant tumor patients with high risk for VTE.Methods:A total of 128 untreated malignant tumor patients were included,of which 40 were diagnosed with VTE within 2 months of malignant tumor diagnosis and categorized as VTE group.A total of 88 patients who did not develop VTE were categorized as non-VTE group.The clinical risk factors and laboratory indicators of the patients in two groups were compared and analyzed;the types of thrombotic events of the patients were analyzed;the diagnostic values of thrombin-antithrombin-complex(TAT),α2-plasmin inhibitor-plasmin complex(PIC),D-dimer(D-dimer),and fibrin degradation products(FDP)in malignant tumors complicated by VTE were assessed using receiver operating characteristic(ROC)curve analysis;Multivariate Logistic regression analysis was used to analyze the correlations of the clinical risk factors and biomarkers with the malignant tumors complicated with VTE.A new thrombus risk assessment model was constructed,consisting of TAT≥0.70 μg·L-1,poor differentiation,and cardiovascular risk factors.The predictive probability of the model for malignant tumors complicated by VTE was evaluated based on the significance,goodness of fit,calibration curve,and C value of the model.The clinical application value of the new thrombus risk assessment model,COMPASS-CAT risk score(CRS),and Khorana risk score(KRS)in assessing malignant tumor patients complicated by VTE was compared using the C value and decision curve analysis(DCA).Results:The plasma levels of TAT(P＜0.001),PIC(P＜0.001),D-dimer(P＜0.05),and FDP(P＜0.01)of the patients in VTE group were higher than those in non-VTE group.Compared with the patients without cardiovascular risk factors,poor differentiation,and lymphatic metastasis,the malignant tumor patients with cardiovascular risk factors(P＜0.001),poor differentiation(P＜0.001),and lymphatic metastasis(P＜0.05)were more likely to develop VTE.Most VTE events(65％)were isolated deep vein thromboembolism(DVT).The ROC curve analysis showed that the area under the curve(AUC),sensitivity,and specificity of TAT and PIC were higher than those of D-dimer and FDP.TAT≥0.70 μg·L-1(P＜0.05),poor differentiation(P＜0.01),and cardiovascular risk factors(P＜0.01)were the independent risk factors for VTE in the malignant tumor patients.A new thrombus risk assessment model consisting of TAT≥0.70 μg·L-1,poor differentiation,and cardiovascular risk factors was constructed.The new risk assessment model had a high goodness of fit(P=0.805)and good predictive ability during internal validation(x2=75.266,P＜0.001).The ROC curve analysis results showed that the C values for the new thrombus risk prediction model,CRS,and KRS were 0.908,0.676,and 0.541,respectively.The DCA curve analysis results showed that the new thrombus risk assessment model had a higher net benefit rate compared with CRS and KRS.Conclusion:TAT and PIC have greater diagnostic efficiency than D-dimer in the early prediction of the malignant tumor patients with high-risk VTE.For the patients included in this study,the new thrombus risk assessment model,constructed from TAT≥0.70 μg·L-1,poor differentiation,and cardiovascular risk factors,has superior diagnostic efficiency and clinical predictive value compared with CRS and KRS.

Objective To investigate the incidence rate,clinical characteristics,and prognosis of neonatal stroke in Shenzhen,China.Methods Led by Shenzhen Children's Hospital,the Shenzhen Neonatal Data Collaboration Network organized 21 institutions to collect 36 cases of neonatal stroke from January 2020 to December 2022.The incidence,clinical characteristics,treatment,and prognosis of neonatal stroke in Shenzhen were analyzed.Results The incidence rate of neonatal stroke in 21 hospitals from 2020 to 2022 was 1/15 137,1/6 060,and 1/7 704,respectively.Ischemic stroke accounted for 75％(27/36);boys accounted for 64％(23/36).Among the 36 neonates,31(86％)had disease onset within 3 days after birth,and 19(53％)had convulsion as the initial presentation.Cerebral MRI showed that 22 neonates(61％)had left cerebral infarction and 13(36％)had basal ganglia infarction.Magnetic resonance angiography was performed for 12 neonates,among whom 9(75％)had involvement of the middle cerebral artery.Electroencephalography was performed for 29 neonates,with sharp waves in 21 neonates(72％)and seizures in 10 neonates(34％).Symptomatic/supportive treatment varied across different hospitals.Neonatal Behavioral Neurological Assessment was performed for 12 neonates(33％,12/36),with a mean score of(32±4)points.The prognosis of 27 neonates was followed up to around 12 months of age,with 44％(12/27)of the neonates having a good prognosis.Conclusions Ischemic stroke is the main type of neonatal stroke,often with convulsions as the initial presentation,involvement of the middle cerebral artery,sharp waves on electroencephalography,and a relatively low neurodevelopment score.Symptomatic/supportive treatment is the main treatment method,and some neonates tend to have a poor prognosis.