Based on the "sweat pore-qi and liquid-collaterals" theory， it is considered that the core pathogenesis of pediatric infectious mononucleosis lies in the obstruction of sweat pores， the failure of qi and liquid to disperse， and damage to the collaterals due to pathogenic toxins. Accordingly， the treatment principles proposed include unblocking the sweat pores， regulating qi and liquid， and smoothing the collaterals. In clinical practice， treatment is differentiated according to stages： initial， acute， and late stages. In the initial stage， invasion of warm pathogenic toxins into the lung defense leads to obstruction of the sweat pores， which should be treated by unblocking the sweat pores and expelling pathogens outward. In the acute stage， the obstruction of the sweat pores worsens， leading to the failure of qi and liquid dispersal， resulting in intense heat toxins with accumulation of dampness， phlegm， and blood stasis， which should be treated by promoting qi movement， resolving dampness and phlegm， clearing heat， detoxifying， and dispersing stasis to regulate qi and liquid. In the late stage， residual pathogens remain， with qi and yin deficiency and unsmooth collaterals， which should be treated by unblocking the collaterals， dissipating nodules， tonifying qi， and nourishing yin to smooth the collaterals. This approach may provide new insights for the clinical treatment of pediatric infectious mononucleosis.

To summarize the nursing care of a case of thrombotic microangiopathy complicated late pregnancy with intrahepatic cholestasis of pregnancy resulting in fetal demise.Nursing interventions include:to optimize the maternal status,reduce the risk of induction of labor;to assess the cervical conditions,and complete the preparations for childbirth;to ensure the safety of childbirth and prevent and treat postpartum hemorrhage;to standardize blood purification,promote the recovery of renal function;to pay attention to breast conditions and be vigilant against the occurrence of mastitis;to provide grief care for perinatal loss.After careful treatment and care,the patient was discharged after 25 d of hospitalization,and the prognosis was good at 1-month follow-up after discharge.

To summarize the nursing care of a case of thrombotic microangiopathy complicated late pregnancy with intrahepatic cholestasis of pregnancy resulting in fetal demise.Nursing interventions include:to optimize the maternal status,reduce the risk of induction of labor;to assess the cervical conditions,and complete the preparations for childbirth;to ensure the safety of childbirth and prevent and treat postpartum hemorrhage;to standardize blood purification,promote the recovery of renal function;to pay attention to breast conditions and be vigilant against the occurrence of mastitis;to provide grief care for perinatal loss.After careful treatment and care,the patient was discharged after 25 d of hospitalization,and the prognosis was good at 1-month follow-up after discharge.

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).

Background The presence of formaldehyde, ammonia, benzene, toluene, and xylene in indoor air of public places has been confirmed to cause health damage. The employees of barber and beauty shops are exposed to relatively enclosed space for a long time, and could surfer more serious health risks from indoor air chemical pollutants. Objective To analyze the concentrations of common indoor air chemical pollutants in barber shops and beauty salons in Liaocheng City, and explore potential health risks of the pollutants for employees. Methods Using a stratified randomized sampling method, 8 to 10 barber shops and 5 to 10 beauty salons were selected in the main urban area of Liaocheng City to conduct monitoring of the sanitary conditions of public places in winter and summer every year from 2016 to 2021; the indoor air concentrations of formaldehyde, ammonia, benzene, toluene, and xylene in the selected sites were measured, and a questionnaire survey was conducted to collect exposure characteristics of indoor pollutants. The concentration distributions of the five chemical pollutants were obtained from the monitoring data for 6 consecutive years, and the health risk assessment model recommended by the U.S. Environmental Protection Agency was used to perform health risk assessment of inhalation exposure. Results In 2016–2021, the median indoor air concentrations of formaldehyde, ammonia, benzene, toluene, and xylene in the two types of sites were lower than the limits of Hygienic Indicators and Limits for Public Places (GB 37488-2019), but the concentrations of some monitoring sites were higher than the limits. The disqualification rates of the five pollutants in the barber shops were 16.8%, 2.7%, 2.4%, 6.4%, and 12.0%, respectively. The disqualification rate of formaldehyde was the highest in all pollutants (22.0%), while the disqualification rates of ammonia, toluene, and xylene were 1.3%, 2.0%, and 2.0% in beauty salons respectively. Both formaldehyde and benzene were found to have carcinogenic risks (CR) in the two types of public places. Both median values of CR were greater than 1.0×10⁻⁶, and both maximum values were greater than 1.0×10⁻⁴. Formaldehyde had the highest non-carcinogenic risk in the indoor air of barber shops and beauty salons. The median non-carcinogenic hazard quotients (HQ) of formaldehyde were both greater than 1, and the maximum values were 16.72 and 12.19 times of the standard value; ammonia and toluene had the lowest non-carcinogenic risks, and their maximum values of HQ were less than 1; the median HQs of benzene and xylene were far less than 1, but their maximum risk values of barber shop were greater than 1. Conclusion For the sake of worker's health, formaldehyde and benzene should be the indoor air pollutant control priority for barber shops and beauty salons in Liaocheng; formaldehyde poses the most serious health hazard to practitioners and should be given high attention and necessary measures to reduce the hazard; benzene poses certain carcinogenic risks, with some of its highest values exceeding 10⁻⁴, which is higher than the recommended safety threshold.

Objective To investigate the effectiveness and safety of thermal ablation of patients with 3－5 cm hepatocellular carcinoma ( HCC ) under the assistance of ultrasound fusion imaging . Methods From December 2010 to December 2017 ,76 HCC patients with 78 medium‐size ( 3 －5 cm ) lesions who underwent radiofrequency ablation ( RFA ) or microwave ablation ( M WA ) were included in the study . Ultrasound fusion imaging was used to assist the ablation procedures and assess the technical success immediately ,then guided supplementary ablation . Contrast‐enhanced CT/M R was performed one month after ablation to assess the technique efficacy rate . T he complication ,local tumor progression ( L T P ) rate were followed up . Results According to the ultrasound fusion imaging evaluation ,24 lesions ( 30 .8% , 24/78) received supplementary ablation immediately during the ablation procedure . Seventy‐one of 78 liver tumors were evaluated to achieve 5 mm ablative margin while the other 7 liver tumors were not achieved . T here were no ablation‐related deaths ,and the major complication rate was 6 .6% ( 5/76 ) .T he technique efficacy rate was 100% ( 78/78) according to the contrast‐enhanced CT/M R one‐month later . Patients were followed up from 6 to 79 months with a median time of 22 months . L T P occurred in 4 lesions and the LT P rate was 5 .1% ( 4/78) . Conclusions With the assistance of ultrasound fusion imaging ,thermal ablation of medium‐sized HCC is effective and safe w hich could achieve a higher technique efficacy rate and a lower L T P rate .

Objective To investigate the potential relationship between neck circumference and obesity related indexes and metabolic disorders associated with insulin resistance.Methods A random cluster sampling method was used to identify study population among the 4 412 60 -70 years old permanent residents in Renqiu region.Face to face health questionnaire,physical examination,laboratory tests were used.According to the gender group,the correlation between neck circumference and obesity related indexes and metabolic disorders associated with insulin resistance were analyzed.Results Comparing neck circumference and waist circumference,waist height ratio, and body mass index(BMI) of man and woman respondents,the differences were statistically significant.Neck circum-ference and waist circumference,waist height ratio,and BMI had positive correlation(male:r =0.752,0.695 and 0.761.W:r =0.707,0.655,0.721,all P <0.01).Increased trends of neck circumference,waist circumference,waist height ratio and BMI coincided with increased trend of thypertension,diabetes,hyperlipidemia and hyperinsulinemia and hyperlipidemia,and no gender differences.With the increase of the neck circumference,the incidence of above mentioned diseases also increased accordingly.Conclusion Neck circumference was associated with obesity related indexes and metabolic disorders associated with insulin resistance.Neck circumference measurement can be used as an effective indicator of central obesity,and had great significance for early prediction and prevention of metabolic disorders associated with clinical insulin resistance.

Objective To investigate waist-to-height ratio(WHtR) and body mass index(BMI) for the screening and prediction of metabolic syndrome and explore the best indicator for predicting metabolic syndrome(MS) in the elderly.Methods A cluster random sampling method was used.5 010 cases aged 60-70 years old of Renqiu permanent residents were selected as a screening subjects.The face to face health questionnaires,anthropometric measurements,and laboratory testing were conducted.Receiver operatiug characteristic (ROC) was used to analyze and calculate the area under the curve(AUC).Results WHtR predict the best point of tangency of MS were 0.54 (men),0.5 5 (women),BMI predict the best point of tangency of MS were 25.25kg/m2 (men),2 5.0 5 kg/m2 (women).In the same gender,the contrast of WHtR and BMI in predicts MS area under the curve,WHtR area under the curve of the larger,WHtR was higher than BMI,WHtR was a better indicator in predicted of MS.Conclusion WHtR and BMI have important roles in the screening and prediction of MS,and WHtR seems to be the best parameter in the screening and prediction of MS in the elderly.

Objective To investigate the relationship of resting heart rate (RHR)and dyslipidemia in the elderly.Methods 3 919 cases of cerebrovascular disease risk factor screening in Renqiu permanent residents aged 60 -70 years were selected,excepted cases of atrial fibrillation and hyperthyreosis and received lipid -lowering and slowing the heart rate drugs as the research subjects,mean age 64(62,67)years,the rates of male and femal were 44.0% and 56.0% respectively.They underwent face -to -face health questionnaire,blood pressure and RHR meas-urement,anthropometric and laboratory tests.According to the RHR,they were divided into four groups:RHR1:<60 times/min,RHR2:>60 times/min and <70 times/min,RHR3:>70 times/min and <80 times/min,RHR4:>80 times/min.The effect of RHR on dyslipidemia was analyzed by multivariate logistic regression analysis.Results The high TC,TG,and the prevalence of high LDL -C increased gradually with heart rate,the differences were statisti-cally significant (all P <0.001).The prevalence low HDL -C and HDL -C levels had no obvious statistically differ-ences.TC,TG,and LDL -C and RHR were positively correlated.RHR1:<60 times/min was set as control group,the correction of gender,age,smoking,drinking,lack of physical activities,hypertension,diabetes,coronary heart disease, stroke or TIA,overweight,abdominal obesity,systolic pressure,diastolic blood pressure,fasting plasma glucose,insu-lin,uric acid,high TC in 60 -70 times/min,70 -80 times/min,and the risk of more than 80 times/min,respectively (OR =1.304,95%CI:0.983 -1.73),(OR =1.579,95%CI:1.195 -2.088),(OR =1.677,95%CI:1.258 -2.237).Conclusion The RHR and the prevalence of dyslipidemia is related,medical workers need to know the rela-tionship between RHR and dyslipidemia,increase the focus on RHR and intervention,in order to effectively control the occurrence of dyslipidemia and cardio -cerebrovascular disease,especially cholesterol heighten.

Objective To investigate the efficacy of acupuncture combined with doctor-nurse cooperation mode on stroke-associated pneumonia in patients with acute stroke. Methods 67 patients of acute stroke within 1 week in our hospital from March, 2013 to January, 2015 were randomly divided into control group (n=35) and treatment group (n=32). Both groups received neurological routine treatment and systematic rehabilitation training by professional physiotherapists under general nursing mode. The treatment group received acupuncture treatment under doctor-nurse cooperation mode additionally. Incidence of stroke-associated pneumonia, swallow function and aspiration rate were recorded. Results Compared with the control group, the incidence of stroke-associated pneumonia significantly decreased in the treat-ment group after treatment (χ2=4.615, P=0.032). The retention volume of epiglottic vallecula and pyriform sinus (tdilute barium=21.01, tthick barium=19.85), the duration of pharynx period (tdilute barium=17.03, tthick barium=13.68), and the start time of pharynx period (tdilute barium=19.63, tthick barium=17.86) were less in the treatment group than in the control group (P<0.05). In the test of dilute barium, the aspiration rate was lower in the treatment group than in the control group (χ2=4.03, P=0.044), however, there was no significant difference between 2 groups in the test of thick bari-um and solid food (P>0.05). Conclusion Acupuncture combined doctor-nurse cooperation mode may decrease the rates of aspiration and stroke-associated pneumonia in acute stroke patients through improving their swallow function.