BackgroundThe functional changes of the default mode network （DMN） are closely related to the onset of major depressive disorders. However， the relationship between the DMN subsystem （core subsystem， dorsomedial prefrontal cortex subsystem， medial temporal lobe subsystem） and symptoms of first-episode major depressive disorder remains unclear. ObjectiveTo investigate abnormal functional connectivity between DMN subsystems and the whole brain in first-episode major depressive disorder patients during the resting-state， and to analyse the correlations between these functional connectivity patterns and clinical symptoms， so as to reveal the potential neural mechanisms from the perspective of DMN subsystem. MethodsFrom September 2020 to September 2023， a total of 64 first-episode outpatients and inpatients meeting the diagnostic criteria for major depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders， fourth edition （DSM-IV） were enrolled at the Inner Mongolia Autonomous Region Mental Health Center as the study group. During the same period， 54 healthy volunteers matched for age， gender， and years of education were recruited from the community as the control group. Both groups were assessed using the Hamilton Depression Scale-24 item （HAMD-24）. Resting-state functional magnetic resonance images （rs-fMRI） of the two groups were acquired using a Siemens 3.0 T scanner， and differences in functional connectivity between DMN subsystems （core subsystem， dorsomedial prefrontal cortex subsystem， medial temporal lobe subsystem） and the whole brain were compared. The functional connectivity values of brain regions with statistically significant differences between the two groups were extracted. Spearman's rank correlation coefficient analysis was used to investigate the correlation between these functional connectivity values and HAMD-24 scores of the study group. ResultsUltimately， 46 patients and 43 controls completed the study. Compared with the control group， the study group exhibited significantly stronger functional connectivity in the following pathways： between the right superior parietal lobule （core subsystem） and right cerebellar lobule VIII （t=3.954， P<0.05， GRF-corrected）， between the right lateral temporal cortex （dorsomedial prefrontal cortex subsystem） and right cerebellar lobule VIII， right and left hippocampi， right medial， and paracingulate gyrus （t=4.595， 4.208， 5.200， 4.038， P<0.05， GRF-corrected）， and between the temporoparietal junction （dorsomedial prefrontal cortex subsystem） and left lingual gyrus and right cerebellar lobule VIII （t=3.557， 4.274， P<0.05， GRF-corrected）. Conversely， weaker functional connectivity was observed between the right inferior frontal gyrus and left gyrus rectus （t=-3.824， P<0.05， GRF-corrected）. Furthermore， within the study group， the functional connectivity values between the right lateral temporal cortex and right hippocampus， as well as between the temporoparietal junction and right cerebellar lobule VIII， were both negatively correlated with the HAMD-24 cognitive impairment factor score （r=-0.306， -0.318， P<0.05）. ConclusionIncreased functional connectivity between the DMN （specifically its core and dorsomedial prefrontal cortex subsystems） and cerebellum， partial limbic system， and lingual gyrus may be associated with the neuropathology of first-episode major depressive disorder. Furthermore， alterations in functional connectivity between the dorsomedial prefrontal cortex subsystem and both the cerebellum and hippocampus in these patients may be related to cognitive function. ［Funded by 2019 Annual Inner Mongolia Autonomous Region Natural Science Foundation Project （number， 2019MS03038）； 2023 Annual Inner Mongolia Autonomous Region Natural Science Foundation Project （number， 2023MS08028）］

Objective To understand the readiness of gynecological wards in conducting the evidence-based practice for the prevention and management of urinary retention after cervical cancer radical resection,and to analyze the influencing factors.Methods The 190 nursing staffs in the gynecological oncology wards of this hospital in June 2020 were selected as the study subjects.The assessment of readiness for evidence-based nursing practice (CREBNA) and general information questionnaire were used to conduct the questionnaire survey,single factor and multiple factor stepwise regression to analyze the influencing factors.Results The score of CREBNA was (135.94±17.83) points,the evidence subscale was (52.41±7.88) points,the organi-zational environment subscale was (40.58±5.01) points and the promoting factors subscale was (42.67±6.24) points.The results of univariate analysis showed that the total score of CREBNA was related to the ed-ucational background,professional title,position,scientific research experience,understand degree on evidence-based and necessity of conducting evidence-based (P<0.05).The multiple stepwise regression analysis showed that the understanding degree on the evidenced-base and necessity of conducting evidence-based were the influencing factors of CREBNA scale (P<0.05).Conclusion The readiness of the evidence-based nursing practice in this study is good and has good feasibility.

Objective To explore the application effect of trauma intelligent first aid platform in the treatment of severe trauma patients. Methods 160 patients with severe trauma admitted to Department of Emergency Medicine,the Affiliated Hospital of Hangzhou Normal University from January to December 2023 were selected as research objects. A total of 80 patients treated in the traditional trauma first aid mode from January to June 2023 were included in control group,and 80 patients treated in the trauma intelligent first aid platform from July to December 2023 were included in observation group. The effectiveness,success rate of rescue and information warning rate of two groups were compared. Results Arrival time of multidisciplinary trauma treatment team,time of completing CT examination,time of staying in rescue room,time of waiting for blood transfusion and time of hospitalization in observation group were shorter than those in control group (P<0.05). The success rate of rescue in observation group was higher than that in control group (P<0.05). Conclusion The intelligent trauma first aid platform can effectively improve the first aid efficiency and success rate of rescue with severe trauma patients.

Objective To explore the application effect of trauma intelligent first aid platform in the treatment of severe trauma patients. Methods 160 patients with severe trauma admitted to Department of Emergency Medicine,the Affiliated Hospital of Hangzhou Normal University from January to December 2023 were selected as research objects. A total of 80 patients treated in the traditional trauma first aid mode from January to June 2023 were included in control group,and 80 patients treated in the trauma intelligent first aid platform from July to December 2023 were included in observation group. The effectiveness,success rate of rescue and information warning rate of two groups were compared. Results Arrival time of multidisciplinary trauma treatment team,time of completing CT examination,time of staying in rescue room,time of waiting for blood transfusion and time of hospitalization in observation group were shorter than those in control group (P<0.05). The success rate of rescue in observation group was higher than that in control group (P<0.05). Conclusion The intelligent trauma first aid platform can effectively improve the first aid efficiency and success rate of rescue with severe trauma patients.

Objective:To investigate the relationship between the level of anti Mullerian hormone (AMH) and antral follicle count (AFC) and oocytes number in patients with in vitro fertilization (IVF). Methods:372 patients with primary infertility who received IVF and embryo transfer (IVF-ET) treatment in the Affiliated Hospital of Guizhou Medical University from January 2020 to December 2020 were prospectively selected as the study subjects. According to the oocytes obtained, the patients were divided into low ovarian response group (LOR group, the number of oocytes obtained ≤5, n=37), normal group (NOR group, the number of oocytes obtained was 6-15, n=292) and high ovarian response group (HOR group, the number of oocytes obtained >15, n=43). The levels of AMH and AFC in the three groups were observed. The relationship between AMH, AFC with LOR and HOR was observed by multivariate logistic analysis. The sensitivity, specificity, optimal cut-off value and area under the curve (AUC) of AMH and AFC for predicting LOR and HOR were calculated by receiver operating characteristic (ROC) curve. Results:There were significant difference in AMH, AFC and oocyte number among the three groups (all P<0.05). The AMH, AFC and oocyte number in NOR group were higher than those in LOR group, and AMH, AFC and oocyte number in HOR group were higher than those in LOR and NOR group (all P<0.05). The results of binary multivariate analysis showed that AFC and AMH were protective factors of LOR (all P<0.05), while AFC and AMH were risk factors of HOR ( P<0.05). The sensitivity and specificity of AMH and AFC in predicting LOR were 83.8% and 75.7%, 65.7% and 84.2%, respectively. The sensitivity of AMH or AFC positive as the standard for predicting LOR was 94.6%, and the specificity of AMH and AFC was 91.6%. The sensitivity and specificity of positive AMH and AFC in predicting HOR were 69.8% and 74.4%, 69.6% and 83.6%, respectively. The sensitivity of AMH or AFC positive as the standard for predicting HOR was 93.0%, and the specificity of AMH and AFC positive as the standard for predicting HOR was 93.0%. Conclusions:AMH and AFC are significantly correlated with oocyte number in patients with primary infertility. Flexible application of AMH and AFC is beneficial to better predict the number of oocytes obtained, which provides a reference for clinical development of individualized ovarian stimulation program.

Objective:To evaluate pelvic floor holistic theory used in the treatment of complete rectal prolapse (CRP).Methods:Forty-two CRP patients at No. 989 Hospital between Oct 2015 and Jun 2019 were divided into group A ( n=23) treated by laparoscopic rectopexy associated with the procedure for PPH, and group B ( n=19), by Altemeier precedure. The degree of rectal prolapse, Wexner fecal incontinence score and Wexner constipation score were evaluated before operation and at the 6th,12th and 24th months after operation Results:The operation time of the two groups were (53±6) and (90±9) min; intraoperative blood loss was (14±5) and (80±19) ml; the hospital stay was (8.9±1.7) and (13.5±2.1)d, all P<0.05. There was no significant difference in postoperative recurrence between the two groups ( P>0.05). The degree of rectal prolapse in group A and B were (9.5±1.7) and (8.7±1.5)cm; the 6 th, 12 th and 24 th months after operation were [(-1.0±1.6), (-0.2±1.8)cm; (-1.0±1.3), (-0.3±1.5)cm; (-0.8±1.2), (-0.5±1.6)cm], all P<0.05. The preoperative constipation in group A and group B was (6.4±1.7) and (6.4±1.5) respectively; the 6 th, 12 th and 24 th months after operation were [(2.8±1.0) vs. (3.0±1.3); (2.6±1.1) vs. (2.8±1.3); (2.0±0.9) vs. (2.3±1.1)], all P<0.05. The preoperative fecal incontinence score of group A and group B were (7.6±1.7) vs. (7.1±1.5); the 6 th, 12 th and 24 th months after operation were [(3.7±1.7) vs. (3.4±1.2); (3.5±1.8) vs. (3.1±1.1); (3.4±1.9) vs. (2.6±1.3)], all P<0.05. Conclusion:Pelvic floor holistic theory help improve the treatment of complete rectal prolapsed.

Ethylene glycol, also known as glycol, is a common low-temperature antifreeze used in automobiles. It is a colorless, odorless, volatile, low-sweet, sticky liquid at room temperature. Ethylene glycol is easily decomposed and absorbed through the digestive tract. Toxic metabolites cause serious clinical symptoms such as central nervous system inhibition, metabolic acidosis, cardiopulmonary symptoms and renal insufficiency, and even death. Misuse and oral suicide are the main causes of ethylene glycol poisoning. This article reports a case of severe ethylene glycol poisoning admitted to the emergency department of the Affiliated Hospital of Hangzhou Normal University in December 2021. After treatment with V-V ECMO combined with blood purification, the patient was improved and discharged from hospital.

Ethylene glycol, also known as glycol, is a common low-temperature antifreeze used in automobiles. It is a colorless, odorless, volatile, low-sweet, sticky liquid at room temperature. Ethylene glycol is easily decomposed and absorbed through the digestive tract. Toxic metabolites cause serious clinical symptoms such as central nervous system inhibition, metabolic acidosis, cardiopulmonary symptoms and renal insufficiency, and even death. Misuse and oral suicide are the main causes of ethylene glycol poisoning. This article reports a case of severe ethylene glycol poisoning admitted to the emergency department of the Affiliated Hospital of Hangzhou Normal University in December 2021. After treatment with V-V ECMO combined with blood purification, the patient was improved and discharged from hospital.

Objective:to construct and test the structural equation model of influencing factors of clinical nursing teaching quality, and analyze the influencing factors and strength of clinical nursing teaching quality.Methods:Based on the literature, 20 indexes influencing the quality of clinical nursing teaching were selected. In July 2019, clinical nursing teachers of a third class a medical institution were selected for convenient sampling survey. Through factor analysis, 20 indexes were classified into 6 dimensions, namely, teaching environment, teaching attitude, teacher quality, teacher behavior, teaching management and teaching quality.Results:The structural equation model of influencing factors of clinical nursing teaching quality was constructed. The fitting index of the model reached the standard value, and the model had a good fit.Conclusion:With the help of this model, the nursing administrators can find out the factors and intensity that affect the quality of clinical nursing teaching, which is helpful to put forward the improvement strategies of improving the quality of clinical nursing teaching, to improve the effect of clinical nursing teaching, to improve the quality of clinical nursing teaching, and to provide reference for the research of similar clinical nursing teaching quality.

Objective:To explore the application effect of medical science competition in nursing interns whocontribute to "healthy China" , and to improve their health education awareness, ability, method and self-confidence.Methods:A total of 205 nursing interns who worked in Union Hospital of Tongji Medical College of Huazhong University of Science and Technology from 2019 to 2020 were selected as the research objects. They were divided into the control group (105 cases) and the experimental group (100 cases) according to whether they participated in the medical science competition. The control group learned the form and method of health education in clinical rotation according to the traditional practice teaching plan. The experimental group volunteered to participate in the medical science competition, which required the dissemination of health knowledge through various forms. Before and after the competition, the health education ability assessment scale was used for comparison.Results:Before the medical science competition, there was no significant difference in the total score of assessment, planning, implementation, evaluation and health education between the control group and the experimental group ( t values were 0.765 - 1.749, all P>0.05). After the medical science competition, the total scores of assessment, planning, implementation, evaluation and health education ability of nursing interns in the experimental group were (24.38 ± 4.72), (17.98 ± 3.98), (25.16 ± 5.36), (12.57 ± 2.96) and (80.09 ± 15.65) respectively, while those in the control group were (22.45 ± 6.29), (16.61 ± 4.77), (23.04 ± 6.55), (11.31 ± 3.46) and (73.41 ± 19.69).The differences between the two groups were statistically significant ( t values were 2.226 - 2.795, all P<0.05). Conclusions:The medical science competition can improve the health education ability of assessment, planning, implementation, evaluation of nursing interns and contribute to "healthy China" .