Objective: To investigate the mediating role of vaccine literacy between vaccine knowledge and vaccine hesitancy and the moderating role of parental education level, so as to provide references for adjusting vaccination strategies. Methods: From May to December 2024, a stratified random sampling method was used to select 10 community hospitals in Guiyang and Zunyi City, Guizhou Province. A total of 1 401 parents of children aged 0-6 years were surveyed regarding their socio demographic characteristics, vaccine knowledge, vaccine literacy, and vaccine hesitancy levels. Data were analyzed using common method bias tests, Spearman correlation analysis, mediation and moderation effects tests. Results: The mean score for vaccine knowledge, vaccine literacy and vaccine hesitancy were (2.96±1.11, 14.25±2.64, 39.12±4.93) among the 1 401 participants. Mediating effect analysis showed that both parental vaccine knowledge ( β =1.28, 95% CI =1.08-1.49) and vaccine literacy ( β =0.75, 95% CI =0.66-0.84) positively predicted vaccine hesitancy (both P <0.01). Meanwhile, vaccine literacy accounted for 28.1% of the total effect of mediation between knowledge and vaccine hesitancy. In the moderated effects analysis, education level positively predicted vaccine literacy ( β =0.40, 95% CI =0.24-0.57), and education level moderated the pathway of vaccine knowledge on vaccine hesitancy ( β = 0.28 , 95% CI =0.05-0.52) (both P <0.01). Conclusions Vaccine literacy partially mediates the relationship between vaccine knowledge and vaccine hesitancy. Parental education level positively moderates the prediction of vaccine knowledge on vaccine hesitancy score.

Objective To investigate the effect and characteristics of anterolateral thigh flap in repair of extremity wound in children.Methods A retrospective case series study was conducted to analyze the clinical data of 69 patients with limb soft tissue defects admitted to Kunming General Hospital of PLA from January 2008 to December 2016.There were 57 boys and 12 girls,aged 2-15 years (mean,6.7 years).There were 56 cases of lower extremity wounds and 13 cases of upper limb wounds.The wound areas ranged from 3 cm ×4 cm to 14 cm × 15 cm,with an average of 52.4 cm2.All wounds were repaired with the anterolateral thigh flap.The type of flap,number of perforators,type of perforation,closure of donor site,healing of the flap,complications,and reoperation were recorded.Results Seventy anterolateral thigh flaps were harvested in 69 children,including 42 musculocutaneous flaps and 28 perforator flaps.Intraoperative visualization identified 76 perforators,including 14 septocutaneous and 62 musculocutaneous perforators.The donor site was closed primarily in 52 cases,and a split-thickness skin graft was required in 18 cases.After operation,vascular crisis occurred in four cases.After exploration,one flap survived,and partial necrosis was found in three flaps.Except for one flap with total necrosis because of infection,the rest of the flaps survived.Other postoperative complications included flap edge necrosis in six cases,local infection in six,and wound dehiscence in three.The follow-up ranged from 6 to 33 months,averaged 14.9 months.Hypertrophic scar occurred at donor site in 27 children.The number of reoperation was 46,including 23 debulking procedures,seven skin grafts,four debridements,and 12 others.Conclusions The anterolateral thigh flap is a safe,reliable option for reconstruction of soft tissue defects in extremities of children.The anterolateral thigh musculocutaneous flap is used commonly in children.However,hypertrophic scar at donor site occurs more often after flap surgery,with high rate of reoperations.

Objective: To analyze the contents of flavonoids in Astragali Radix before and after sodium pyrosulfite solution soa-king, so as to provide reliable methods for scientifically evaluating and effectively controlling the quality of Astragali Radix. Methods:After sodium pyrosulfite solution soaking, the contents of calycosin glucoside, ononin, formononetin and pterostilbene were analyzed by HPLC-DAD. Results: Calycosin glucoside, ononin, formononetin and pterostilbene showed a good linear relationship within the range of 0. 048-60. 000 μg·ml-1, 0. 019-30. 000 μg·ml-1, 0. 019-40. 000 μg·ml-1and 0. 019-40. 00 0μg·ml-1, respectively. After sodium pyrosulfite solution soaking, the contents of calycosin glucoside and ononin decreased, furthermore, with the increase of sodium sulfite solution concentration and soaking time, the decrease trend was more obvious, and the differences between the high concentra-tion group and the normal group were 2-3 times. The content of formononetin was essentially the same, while the difference in pterostil-bene content between the high concentration groups and the normal group was 10 times. Conclusion: After sodium pyrosulfite solution soaking, the contents of flavonoid glycoside components are reduced, therefore, it is not advisable to use sodium pyrosulfite solution soaking to achieve keeping fresh, mothproof and prolonging the shelf life of Astragali Radix.

Objective To explore the effect of research practical teaching mode on the critical thinking ability and innovation ability of nursing in the course of community nursing teaching.Methods The research practical teaching was provided for 90 nursing students.They were investigated with the WatsonGlaser Critical Thinking Appraisal (WGCTA) and the test of self innovation level scale before and after teaching.Results After the teaching,the total score of critical thinking and the score of innovation ability among nursing students were significantly improved.the recognition hypothesis,deduction, explanation,evaluation discussed dimensions were statistically significant,but before and after teaching reasoningdimensions showed no significant difference.Conclusions Research practical teaching mode can improve critical thinking ability and innovation ability of nursing students in the course of community nursing teaching.

OBJECTIVE To investigate the management criteria for selecting and applying of prosthesis and implants.METHODS Through a standard system and appropriate measures,the strict management to the purchase and entire application of prosthesis and implants was encouraged.RESULTS The systemic management ensured the hospital to use prosthesis and implants safely on patients and prevent from improper or illegal use,thus to safeguard the interests of both the patients and the hospital,avoiding unnecessary harms to patients′ body and spirit,therefore to minimize the conflicts between hospitals and patients.During the implementation of the management,further improvement and investigation were required.CONCLUSIONS Maintaining the mutual inferests between patients and hospital,avoiding unnecessary harms to patients′can minmize the medical conflicts and persistent improvements.