In 2022， Hainan provincial government launched the project for the prevention and control of viral hepatitis with the goals of a hepatitis B screening rate of 90%， a diagnostic rate of 90%， and a treatment rate of 80% among people aged 18 years and above by the year 2025， and the main intervention measures include population-based prevention， case screening， antiviral therapy， and health management. As of December 31， 2024， a total of 6.875 million individuals in the general population had been screened for hepatitis B， with a screening rate of 95.6%. A total of 184 710 individuals with positive HBsAg were identified， among whom 156 772 were diagnosed through serological reexamination， resulting in a diagnostic rate of 84.9%. A total of 50 742 patients with chronic hepatitis B were identified， among whom 42 921 had hepatitis B-specific health records established for health management， with a file establishment rate of 84.6%. A total of 31 553 individuals received antiviral therapy， with a treatment rate of 62.2%. A total of 2.503 million individuals at a high risk of hepatitis C were screened， among whom 4 870 tested positive for HCV antibody and 3 858 underwent HCV RNA testing， resulting in a diagnostic rate of 79.2%， and 1 824 individuals with positive HCV RNA were identified， among whom 1 194 received antiviral therapy， with a treatment rate of 65.5%. In addition， 159 301 individuals with negative HBsAg and anti-HBs and an age of 20 — 40 years were inoculated with hepatitis B vaccine free of charge. Through the implementation of the project for the prevention and control of viral hepatitis， a large number of hepatitis patients have been identified， treated， and managed in the province within a short period of time， which significantly accelerates the efforts to eliminate the crisis of viral hepatitis.

Objective: To investigate the mediating role of children s sleep quality in the association between mother-child relationship and the executive function of preschool children, providing a reference for promoting the development of the executive function of preschool children. Methods: A stratified cluster sampling method was used to select 842 preschoolers from 12 kindergartens in Wuhu City, Anhui Province in December 2021 as the subjects of the first follow up study with follow up every six months thereafter. Finally, 746 children were included in the study after 3 follow up. Spearman correlation analysis was used to explore the associations among mother-child relationship, sleep quality and executive function in preschool children. Bootstrap program and PROCESS software were applied to test the mediating effect of sleep quality in the association between mother-child relationship and the executive function of preschool children. Results: Conflictual mother-child relationship was positively correlated with the total score of executive function, as well as scores of inhibitory, shifting, emotional control, working memory, and organizational planning ( r=0.40, 0.37, 0.36, 0.41, 0.38 , 0.34, all P <0.05). Dependent mother-child relationship was positively correlated with the total score of executive function, as well as scores of inhibitory, shifting, emotional control, working memory , and organizational planning ( r=0.23, 0.20, 0.21, 0.22 , 0.22, 0.19, all P <0.05). Sleep quality was positively correlated with the total executive function score ( r=0.27, P <0.01). After adjusting for confounding factors, sleep quality played a partial mediating role in the associations between dependent and conflictual mother-child relationships and executive function, the mediating effects were 19.40% and 11.22% respectively. Conclusions Sleep quality plays a mediating role in the association between mother-child relationship and the executive function of preschool children. Improving sleep quality in the early stage can promote the executive function of preschool children.

BACKGROUND: Urolithiasis is a widespread disease with a high prevalence worldwide. This study aims to evaluate the disease burden of urolithiasis and its trends from 1990 to 2021 globally, based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 database. METHODS: The numbers and age-standardized rates (ASRs) of incidence, disability-adjusted life years (DALYs), and mortality of urolithiasis were extracted from GBD 2021 to represent the disease burden. Joinpoint regression analyses were conducted to assess the temporal trends in the burden of urolithiasis. The male-to-female ASR ratio indices were used to evaluate sex disparities. Additionally, we explored the relationship between the ASR ratio and the sociodemographic index (SDI). RESULTS: The total numbers of incidence, DALY, and mortality of urolithiasis were 105,983,780 cases (95% uncertainty interval [UI] = 88,349,356-128,645,155 cases), 693,444 cases (95% UI = 567,765-850,490 cases), and 17,672 cases (95% UI = 13,932-21,241 cases), respectively, in 2021. There is an increasing trend in the number of these measures globally, whereas the ASRs have decreased over the past 30 years. The age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) were significantly higher in males than in females in 2021. The sex disparities in the age-standardized DALY rate (ASDR) and ASMR of urolithiasis were negatively correlated with the SDI. In 2021, the ASIR of urolithiasis was 964.70 (95% UI = 801.26-1175.09) per 100,000 people in China, which is much lower than the global average (1242.84 [95% UI = 1034.94-1506.99] per 100,000 people). Compared with the global average, a more pronounced decline in ASIR was observed in China from 1793.16 (1446.0-2235.14) in 1990 to 964.70 (801.26-1175.09) per 100,000 people in 2021. CONCLUSIONS Urolithiasis poses a significant healthcare burden worldwide. More robust global and national strategies are warranted to address the prevention and treatment, especially in low SDI countries and regions.
Humans ; Urolithiasis/mortality* ; Male ; Female ; Incidence ; Global Burden of Disease ; Disability-Adjusted Life Years ; Adult ; Middle Aged ; Risk Factors ; Sex Factors

Objective:To investigate the etiological distribution of hydronephrosis caused by upper uri-nary tract obstruction in adult patients and to improve the diagnostic accuracy for this condition.Me-thods:The clinical information of adult patients with newly diagnosed hydronephrosis in Upper Urinary Tract Repair Outpatient Clinic of Peking University First Hospital from May 2020 to May 2021 were pro-spectively and continuously collected.Patients with ureteral calculi or upper urinary tract tumor were ex-cluded.A total of 767 patients were involved.The underlying causes of upper urinary tract obstruction were identified by senior urological surgeons according to symptoms,medical history,physical examina-tion,and a range of diagnostic imaging techniques including ultrasound,computed tomography(CT),magnetic resonance imaging(MRI),retrograde pyelography,antegrade pyelography,radionuclide reno-gram and ureteroscopy.Results:Among the 767 patients,359(46.8％)were male and 408(53.2％)were female.The median age of these patients was 37 years(range,14-84 years).Hydronephrosis was observed at left-sided in 357 cases(46.6％),right-sided in 251 cases(32.7％),and bilateral in 159 cases(20.7％).The causes of hydronephrosis were classified as follows:(1)Non-iatrogenic factors were found in 464 cases(60.5％).These included urinary malformations in 355 cases(76.5％),infec-tion in 29 cases(6.3％),pelvic lipomatosis and/or cystitis glandularis in 23 cases(5.0％),ureteral en-dometriosis in 18 cases(3.9％),retroperitoneal fibrosis in 15 cases(3.2％),trauma in 7 cases(1.5％)and other non-iatrogenic factors in 12 cases(2.6％).Some of these patients had multiple non-iatrogenic causes.Among the 355 cases with urinary system malformations,252 cases(71.0％)had ureteropelvic junction obstruction.(2)Iatrogenic ureteral injuries accounted for 210 cases(27.4％),including 112 cases(53.3％)of urological surgical injuries,51 cases(24.3％)of radiotherapy for malignant tumor re-lated injuries,34 cases(16.2％)of gynecological and obstetrical surgical injuries,and 13 cases(6.2％)of general surgical injuries.(3)The cause of hydronephrosis remained unknown in 93 cases(12.1％).Conclusion:Hydronephrosis in adults due to upper urinary tract obstruction has a diverse range of cau-ses,with urinary malformations and iatrogenic ureteral injuries being significant contributors.Urological surgeon involved in upper urinary tract reconstruction should be familiar with these potential causes to fa-cilitate accurate diagnosis and effective treatment.

The incidence of osteoporotic thoracolumbar vertebral fracture (OTLVF) in the elderly is gradually increasing. The kyphotic deformity caused by various factors has become an important characteristic of OTLVF and has received increasing attention. Its clinical manifestations include pain, delayed nerve damage, sagittal imbalance, etc. Currently, the definition and diagnosis of OTLVF with kyphotic deformity in the elderly are still unclear. Although there are many treatment options, they are controversial. Existing guidelines or consensuses pay little attention to this type of fracture with kyphotic deformity. To this end, the Lumbar Education Working Group of the Spine Branch of the Chinese Medicine Education Association and Editorial Committee of Chinese Journal of Trauma organized the experts in the relevant fields to jointly develop Clinical guidelines for the diagnosis and treatment of osteoporotic thoracolumbar vertebral fractures with kyphotic deformity in the elderly ( version 2024), based on evidence-based medical advancements and the principles of scientificity, practicality, and advanced nature, which provided 18 recommendations to standardize the clinical diagnosis and treatment.

Objective To conduct a scoping review of research on the application of mobile health(mHealth)in the management of home enteral tube feeding,so as to provide references for future research and clinical practice.Methods A literature search was performed in the PubMed,Cochrane Library,Embase,Web of Science,CINAHL,CNKI,Wanfang,and CMB databases to identify relevant studies.The search period spanned from the establishment of databases until February 18,2024.According to the scoping review framework,2 researchers independently screened the studies,extracted the data of the included studies,and collaborated on the final analysis.Results A total of 24 studies were included.9 studies were conducted with interventions based on nursing models such as discharge planning model,"Hospital to Home"nutrition management model,guided care nursing model.The management forms included application,network communication software,and website.The content elements included education,assessment,consultation,referral,self-management,electronic health archive,appointment service,peer support.The outcome indicators included patients'physical and mental health,self-management ability,caregiver competence,family burden and user assessment.Conclusion The mHealth has played a positive role in the management of home enteral tube feeding.In the future,it is recommended to establish a multidisciplinary team to conduct high-quality research and continuously improve the form and content of mHealth management.

Objective:To evaluate the anesthetic effect of transcutaneous electrical acupoint stimulation (TEAS)-erector spinal plane block (ESPB)-general anesthesia in elderly patients undergoing lumbar spine surgery.Methods:A total of 100 American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ elderly patients, aged 65-75 yr, with a body mass index of 19-27 kg/m 2, undergoing elective lumbar fusion internal fixation within two levels in the First Affiliated Hospital of Guangzhou University of Chinese Medicine from October 2023 to March 2024, were selected and divided into 2 groups ( n=50 each) using a random number table method: TEAS group (T group) and control group (C group). In T group, TEAS was performed at 30 min before anesthesia induction until the end of operation, then transcutaneous electrical stimulation of bilateral Hegu, Neiguan and Zusanli was performed for 2 consecutive days after surgery, once a day, 30 min per time. Electrodes were applied to the same acupoints without electrical stimulation in group C. After induction of general anesthesia, bilateral ESPB was performed under ultrasound guidance, and 0.375% ropivacaine 20 ml was injected on each side in both groups. Patient-controlled intravenous analgesia was carried out with sufentanil citrate from the end of surgery until 48 h after surgery. When VAS score≥4, tramadol was intravenously injected as rescue analgesic. The consumption of remifentanil and propofol, the total number of successfully delivered doses (D1) and the number of attempts (D2) within 48 h after operation, and the D1/D2 ratio and rescue analgesia were recorded. The concentrations of interleukin-6, interleukin-10, tumor necrosis factor-α and T-lymphocyte subsets (CD3 +, CD4 +, CD8 + ) were determined before stimulation of acupoints and at 24 and 48 h after surgery. The CD4 + /CD8 + ratio was calculated. Results:Compared with group C, the consumption of intraoperative remifentanil was significantly decreased, D1 and D2 were reduced, the D1/D2 ratio was increased, the rate of rescue analgesia was decreased, the serum concentrations of interleukin-6, interleukin-10 and tumor necrosis factor-α were decreased at each time point after operation, and the serum concentrations of CD3 + and CD4 + and CD4 + /CD8 + ratio were increased in group T ( P<0.05). Conclusions:Compared with combination of ESPB and general anesthesia, TEAS-ESPB-general anesthesia can provide better analgesic effect, reduce postoperative inflammatory responses and improve the immune function in elderly patients undergoing lumbar spine surgery.

Objective:To sort out the development context of precision nursing and compare and analyze the advantages and shortcomings in this field at home and abroad, so as to provide reference for the development of precision nursing in China.Methods:Through Web of Science core collection and CNKI database, literature related to precision nursing at home and abroad from January 1, 2012 to December 31, 2022 was retrieved. CiteSpace software was used to draw a scientific knowledge map for visualization analysis.Results:A total of 509 literatures in Chinese and 1 037 literatures in English were detected, and the annual number of publications showed a significant upward trend since 2015. The high-yielding institutions were mostly located in the United States, and the distribution of domestic institutions was relatively dispersed. From the perspective of research hotspots and frontiers, foreign research focused on health promotion and disease prevention research oriented by biological information, while Chinese research focused on individualized nursing research oriented by patient needs.Conclusions:In recent 10 years, the research of precision nursing in China has developed rapidly, but relatively speaking, the depth and breadth of its research still need to be improved. Chinese research should learn from the experience of foreign precision nursing practice and explore the mode of precision nursing that conforms to national conditions in China.

Objective:To systematically review the risk prediction model for vaginal delivery failure in low-risk primiparas, so as to provide reference for clinical practice and future research.Methods:Literature on the risk prediction model for vaginal delivery failure in low-risk primiparas was retrieved from China National Knowledge Infrastructure, WanFang Data, China Biology Medicine disc, PubMed, Embase, Cochrane Library, CINAHL, Web of Science and so on. The search period was from the establishment of the database to September 20, 2023. Two researchers independently screened literature, extracted data, and evaluated the risk of bias in the included studies.Results:A total of 10 articles were included, involving 14 models. Twelve models were constructed using Logistic regression, and the area under the receiver operating characteristic curve of the models ranged from 0.680 to 0.847. Common predictive factors of the model involved age of pregnant woman, height of pregnant woman, pre-pregnancy body mass index, gestational weight gain, gestational week, fetal birth weight, induction method, fetal biological measurements, and pre-delivery cervical Bishop score.Conclusions:The predictive performance of the vaginal delivery failure risk prediction model for low-risk primiparas is good, but the model construction method is relatively simple, and the overall bias risk is high. The model needs to be further optimized through machine learning, artificial intelligence, and other means, and extensively validated externally.

Objective To explore the effect of transcutaneous electrical acupoint stimulation(TEAS)on perioperative analgesia in elderly patients undergoing lumbar fusion internal fixation.Methods Eighty-two elderly patients undergoing lumbar fusion internal fixation within two levels,57 males and 25 fe-males,aged 65-74 years,BMI 18.5-24.0 kg/m2,ASA physical status Ⅰ-Ⅲ,were randomly divided into two groups:TEAS group and control group,41 patients in each group.Both groups were given tracheal intubation intravenous general anesthesia.TEAS group was treated with TEAS from 30 minutes before anes-thesia induction to the end of the operation,and continued TEAS for 2 days after surgery,once a day,30 minutes once time,and the stimulation sites were bilateral Hegu,Neiguan,and Zusanli.In the control group,the electrodes were only connected at the same time point without electrical stimulation.Both groups were treated with bilateral erector spinae plane block(ESPB)under ultrasound guidance after anesthesia in-duction.PCIA was performed by connecting the analgesic pump after operation.HR and MAP before stimu-lation and at the time of skin incision were recorded.The dosage of propofol and remifentanil and the number of sufentanil additions during operation were recorded.The addition rate of sufentanil was calculated.The resting and activity VAS pain scores 2,4,8,12,24,and 48 hours after operation were recorded.First compression time of analgesic pump,the consumption of sufentanil 48 hours after operation,the ratio of ef-fective pressing times of analgesic pump to actual pressing times(D1/D2),rescue analgesia rate and ad-verse reactions were recorded.Results Compared with control group,HR was slowed down significantly and MAP was decreased significantly at the time of skin incision in TEAS group,the rate of sufentanil addi-tions,the activity VAS scores 2,4,8,12,24,and 48 hours after operation,the resting VAS pain scores 12,24,and 48 hours after operation in TEAS group were significantly decreased,the first compression time of analgesic pump was significantly prolonged,the consumption of sufentanil 48 hours after operation was significantly decreased,D1/D2 was significantly increased,the rate of rescue analgesia,nausea and vomi-ting,dizziness were significantly decreased(P＜0.05).Conclusion TEAS can provide better analgesia for elderly patients undergoing lumbar fusion internal fixation,reduce the use of opioids,prolong the postop-erative analgesia time and reduce the incidence of postoperative adverse reactions.