Objective To systematically evaluate the efficacy and safety of Kangfuxin liquid combined with conventional treatment in postoperative patients with gastrointestinal endoscopy.Methods PubMed,Embase,Cochrane Library,CNKI,WanFang Data,VIP databases were electronically searched to collect randomized controlled trials(RCTs)about Kangfuxin liquid combined with conventional treatment versus conventional treatment for postoperative complications of gastrointestinal endoscopy,from inception to December 31,2023.Two reviewers independently screened literature,extracted data and assessed the risk of bias in the included studies.Meta-analysis was then performed by using RevMan 5.3 software and Stata 14 software.Results A total of 14 RCTs involving 1 359 patients were included.The results of Meta-analysis showed that compared with the conventional treatment group,the Kangfuxin liquid combination group could improve postoperative ulcer complete healing rate(RR=1.32,95％CI 1.07 to 1.61,P=0.009)and postoperative clinical symptomatic relief rate(RR=1.20,95％CI 1.13 to 1.27,P＜0.001),but there was no statistically significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Subgroup analyses showed that the ulcer complete healing rate in the Kangfuxin liquid combination group was higher than that in the conventional treatment group at 2 weeks postoperatively(RR=1.56,95％CI 1.28 to 1.92,P＜0.001),but there was no statistically significant difference in ulcer complete healing rate between the two groups at 4 weeks postoperatively(P＞0.05);the efficacy of oral administration(RR=1.19,95％CI 1.11 to 1.27,P＜0.001)and transendoscopic topical spray administration(RR=1.23,95％CI 1.09 to 1.39,P＜0.001)of Kangfuxin liquid groups were better than those of the conventional treatment group in relieving postoperative clinical symptoms.Conclusion Combining Kangfuxin liquid treatment with conventional medication after gastrointestinal endoscopy may further improve clinical efficacy,especially in promoting the ulcer complete healing within 2 weeks after surgery and relieving postoperative clinical symptoms,but there is insufficient evidence on whether it reduces the incidence of adverse effects.Due to the limitations of the number and quality of included studies,the above conclusions are yet to be validated by more high-quality studies.

This paper takes the teaching of pathogeny biology and clinical laboratory diagnostics for postgraduates in Shandong Second Medical University as examples. By constructing innovative thinking in scientific research, training research innovation skills, and establishing modular, multi-evaluation systems, a comprehensive training mode for scientific research and innovation ability of medical academic postgraduate students had been proposed, and the implementation and effects of this training mode were thoroughly explored. This mode is expected to bring a positive impact on the training of medical postgraduate students and improve their scientific research and innovation ability, thereby promoting the cultivation of more medical talents with a high degree of scientific research and innovation ability.

Currently, the teaching work for postgraduates mainly centers on specific disciplines, and there is a lack of effective connection between disciplines, which leads to the insufficient ability of postgraduates in effectively integrating and applying the knowledge of various disciplines and restricts the development of innovation ability. This paper proposes a program for the cultivation of innovation ability of postgraduate students in clinical laboratory diagnostics based on multi-disciplinary integration from the three aspects of curriculum setting, multi-disciplinary interactive platform construction, and tutor team construction, aiming at helping postgraduate students to enhance the ability of knowledge integration and application and form a comprehensive disciplinary perspective. Additionally, the paper explores the practical application and effect of the cultivation program, offering novel insights and approaches for talent cultivation in the realm of clinical laboratory diagnostics.

Objective:To explore the reasons for delayed medical treatment in patients with polycystic ovary syndrome (PCOS) using the treatment pathway theory as a framework, and to propose corresponding strategies to guide timely medical care for PCOS patients.Methods:Purposeful sampling was used to select 14 PCOS patients who sought treatment at Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School between November 2022 and May 2023. Semi-structured interviews were conducted, and directed content analysis was applied to analyze and extract data.Results:The delay in seeking medical treatment for PCOS patients ranged from five to 60 months. Four main themes and 11 sub-themes were identified as reasons for treatment delays: misconception and delayed recognition of the disease (misunderstanding of symptoms, intermittent symptom presentation) ; delayed seeking of medical help (mismanagement of symptoms, feelings of shame, role conflict, distance and financial constraints, lack of social support) ; delayed diagnosis by healthcare providers (misdiagnosis by healthcare providers, lack of medical resources and services) ; and delayed participation in treatment (lack of health education from medical staff, no immediate fertility needs) .Conclusions:Delays in seeking medical care for PCOS patients are common. Efforts should be made to enhance public education on PCOS for adolescent and reproductive-age women, emphasize the management of the disease in patients without immediate fertility needs, improve primary healthcare institutions' capacity for managing PCOS, and mobilize the social support system to encourage patients to seek medical treatment early, thus reducing the occurrence of delayed medical care.

BACKGROUND:Root canal preparation is a key step in root canal therapy.In recent years,with the rapid development of new nickel-titanium instruments,the results of root canal shaping ability have been significantly improved.However,the shaping abilities of different nickel-titanium instruments are also different.At present,there are few reports about the influence of the shaping ability of R-phase heat treatment NIC X-FILE and DENCO Pre-Shaper in simulated curved canals. OBJECTIVE:To compare the shaping effect of NIC X-FILE and DENCO Pre-Shaper nickel-titanium instruments in preparation for simulated curved canals. METHODS:Fifty simulated resin-curved canals were selected and randomly divided into two groups(n=25).NIC X-FILE and DENCO Pre-Shaper nickel-titanium files were used for root canal preparation.The root canal preparation time was recorded.Images of pre-and post-root canal preparation were taken.Image processing and analysis software were used to measure the amount of resin removed from the inner and outer walls of the root canal at each observation point.Statistical software was used to compare the root canal preparation time and centering ability of two kinds of mechanical nickel-titanium files. RESULTS AND CONCLUSION:(1)The average root canal preparation time was(1.58±0.02)minutes in the DENCO Pre-Shaper group and(2.22±0.03)minutes in the NIC X-FILE group.There was a significant difference between the two groups(P<0.05).(2)The amount of resin removed from the inner walls of the root canal of the DENCO Pre-Shaper group at 4,5,7,8,9,and 10 mm from the apical foramen was higher than that of the NIC X-FILE group(P<0.05).The amount of resin removed from the outer walls of the root canal of the DENCO Pre-Shaper group at 3,5,6,7,and 8 mm from the apical foramen was lower than that of the NIC X-FILE group(P<0.05).(3)At 2,4,5,6,7,8,and 9 mm away from apical foramen,the centering ability of the NIC X-FILE group was better than that of the DENCO Pre-Shaper group(P<0.05),and the centering ability of the NIC X-FILE group was the best at 4 mm away from apical foramen.(4)The results show that DENCO Pre-Shaper has higher mechanical efficiency than NIC X-FILE nickel-titanium root canal files.However,the centering ability of DENCO Pre-Shaper is inferior to NIC X-FILE nickel-titanium root canal files.

Objective:To analyze the effect of montelukast combined with budesonide in the treatment of children with intermittent asthma, and the impact on airway remodeling and T helper type 1 (Th1)/T helper type 2 (Th1/Th2) related cytokines.Methods:A prospective study was conducted among 120 children with intermittent asthma admitted to Huanghua Municipal People′s Hospital from December 2021 to February 2023. The children were randomly divided into the control group (60 children treated with budesonide atomizationinhalation) and the observation group (60 children treated with montelukast on the basis of the treatment of control group). Clinical efficacy, airway remodeling indicators [total area of airway (Ao), outer diameter of airway (D) and wall area to total airway cross-sectional area (WA%)], pulmonary function [peak expiratory flow (PEF), forced expiratory volume in 1 second (FEV 1)/forced vital capacity (FVC) and the maximum expiratory flow at 25% of vital capacity (MEF25%)], Th1/Th2 related cytokines, inflammatory factors [tumor necrosis factor-α (TNF-α), interleukin-4 (IL-4), interleukin-6 (IL-6) and interferon-gamma (IFN-γ)], recurrence, and the incidence of adverse reactions were compared between the two groups. Results:The total effective rate in the observation group was higher than that in the control group: 90.00% (54/60) vs. 75.00% (45/60) ( P<0.05). After treatment, Ao, D and WA% in the observation group were lower than those in the control group: (17.58 ± 1.89) mm 2 vs. (19.22 ± 1.94) mm 2, (4.25 ± 0.48) mm vs. (4.48 ± 0.49) mm, (63.75 ± 6.49)% vs. (69.22 ± 7.14)% ( P<0.05). PEF, FEV 1/FVC and MEF25% in the observation group were higher than those in the control group: (3.13 ± 0.34) L/s vs. (2.86 ± 0.35) L/s, (87.45 ± 8.86) % vs. (83.59 ± 8.42) %, (87.63 ± 8.86)% vs. (82.15 ± 8.43)% ( P<0.05). The levels of Th1 and Th1/Th2 in the observation group were higher than those in the control group: (14.13 ± 1.46) % vs. (10.27 ± 1.25) %, 3.46 ± 0.39 vs. 1.88 ± 0.25, and the level of Th2 was lower than that in the control group: (3.96 ± 0.45)% vs. (5.48 ± 0.56)% ( P<0.05). After treatment, the levels of TNF-α and IFN-γ in the observation group were higher than those in the control group: (76.15 ± 7.78) ng/L vs. (66.38 ± 6.47) ng/L, (7.15 ± 0.74) ng/L vs. (6.14 ± 0.66) ng/L. The levels of IL-4 and IL-6 were lower than those in the control group: (77.85 ± 7.96) ng/L vs. (86.42 ± 8.74) ng/L, (37.25 ± 3.89) mg/L vs. (44.23 ± 4.57) mg/L ( P<0.05). The recurrence rate in the observation group was lower than that in the control group: 3.33% (2/60) vs. 15.00% (9/60) ( P<0.05). The incidence rates of adverse reactions in the two groups were without statistically significant difference between the groups ( P>0.05). Conclusions:Montelukast combined with budesonide can reduce airway remodeling in children with intermittent asthma, improve their pulmonary function, Th1/Th2 related cytokines and inflammatory response indicators, and reduce recurrence rate, with good safety.

Objective:To assess the predictive value of aspartate aminotransferase-to-alanine amino-transferase ratio (DRR) on overall survival of patients with pancreatic ductal adenocarcinoma (PDAC) who underwent radical pancreaticoduodenectomy.Methods:A retrospective analysis was performed on the clinical data of 137 patients who underwent radical pancreaticoduodenectomy and were diagnosed with PDAC postoperatively at the Chinese PLA General Hospital from January 2015 to December 2020. There were 97 male and 40 female patients, with an average age of (58±10) years old. The patients were grouped according to the optimal survival risk cutoff value of DRR, and the differences in key clinical and pathological indicators between the groups were compared. Kaplan-Meier method was used for survival analysis, and log-rank test was used for comparison of survival rates. Multivariate Cox analysis was performed to evaluate the prognostic factors affecting survival.Results:The 137 PDAC patients were divided into two groups based on the optimal cutoff value of DRR, namely 1.1: DRR≥1.1 was defined as the high-DRR group ( n=29), and DRR<1.1 was defined as the low-DRR group ( n=108). The cumulative survival rate of the low-DRR group was better than that of the high-DRR group, and the difference was statistically significant ( P=0.003). The results of the multivariate Cox regression analysis showed that DRR≥1.1 ( HR=2.485, 95% CI: 1.449-4.261, P=0.001), preoperative biliary drainage ( HR=1.845, 95% CI: 1.030-3.306, P=0.039), lymph node metastasis N2 stage ( HR=2.240, 95% CI: 1.123-4.470, P=0.022), high tumor differentiation ( HR=2.001, 95% CI: 1.279-3.129, P=0.002), and intravascular cancer emboli ( HR=2.240, 95% CI: 1.123-4.470, P=0.022) were risk factors for poor overall survival in PDAC patients who underwent radical pancreaticoduodenectomy. Conclusion:DRR has predictive value for overall survival after surgery in PDAC patients undergoing radical pancreatoduodenectomy. A DRR of 1.1 or greater is a risk factor for poor overall survival after surgery in PDAC patients.

Objective To develop an Exercise Behavior Perception Scale for Lung Cancer Patients in China,and to test its reliability and validity.Methods According to the health belief model,the first draft of the scale was formed through literature review,semi-structured interview,research group discussion,2 rounds of expert correspondence and pre-survey.A total of 842 patients with lung cancer who received treatment in a tertiary A hospital in Zhengzhou City from October 2022 to April 2023 were selected for investigation,and item analysis,validity analysis,and reliability analysis were applied to adjust the items to form a formal scale.Results The Exercise Behavior Perception Scale for Lung Cancer Patients contained 24 items,and exploratory factor analysis generated 6 common factors,including physical rehabilitation benefits,emotional and mental benefits,information disorders,disease symptom disorders,condition disorders,and psychological disorders.The cumulative variance contribution rate reached 73.916％,and the results of confirmatory factor analysis showed that the model fit was good,the x2/df was 2.371,the root mean square error of approximation was 0.057,the normed fit index was 0.924,and the comparative fit index was 0.954,the scale score was moderately positively correlated with the total score of the Frenchay activities index(r=0.529,P＜0.001).The Cronbach's α,coefficient,half reliability,and retest reliability of the scale were 0.884,0.741,and 0.889,respectively.Conclusion The Exercise Behavior Perception Scale for Lung Cancer Patients had good reliability and validity,and it can be used to effectively evaluate the exercise behavior perception status of lung cancer patients.

AIM: To compare the changes of exotropia deviation in children with basic type of intermittent exotropia before and after monocular occlusion test.METHODS: Prospective clinical study. A total of 258 children with basic type of intermittent exotropia who underwent strabismus correction in our hospital from July 2021 to September 2022 were selected, including 122 males and 136 females, aged from 5 to 12 years, with an average age of 8.0±3.1 years. The exotropia deviation was measured at distance(6 m)and near(33 cm)fixation by prism alternating occlusion method, and the exotropia deviation was checked again after covering the non-dominant eyes of children for 40 min.RESULTS: Before and after the monocular occlusion test, the exotropia deviation at distance(6 m)fixation was 28.23△±10.79△ and 29.79△±10.85△, respectively(t=-0.903, P=0.368), while the exotropia deviation at near(33 cm)fixation was 33.14△±8.89△ and 36.90△±10.76△, respectively(t=-2.377, P=0.019).CONCLUSIONS: Monocular occlusion test has a great impact on the exotropia deviation at near(33 cm)fixation in children with basic type of intermittent exotropia before surgery. It can expose the maximum exotropia deviation, reduce the rate of undercorrection after strabismus surgery, and provide a reliable surgical plan.

Objective: To investigate the resistance to rifampicin and isoniazid and the changing trends among patients with pulmonary tuberculosis in Luohu District, Shenzhen City, Guangdong Province from 2012 to 2022, so as to provide insights into improving drug-resistant pulmonary tuberculosis control and prevention strategies. Methods: Basic information, treatment classification and drug resistance data of patients with pulmonary tuberculosis and positive pathogenic detection in Luohu District from 2012 to 2022 were collected through the Tuberculosis Surveillance System of Chinese Disease Prevention and Control Information System, and resistance rates of rifampicin and isoniazid and the changing trends were analyzed. Results: A total of 2 126 patients with pulmonary tuberculosis were collected and had a median age of 34 (interquartile range, 25) years, including 1 334 males (62.75%) and 792 females (37.25%). There were 302 patients with drug-resistance in Luohu District from 2012 to 2022, with a resistance rate of 14.21%. Among them, 60 patients were monoresistant to rifampicin (2.82%), 113 patients were monoresistant to isoniazid (5.32%), and 129 patients were multidrug resistant (6.07%). The rate of rifampicin monoresistance showed a downward trend from 2012 to 2022, while the rate of multidrug resistance showed an upward trend (both P<0.05). There was no significant tendency in the rate of isoniazid monoresistance (P>0.05). The rate of multidrug resistance among patients without Shenzhen residence was higher than that among patients with Shenzhen residence; the rates of rifampicin resistance and multidrug resistance among retreated patients were higher than those among treatment-naïve patients (all P<0.05). Conclusions The rate of rifampicin monoresistance appeared a downward trend and the rate of multidrug resistance appeared an upward trend among patients with pulmonary tuberculosis in Luohu District from 2012 to 2022. Attention should be given to non-Shenzhen residence and retreated patients.