Objective To assess the clinical efficacy of butylphthalide sequential therapy(BST)as an adjuvant therapy for delayed onset encephalopathy caused by acute carbon monoxide poisoning(DEACMP).Methods DEACMP patients who visited the department of neurology at Yan'an People's Hospital from January 2018 to June 2023 were selected as the research subjects.Using a random number table method,DEACMP patients were randomly divided into hyperbaric oxygen therapy(HBOT)group,glucocorticoid(GC)group(GC combined with,HBOT),and BST group(HBOT,GC combined with BST),all of which were treated continuously for 30 days.The incidence of adverse reactions and clinical efficacy during the treatment among three groups of DEACMP were observed and compared.Inflammation indicators,neurological damage indicators,cognitive function,neurological function,and daily living ability before and after treatment among three groups were compared.Results A total of 120 patients were included in the study,with 40 patients in each group.During the treatment period,no serious adverse reactions were observed in any of the three groups of patients,and no patient terminated treatment due to adverse reactions.The total effective rate of BST group was significantly higher than those of GC group and HBOT group,while the total effective rate of GC group was higher than that of HBOT group(P<0.05).Before treatment,there was no statistically significant difference(P>0.05)in the scores of inflammation indicators,neurological damage indicators,cognitive function,neurological function,and daily living function among the three groups.After treatment,the serum LP-PLA2,SIRI,TNF-α,S100-β,and the NSE levels decreased compared to before treatment(P<0.05),and the indicators of the BST group was lower than those of the HBOT group and GC group,while the indicators of the GC group was lower than those of the HBOT group(P<0.05).After treatment,the MMSE,MoCA,and BI scores of the three groups increased compared to before treatment(P<0.05),but the NIHSS score decreased(P<0.05).In addition,the MMSE,MoCA,and BI scores of the BST group were higher than those of the HBOT and GC groups(P<0.05),while the NIHSS scores were lower than those of the HBOT and GC groups(P<0.05).The MMSE,MoCA,and BI scores in the GC group were higher than those in the HBOT group,while the NIHSS scores were lower than those in the HBOT group(P<0.05).Conclusion Compared with HBOT treatment and HBOT combined with GC treatment,BST adjuvant therapy can improve the clinical efficacy,inflammatory status,cognitive function,and daily living ability of DECAMP patients.

Background ¹³⁷Cs in atmospheric aerosol is the product of past nuclear weapon tests and nuclear accidents. When ¹³⁷Cs is released into the atmosphere, it will deposit in dry land and marine environment, causing pollution of soil surface, water, agricultural products, and animal byproducts, and affecting public health. Objective To identify the variation pattern of ¹³⁷Cs activity concentration in aerosol and its correlation with dust concentration in Beijing area from 2017 to 2020. Methods A total of 958 aerosol samples were collected from November 1, 2017 to June 30, 2020 in Beijing with a high volume air sampler at a sampling flow rate about 600 m³·h⁻¹ and a collection time for each sample about 24 h. The activity concentration of ¹³⁷Cs in the aerosol samples was determined with a low-background high-purity germanium γ spectrometer. The dust concentration was calculated using the difference in the mass of the aerosol filter before and after sampling. The detection rate of ¹³⁷Cs and dust concentration in different seasons were compared. Spearman rank correlation test was used to analyze the correlation between ¹³⁷Cs activity concentration and dust concentration. Results From 2017 to 2020, the ¹³⁷Cs activity concentrations of 33 from 958 aerosol samples in Beijing were above the minimum detectable activityconcentration, the overall detection rate of ¹³⁷Cs was 3.4%, and the activity concentration ranged from 1.86 to 45.53 μBq·m⁻³, with a median value of 4.85 μBq·m⁻³. The detection rate of ¹³⁷Cs was highest in spring, followed by autumn, and lowest in winter and summer (8.4%, 3.0%, 1.1%, and 0.5%, respectively). The dust concentration ranged from 0.03 to 1.55 mg·m⁻³, with an average value of 0.18 mg·m⁻³. There was a statistically significant difference in the dust concentrations in spring, summer, autumn, and winter (F=45.51, P<0.05), and the highest value was 0.24 mg·m⁻³ in spring (P<0.05). The ¹³⁷Cs activity concentration was positively correlated with the dust concentration (P<0.05). Conclusion The ¹³⁷Cs activity concentration in aerosol in Beijing from 2017 to 2020 fluctuates within the range of background level, and its activity concentration is highest in spring, followed autumn, and lowest in summer and winter.

AIM: To assess the gap between the peak of the base curve to the surface of the cornea, as well as examines the correlation between the thickness of the tear film and the fitting of the orthokeratology lens through optical coherence tomography(OCT), providing an intuitive and quantitative clinical evaluation method for the fitting of the orthokeratology lens.METHODS: Myopia patients who fitted orthokeratology at our hospital from January to December 2023 were included. Examinations, including naked vision, slit lamp, non-contact intraocular pressure, ocular fundus, eye position, corneal diameter, corneal topography, tear film rupture time, optometry, etc., were performed on all patients before fitting. The trial lens parameter was selected according to the examination results, and fluorescein staining was performed to evaluate lens fitting state after patients adapted to wearing glasses. According to the performance of fluorescein staining, the inspected eyes are divided into three groups: lens loose group, lens fitting group, and lens tight group. In addition, the tear film thickness of three groups of subjects was measured by OCT, and the differences between the three groups of data were evaluated.RESULTS: A total of 49 myopic patients(77 eyes)were included. The average sphere degree was -3.10±1.25 D, the average cylinder degree was -0.43(-0.75, 0)D, the average horizontal keratometry(HK)was 42.48±0.81 D, and vertical keratometry(VK)was 42.98(42.25, 43.50)D. There were 21 cases(34 eyes)in the lens fitting group, with 13 cases of bilateral eyes, 8 cases of one eye, 14 cases(22 eyes)in the lens loose group, with 8 cases of bilateral eyes, 6 cases of one eye, and 14 cases(21 eyes)in the lens tight group, with 7 cases of bilateral eyes, 7 cases of one eye. There was no statistical difference in the main basic data of the subjects in the three groups(all P>0.05). OCT showed that the tear film thickness of the lens fitting group, the lens loose group, and the lens tight group was 231.18(219.0, 243.0), 220.41(214.0, 224.3), and 249.00(241.5, 258.0)μm, respectively, and there was statistical significance in the thickness among the three groups(P<0.05).CONCLUSION: OCT can serve as a safe and reliable method for measuring the tear film thickness, which can help evaluate the suitability of orthokeratology and provide a non-invasive, more intuitive, and quantitative evaluation method for the fitting and evaluation of orthokeratology.

China has classified the Corona Virus Disease 2019(COVID-19) as a statutory category B infectious disease and managed it according to Category B since January 8, 2023.In view that Omicron variant is currently the main epidemic strain in China, in order to guide the treatment of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection in children with the times, refer to the Diagnosis and Treatment Protocol for Novel Coronavirus Infection (Trial 10 th Edition), Expert Consensus on Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fourth Edition) and the Diagnosis and Treatment Strategy for Pediatric Related Viral Infections.The Expert Consensus on the Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fifth Edition) has been formulated and updated accordingly on related etiology, epidemiology, pathogenic mechanism, clinical manifestations, auxiliary examination, diagnosis and treatment, and added key points for the treatment of COVID-19 related encephalopathy, fulminating myocarditis and other serious complications for clinical reference.

Objective:To search, review and summarize the best evidence on promoting maturation of autologous arteriovenous fistula (AVF) in patients undergoing maintenance hemodialysis (MHD) .Methods:In accordance with the relevant methods of evidence-based nursing, evidence was retrieved from relevant websites and databases according to the "6S" pyramid model, including clinical decision-making, guidelines, expert consensus, group standards, and systematic reviews. The search time limit was from April 20, 2012 to April 20, 2022. Two investigators assessed the quality of the evidence, and the evidence team extracted and summarized the evidence.Results:A total of 17 articles were included, including 1 clinical decision-making, 6 guidelines, 1 expert consensus, 1 group standard and 8 systematic reviews. Totally 28 best evidences were summarized from 6 aspects: team education, perioperative management, functional exercise, physical therapy, drug application, first puncture timing and scheme.Conclusions:The best evidence provides a reference for medical staff to standardize the management of AVF in MHD patients. It is recommended that medical staff develop individualized plans based on medical conditions, clinical judgment, and patient wishes when applying relevant evidence.

Objective:To explore the effects of a scenario-based experiential intervention rooted in the transition shock model for the role adaptation of newly employed nurses.Methods:A convenience sampling was used to select newly employed nurses from the First Affiliated Hospital of Xinjiang Medical University between September and November 2020 were designated as the control group ( n=57) , who received standard new nurse training. Those employed between September and November 2021 formed the observation group ( n=62) , who underwent a scenario-based experiential intervention rooted in the transition shock model for three months. The degree of transition shock, psychological resilience, and turnover rates were compared between the two groups. Results:After the intervention, scores on the transition shock scale and its physical, psychological, knowledge and skills, social culture, and development dimensions in the observation group were significantly lower than those in the control group, with statistically significant differences ( P<0.05) . Scores on the Connor Davidson Resilience Scale (CD-RISC) and its tenacity, strength, and optimism dimensions in the observation group were notably higher compared to the control group, which were statistically significant ( P<0.05) . Within one year post-employment, the turnover rates for the observation group and control group were 11.29% (7/62) and 28.07% (16/57) , respectively, with a statistically significant difference ( P<0.05) . Conclusions:The scenario-based experiential intervention founded on the transition shock model can effectively alleviate the transition shocks faced by newly employed nurses. It also enhances their psychological resilience, facilitates their adaptation to new nursing roles, and reduces turnover rates.

Objective To ensure the accuracy of gamma spectrometer in our laboratory for the analysis of radionuclides in samples and to improve the laboratory personnel’s ability to perform analyses of radionuclides. Methods Our laboratory had continuously participated in the national assessments of gamma spectrometry of radionuclides organized by the Chinese Center for Disease Control and Prevention. The samples were measured by a high-purity germanium gamma spectrometer (GEM-MX7080P4). An analysis was performed on the results of the gamma spectrometry assessments from 2014 to 2021. Results Our laboratory had an overall qualified rate of 100% (8/8) and an overall excellent rate of 39% (3/8) in the gamma spectrometry assessments from 2014 to 2021. The distribution ranges of RD, Z, U, and U_rel for 28 measurements involving radionuclides ²⁰⁸Tl, ²²⁸Ac, ²³²Th, ⁴⁰K, ²³⁸U, and ¹³⁷Cs were −11.82% to 5.97%, −0.59 to 0.30, 0.02 to 0.92, and 4.33% to 10.49%, respectively. Conclusion The methods used in our laboratory for gamma spectrometry of radionuclides are accurate and the testing reports issued by our laboratory are reliable.

Monkeypox is a zoonotic disease.Previous studies have shown that children are vulnerable to monkeypox and are also at high risk for severe disease or complications.In order to improve pediatricians′ understanding of monkeypox and achieve early detection, early diagnosis, early treatment and early disposal, the committee composed of more than 40 experts in the related fields of infectious diseases, pediatrics, infection control and public health formulate this expert consensus, on the basis of the latest clinical management and infection prevention and control for monkeypox released by the World Health Organization (WHO), the guidelines for diagnosis and treatment of monkeypox (version 2022) issued by National Health Commission of the People′s Republic of China and other relevant documents.During the development of this consensus, multidisciplinary experts have repeatedly demonstrated the etiology, epidemiology, transmission, clinical manifestations, laboratory examinations, diagnosis and differential diagnosis, treatment, discharge criteria, prevention, case management process and key points of prevention and control about monkeypox.

Since December 2019, severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infections have raged globally for more than 2 years.China has always adopted scientific and effective prevention and control measures to achieved some success.However, with the continuous variation of SARS-CoV-2 cases and imported cases from abroad, the prevention and control work has become more difficult and complex.With the variation of the mutant strain, the number of cases in children changed, and some new special symptoms and complications were found, which proposed a new topic for the prevention and treatment of SARS-CoV-2 infection in children in China.Based on the third edition, the present consensus according to the characteristics of the new strain, expounded the etiology, pathology, pathogenesis, and according to the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of effective prevention and treatment of SARS-CoV-2 infection in children in China.

OBJECTIVE：To optim ize ethanol extraction technology of Mongolian medicine Naru- 3. METHODS ：The L 9（34） orthogonal design was used to optimize ethanol extraction technology of Mongolian medicine Naru- 3 with solid-liquid ratio ，ethanol volume fraction and extraction time as factors ，using comprehensive scores for the contents of benzoylaconitine ，benzoylneoaconitine， benzoylhypoaconitine，aconitine，neoaconitine，hypoaconitine，piperine and gallic acid as indexes. RESULTS ：The optimal ethanol extraction technology was that solid-liquid ratio of 1∶10（g/mL），ethanol volume fraction of 75％，extracting for 1.5 h. After 3 times of validation tests ，average contents of above 8 components in ethanol extract from Naru- 3 were 1.69，1.48，14.69，0.28， 0.05，0.08，26.01，17.33 mg/g（RSDs were 0-4.96％，n＝3），respectively. Average comprehensive score was 19.03（RSD＝1.42％， n＝3）. CONCLUSIONS ：The optimal ethanol extraction technology of Mongolian medicine Naru- 3 is stable and feasible.