Objective To observe the effects of tactile/motor stimulation massage on feeding outcomes and neuromotor development levels of preterm infants.Methods A total of 136 preterm hospitalized infants in the neonatal intensive care unit of a tertiary hospital in Yunnan Province from January 2024 to July 2024 were enrolled and randomly assigned to a control group and an experimental group,with 68 cases in each group.The control group received the routine care for preterm infants,while the experimental group received tactile/motor stimulation massage as an intervention in addition to the routine care.The time taken from gavage to oral feeding(d),the rate of complete oral feeding(%),the incidence of feeding intolerance(%),the weight(g),the length(cm),the head circumference(cm),neonatal behavioral neurometric score(NBNA)and Psychomotor development index(PDI)were compared between the two groups.Results The time from gavage to oral feeding in the experimental group(12.73±1.86)days was significantly shorter than that in the control group(13.66±1.68)days,and the difference was statistically significant(P<0.05);the rate of complete oral feeding in the experimental group(89.7%)was significantly higher than that in the control group(70.6%),P<0.05,and the incidence of feeding intolerance in the experimental group(8.8%)was significantly lower than that in the control group(16.2%),P<0.05;The experimental group showed superior results in weight,length,and head circumference compared to the control group(P<0.05);The neonatal behavioral neurometry score of the experimental group(36.16±1.53)was significantly higher than that of the control group(35.10±2.66),P<0.05,and the motor development index in the experimental group(76.88±6.12)was significantly higher than that in the control group(74.34±5.07),P<0.05.Conclusion Tactile/motor stimulation massage can effectively improve the feeding status and promote the neuromotor development of preterm infants.

Objective:To construct a debriefing and reflection training program for nursing undergraduate interns, and to provide a basis for implementing such a program and improve the practical clinical skills of the interns.Methods:Based on competency theory, the draft of the debriefing and reflection training program for undergraduate nursing interns was constructed through literature review and expert conference discussion. Delphi expert consultation was conducted from August to October 2024, and the final version of the program was established based on the experts' opinions. The weight of each indicator was determined using the analytic hierarchy process. Excel 2019 was used for data entry, and SPSS 19.0 was used for data analysis.Results:Two rounds of expert consultation were conducted, with a questionnaire recovery rate of 100.00% for both. The experts consulted in the second round had an authority coefficient of 0.861, a coefficient of variation for each index of 0.048 to 0.237, and a Kendall's concordance coefficient of 0.137 ( P<0.05). The final program included 5 primary indicators, 16 secondary indicators, and 73 tertiary indicators. Conclusions:The debriefing and reflection training program for undergraduate nursing interns proposed in this study has high scientifical validity and reliability. It can provide a reference for debriefing and reflection training of nursing undergraduate interns in China, thereby cultivating qualified clinical nursing talents.

Objective:To explore the differentially expressed tRNA-derived RNA fragment(tRF)and tRNA halves(tiRNA)in plasma of collagen-induced arthritis(CIA)rats,analyze the biological functions and related pathways of the tRF and tiRNAs target genes in order to identify new targets for diagnosis and therapy of rheumatoid arthritis(RA).Methods:Rat model of RA was estab-lished by injecting typeⅡ collagen.Arthritis index(AI)score and HE staining were conducted to evaluate the successfully establishment model.Illumina platform was used to obtain the tRF and tiRNA expression profiles.RT-qPCR was performed to validate expressions of tRF and tiRNA.Combining miRanda and TargetScan databases,the target genes of differentially expressed tRF and tiRNA were ob-tained.GO and KEGG enrichment analysis were used to annotate the functions of target genes.Results:A total of 25 tRFs and tiRNAs were significantly differentially expressed in plasma in rats after modeling,of which 23 were up-regulated and 2 were down-regulated.Besides,six specifically expressed tRFs and tiRNAs induced by CIA rats were screened,including Other-36:73-tRNA-Arg-CCT-4,Other-57:70-tRNA-Glu-CTC-1-M3,tRF-1:32-Gly-CCC-1-M2,tRF-1:31-Gly-CCC-1-M2,tRF-1:32-Pro-AGG-1-M4 and tRF-1:32-Glu-TTC-2-M2.GO analysis of target genes mainly involved organelle-associated items.What's more,KEGG analysis enriched multi-ple classical signal pathways associated with RA.Conclusion:Target genes of differentially expressed tRFs and tiRNAs in CIA rats may be involved in regulating important pathophysiological processes of RA and drug therapy targets.

Objective:To explore the differentially expressed tRNA-derived RNA fragment(tRF)and tRNA halves(tiRNA)in plasma of collagen-induced arthritis(CIA)rats,analyze the biological functions and related pathways of the tRF and tiRNAs target genes in order to identify new targets for diagnosis and therapy of rheumatoid arthritis(RA).Methods:Rat model of RA was estab-lished by injecting typeⅡ collagen.Arthritis index(AI)score and HE staining were conducted to evaluate the successfully establishment model.Illumina platform was used to obtain the tRF and tiRNA expression profiles.RT-qPCR was performed to validate expressions of tRF and tiRNA.Combining miRanda and TargetScan databases,the target genes of differentially expressed tRF and tiRNA were ob-tained.GO and KEGG enrichment analysis were used to annotate the functions of target genes.Results:A total of 25 tRFs and tiRNAs were significantly differentially expressed in plasma in rats after modeling,of which 23 were up-regulated and 2 were down-regulated.Besides,six specifically expressed tRFs and tiRNAs induced by CIA rats were screened,including Other-36:73-tRNA-Arg-CCT-4,Other-57:70-tRNA-Glu-CTC-1-M3,tRF-1:32-Gly-CCC-1-M2,tRF-1:31-Gly-CCC-1-M2,tRF-1:32-Pro-AGG-1-M4 and tRF-1:32-Glu-TTC-2-M2.GO analysis of target genes mainly involved organelle-associated items.What's more,KEGG analysis enriched multi-ple classical signal pathways associated with RA.Conclusion:Target genes of differentially expressed tRFs and tiRNAs in CIA rats may be involved in regulating important pathophysiological processes of RA and drug therapy targets.

Objective:To construct a debriefing and reflection training program for nursing undergraduate interns, and to provide a basis for implementing such a program and improve the practical clinical skills of the interns.Methods:Based on competency theory, the draft of the debriefing and reflection training program for undergraduate nursing interns was constructed through literature review and expert conference discussion. Delphi expert consultation was conducted from August to October 2024, and the final version of the program was established based on the experts' opinions. The weight of each indicator was determined using the analytic hierarchy process. Excel 2019 was used for data entry, and SPSS 19.0 was used for data analysis.Results:Two rounds of expert consultation were conducted, with a questionnaire recovery rate of 100.00% for both. The experts consulted in the second round had an authority coefficient of 0.861, a coefficient of variation for each index of 0.048 to 0.237, and a Kendall's concordance coefficient of 0.137 ( P<0.05). The final program included 5 primary indicators, 16 secondary indicators, and 73 tertiary indicators. Conclusions:The debriefing and reflection training program for undergraduate nursing interns proposed in this study has high scientifical validity and reliability. It can provide a reference for debriefing and reflection training of nursing undergraduate interns in China, thereby cultivating qualified clinical nursing talents.

Objective: To analyze the use of preexposure prophylaxis (PrEP) among male students who had sex with men (MSM) with different sexual behavior patterns using potential categories, so as to provide evidence for determining the use patterns of PrEP consistent with MSM. Methods: A questionnaire survey was conducted by proportional sampling method on MSM in 31 provincial administrative regions in mainland China from 20 October to 30 December 2021, a total of 1 040 students were selected for the study. Latent variable analyses were conducted on a total of seven sexual behavioral characteristics, including knowledge of sexual partner HIV infection, frequency of condom use, number of sexual partners, engaging in group sex, provision of commercial sex, use of sex aids, and history of sexually transmitted infections (STIs) in the past year. And demographic characteristics were analyzed by Logistic regression analysis. The rates of PrEP awareness, willingness to use and usage rate in different sexual behavior risk groups were investigated. Results: Student MSM could be divided into two potential category groups:a lowrisk behavior group (82.4%) and a highrisk behavior group (17.6%). The PrEP usage rate (15.8%) was higher in the highrisk behavior group, and the difference was statistically significant compared to the lowrisk behavior group (7.2%) (χ2=13.43, P<0.05). Student MSM residing in the northeast, south, and northwest of China, in the pilot city, and with a sex role of "0.5" (possible acceptance and insertion of sexual behavior) were more likely to be in the highrisk behavior group (OR=3.13, 3.07, 3.87, 2.22, 1.66, P<0.05). Conclusion Student MSM in highrisk and lowrisk sexual differs in the behavior of PrEP, and targeted interventions should be implemented to promote the use of PrEP and reduce HIV infection in this population.

Objective: To investigate the current situation and related factors of antiretroviral therapy (ART) among HIV infected male students engaging in men who have sex with men (MSM), so as to provide the reference data for HIV prevention and treatment. Methods: In November 2021, 137 MSM students from 31 provincial administrative regions in China were recruited. An online survey was conducted to collect data on demographic characteristics, ART status, CD4 count, and HIV viral load before treatment. Logistic regression was used to analyze the factors related the effectiveness of ART in MSM. Results: Among the included research subjects, 14.6% had late detection of HIV,97.1% of participants were currently undergoing ART. Among those whose ART duration was less than 6 months, while 76.9% were undergoing ART. Logistic regression indicated that HIV infected students who received ART for more than 24 months ( OR =5.28, 95% CI =1.38-20.22) had a higher rate of successful HIV suppression. HIV infected students who reported physical sensory side effects ( OR =0.08, 95% CI =0.01-0.71) and cognitive side effects ( OR =0.28, 95% CI =0.09-0.90) were more likely to experience failure of ARI inhibition ( P <0.05). Conclusions There is still room for improvement in the efficacy of ART among MSM students. Strategies to improve treatment adherence must consider individual variances among HIV infected patients and the side effects of medications when designing treatment plans.

Objective To investigate the feasibility of developing a grading diagnostic model for schistosomiasis-induced liver fibrosis based on B-mode ultrasonographic images and clinical laboratory indicators. Methods Ultrasound images and clinical laboratory testing data were captured from schistosomiasis patients admitted to the Second People’s Hospital of Duchang County, Jiangxi Province from 2018 to 2022. Patients with grade I schistosomiasis-induced liver fibrosis were enrolled in Group 1, and patients with grade II and III schistosomiasis-induced liver fibrosis were enrolled in Group 2. The machine learning binary classification tasks were created based on patients’radiomics and clinical laboratory data from 2018 to 2021 as the training set, and patients’radiomics and clinical laboratory data in 2022 as the validation set. The features of ultrasonographic images were labeled with the ITK-SNAP software, and the features of ultrasonographic images were extracted using the Python 3.7 package and PyRadiomics toolkit. The difference in the features of ultrasonographic images was compared between groups with t test or Mann-Whitney U test, and the key imaging features were selected with the least absolute shrinkage and selection operator (LASSO) regression algorithm. Four machine learning models were created using the Scikit-learn repository, including the support vector machine (SVM), random forest (RF), linear regression (LR) and extreme gradient boosting (XGBoost). The optimal machine learning model was screened with the receiver operating characteristic curve (ROC), and features with the greatest contributions to the differentiation features of ultrasound images in machine learning models with the SHapley Additive exPlanations (SHAP) method. Results The ultrasonographic imaging data and clinical laboratory testing data from 491 schistosomiasis patients from 2019 to 2022 were included in the study, and a total of 851 radiomics features and 54 clinical laboratory indicators were captured. Following statistical tests (t = −5.98 to 4.80, U = 6 550 to 20 994, all P values < 0.05) and screening of key features with LASSO regression, 44 features or indicators were included for the subsequent modeling. The areas under ROC curve (AUCs) were 0.763 and 0.611 for the training and validation sets of the SVM model based on clinical laboratory indicators, 0.951 and 0.892 for the training and validation sets of the SVM model based on radiomics, and 0.960 and 0.913 for the training and validation sets of the multimodal SVM model. The 10 greatest contributing features or indicators in machine learning models included 2 clinical laboratory indicators and 8 radiomics features. Conclusions The multimodal machine learning models created based on ultrasound-based radiomics and clinical laboratory indicators are feasible for intelligent identification of schistosomiasis-induced liver fibrosis, and are effective to improve the classification effect of one-class data models.

Objective To report single-center experience on CBA combined with LAAC in treat-ment of AF.Methods A retrospective study was conducted on 27 AF patients undergoing one-stop surgery of CBA combined with LAAC in Department of Cardiovascular Diseases of the People's Hospital of Liaoning Provincie from August 2020 to November 2022.The efficacy and safety of the surgery were analyzed.Results There were 22 patients(81.5％)with LAmbre and 5 patients with Watchman(18.5％,including one case of 24 mm Watchman FLX).All the patients achieved complete pulmonary vein isolation,and conversion to sinus rhythm during operation.During a mean follow-up of 30.0±9.2 months,24 patients(88.9％)maintained sinus rhythm at 12-month follow-up,and 22 patients(81.5％)maintained sinus rhythm at 24-month follow-up.TEE at 3 months after operation displayed that all the devices were in good positions and no PDL or DRT was observed.In the 11 patients undergoing cardiac enhanced CT in 12-36 months after surgery,PDL was detected in one patient(9.1％),and uncomplete endothelialisation of the device was observed in another one(9.1％)using the Watchman device.TEE at 26 months revealed one patient(3.7％)of DRT.Conclusion One-stop surgery of CBA combined with LAAC is a feasible treatment option for patients with NVAF and at high risk of stroke.

Objective:To analyze the effective and safety of endovascular aneurysm repair (EVAR) for ruptured abdominal aortic aneurysm (RAAA) at one tertiary center, and to improve the outcomes of RAAA under fast-track protocol.Methods:Nineteen cases of RAAA in the 940th Hospital of Joint Logistic Support Force of PLA from January 2014 to December 2020 were reviewed retrospectively. EVAR-fist strategy was employed from the emergency room to the operating room by using fast-track protocol. Preoperative management, anatomic characteristics, choice of anesthesia, operative procedures and postoperative complications were collected and analyzed. Abdominal compartment syndrome (ACS) and hospital mortality were paid special attention.Results:Nineteen cases were undergone EVAR procedures. The age was (73.4 ± 7.4) years old, and the AAA size was (67.8 ± 13.6) mm. Two cases underwent cardiopulmonary resuscitation at emergency department. General anesthesia was used in 13 patients and local anaesthesia in 6 patients. Successful stent graft deployment was achieved in all cases. The duration from emergency room to operating room was (84.8 ± 22.4) min. The hospital stay time was (9.7 ± 5.7) d. The hospital mortality was 5/19. The 5 deaths were reviewed: 3 died for multiple organ failure, 1 for irreversible shock, and 1 for ongoing bleeding.Conclusions:Excellent results were confirmed by using EVAR-first strategy for RAAA. The management of hemodynamically unstable state, standardized endovascular procedure, fast-track program and multidiscipline team collaboration were the very important determining factors for the implementation of EVAR. Focused efforts to reduce RAAA mortality are warranted.