Objective To explore the expression level of visceral adipose tissue-derived serine protease inhibitor(Vaspin)and secreted frizzled-related protein5(SFRP5)in the serum of children with idiopathic short stature(ISS)and its diagnostic value.Methods 70 children with ISS diagnosed in the First Hospital of Zhangjiakou from December 2021 to February 2023 were selected as the disease group,while 72 healthy volunteer children who underwent physical examination were collected as the control group.Immunoluminescence was applied to detect the expression level of VASPIN,Enzyme-linked immunosorbent assay(ELISA)was applied to detect the expression level of SFRP5 the clinical data of children in two groups were analyzed.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of serum Vaspin and SFRP5 for ISS,multivariate Logistic regression was used to analyze the influencing factors of ISS.Results Compared with the control group,the serum Vaspin level in the disease group was obviously increased(2.89±0.92 ng/ml vs 1.81±0.42 ng/ml),while the SFRP5 level was obviously reduced(10.22±2.84 pg/ml vs 13.21±3.53 pg/ml),the differences were statistically significant(t=9.040,5.552,all P＜0.05).The weight,height,body mass index(BMI)and proportion of sexual development stage II～V of children in the disease group were obviously lower than those in the control group,and the differences were statistically significant(t=7.687,6.330,5.559,7.024,all P＜0.05).The area under ROC curve showed that the AUC of Vaspin and SFRP5 and their combined detection in the diagnosis of ISS were 0.768,0.849 and 0.925,respectively,the combined diagnosis efficacy of Vaspin and SFRP5 was better than that of serum Vaspin and SFRP5 alone(Z =3.829,P＜0.001;Z =2.141,P=0.032).Multivariate Logistic regression analysis showed that BMI(OR=0.508,95%CI:0.260～0.991),Vaspin(OR=3.458,95%CI:1.125～10.631)and SFRP5(OR=0.378,95%CI:0.153～0.935)were the influencing factors for ISS(all P＜0.05).Conclusion The expression level of Vaspin in the serum of children with ISS is obviously increased,while the expression level of SFRP5 is obviously reduced.The two are influencing factors of ISS,and the combined detection of their expression levels has certain value in the diagnosis of ISS.

Objective To investigate the prevalence of zika virus(ZIKV),dengue virus(DENV)and chikungunya virus(CHIKV)infections in blood donors in Kunming,China.Methods A total of 10 662 samples from blood donors in Kunming from August 2022 to October 2023 were randomly collected,and ZIKV RNA,DENV RNA and CHIKV RNA were detected by real-time fluorescence quantitative reverse transcription polymerase chain reaction(RT-qPCR).Results Effec-tive test results were obtained from 10 554 samples,and no positive case of ZIKV RNA,DENV RNA and CHIKV RNA was found in this investigation.Conclusion The risk of ZIKV,DENV and CHIKV infections among blood donors in Kunming is low,and there is no immediate need for routine screening for these viruses among blood donors in this region.

Objective:To assess the safety and feasibility of selectively preserving the first branch of the right gastro-omental artery using bidirectional dissection in laparoscopic pylorus-preserving gastrectomy (LPPG).Methods:In this retrospective analysis, we studied preoperative, intraoperative, postoperative, and follow-up data of 30 patients with early gastric cancer treated in the Department of Gastric Cancer in Zhejiang Cancer Hospital (28 patients), Department of Gastrointestinal Surgery in Jiaxing Second Hospital (one patient) and Department of Gastrointestinal Surgery in Hangzhou Red Cross Hospital (one patient) who had undergone selective preservation of the first branch of the right gastro-omental artery during LPPG. The main variables studied were as follows: (1) intraoperative preservation of the first branch of the right gastro-omental artery; (2) the overall surgical situation; and (3) postoperative small bowel follow-through and endoscopy findings.Results:LPPG with selective preservation of the right gastro-omental artery vascular branch was achieved in all 30 of the study patients. The mean operation time was (244.3±29.3) minutes and the median intraoperative blood loss 50 (20–200) mL. The median tumor diameter was 1.2 (0.5–3.6) cm and an average of 32.3±11.6 lymph nodes were dissected. The overall median number of positive lymph nodes was 0 (0–6), and of No. 6 lymph nodes 5.1±1.5. Postoperative feeding resumed at an average of 5.2±0.5 days and the postoperative hospital stay averaged 8.4±3.4 days. Pathological stages were as follows: T1a (14 cases), T1b (10 cases), and T2 (6 cases). Small bowel follow-through imaging showed good results in 28 patients 5 days post-surgery, the remaining two exhibiting good results 9 days post-surgery. There were no instances of delayed gastric emptying, and only one patient (3.3%) developed intra-abdominal infection (resolved with conservative treatment).Conclusion:Selective preservation of the right gastro-omental artery during laparoscopic early gastric cancer surgery is a safe and feasible procedure for treating early mid-gastric body cancer with pyloric preservation.

Objective:To assess the safety and feasibility of selectively preserving the first branch of the right gastro-omental artery using bidirectional dissection in laparoscopic pylorus-preserving gastrectomy (LPPG).Methods:In this retrospective analysis, we studied preoperative, intraoperative, postoperative, and follow-up data of 30 patients with early gastric cancer treated in the Department of Gastric Cancer in Zhejiang Cancer Hospital (28 patients), Department of Gastrointestinal Surgery in Jiaxing Second Hospital (one patient) and Department of Gastrointestinal Surgery in Hangzhou Red Cross Hospital (one patient) who had undergone selective preservation of the first branch of the right gastro-omental artery during LPPG. The main variables studied were as follows: (1) intraoperative preservation of the first branch of the right gastro-omental artery; (2) the overall surgical situation; and (3) postoperative small bowel follow-through and endoscopy findings.Results:LPPG with selective preservation of the right gastro-omental artery vascular branch was achieved in all 30 of the study patients. The mean operation time was (244.3±29.3) minutes and the median intraoperative blood loss 50 (20–200) mL. The median tumor diameter was 1.2 (0.5–3.6) cm and an average of 32.3±11.6 lymph nodes were dissected. The overall median number of positive lymph nodes was 0 (0–6), and of No. 6 lymph nodes 5.1±1.5. Postoperative feeding resumed at an average of 5.2±0.5 days and the postoperative hospital stay averaged 8.4±3.4 days. Pathological stages were as follows: T1a (14 cases), T1b (10 cases), and T2 (6 cases). Small bowel follow-through imaging showed good results in 28 patients 5 days post-surgery, the remaining two exhibiting good results 9 days post-surgery. There were no instances of delayed gastric emptying, and only one patient (3.3%) developed intra-abdominal infection (resolved with conservative treatment).Conclusion:Selective preservation of the right gastro-omental artery during laparoscopic early gastric cancer surgery is a safe and feasible procedure for treating early mid-gastric body cancer with pyloric preservation.

Objective To analyze the research hotspots and trends in the field of cancer pain drugs based on literature.Methods This article included research literature related to cancer pain and drugs published in the China National Knowledge Infrastructure(CNKI)and Web of Science databases.The visual analysis of the literature was performed by software of VOS-viewer 1.6.18 and CiteSpace 6.2.R3,including drawing the graphs and comparing the number of published articles,journals,institutions,authors and keywords were also analyzed.Results A total of 4 774 literatures were included.The journals with the largest number of articles published were the Chinese Journal of Pain Medicine and the Journal of Pain and Symptom Management.The authors with the highest number of articles published were Liu Duanqi and Bruera Eduardo.The institutions with the highest number of publications were Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology,and the University of Texas Anderson Cancer Center.The most frequent keyword was cancer pain.The keywords with the strongest citation bursts included Clinical efficacy average daily cost,and primary care.Conclusion Since the beginning of the 21st century,the research on cancer pain drugs has gradually heated up,and the number of papers has shown an upward trend.From 2019 to 2022,the research on cancer pain drugs at home and abroad mainly focused on the clinical efficacy and average daily cost.This article has clarified the research hotspots of cancer pain drugs in recent years to a certain extent and has certain reference significance for future research.

Objective:To explore the mediating effect of psychological resilience between structural empowerment and work engagement of clinical nurses.Methods:This study was a cross-sectional study. Using the convenient sampling method, a total of 1 723 nurses from three Class Ⅲ Grade A hospitals in Henan Province were selected as the research objects from March to May 2023. The survey was conducted using general information questionnaire, Conditions of Work Effectiveness Questionnaire-Ⅱ (CWEQ-Ⅱ), Nurses Psychological Resilience Scale and Utrecht Work Engagement Scale (UWES). Pearson correlation analysis was used to explore the correlation between structural empowerment, psychological resilience and job engagement. AMOS 24.0 software was used to establish the structural equation model and analyze the mediating effect.Results:A total of 1 723 questionnaires were sent out in this study, and 1 590 were effectively collected, with an effective recovery rate of 92.28%. The total scores of structural empowerment, psychological resilience and job engagement of 1 590 clinical nurses were (70.42±15.61), (96.84±13.15) and (62.24±11.02), respectively. Pearson correlation analysis showed that job engagement was positively correlated with structural empowerment and psychological resilience ( r=0.637, 0.670, P<0.01). The results of structural equation model showed that psychological resilience had a partial mediating effect between structural empowerment and job engagement. The mediating effect value was 0.321, accounting for 48.86% of the total effect. Conclusions:In this study, the structural empowerment, psychological resilience and job engagement of clinical nurses are above the medium level, and psychological resilience has a partial mediating effect between structural empowerment and job engagement. Nursing managers should fully empower nurses at the organizational level, take targeted measures to improve their psychological resilience and enhance their level of work engagement.

【Objective】 To explore the intention of voluntary blood donation in students from a middle vocational school in Jinhua and its influencing factors. 【Methods】 A total of 400 students were enrolled from a middle vocational school in Jinhua by convenience sampling, and a self-designed questionnaire was issued to each student to investigate the cognition, intention and attitude of voluntary blood donation. The influencing factors of voluntary blood donation intention were analyzed by Logistic regression. 【Results】 A total of 394 valid questionnaires(98.50%) were collected. For 394 surveyed students, the average score of cognition of voluntary blood donation was (7.27±2.69) points, and the overall rate of intention to voluntary blood donation was 21.32%. Logistic regression analysis equation consisted of family support, better cognition, feeling happy about blood donation and worrying about blood donation, with risk ratios(OR) as 31.78, 188.69, 26.27 and 0.01, respectively(all P<0.05). 【Conclusion】 Students from a middle vocational school showed poor congnition and intention of voluntary blood donation.Family support for voluntary blood donation, better cognition of voluntary blood donation and happiness for blood donation were positive factors, and the fear of blood donation was a negative factor.It is necessary to strengthen the publicity of blood donation among students in middle vocational school to improve their congnition and intention to voluntary blood donation.

Objective:To investigate the effects of miRNA-30a-5p (miR-30a-5p) and metadherin (MTDH) on the proliferation, invasion and migration abilities of human breast cancer cells in vitro.Methods:The expression of MTDH in cancer and paracancerous tissues of 112 breast cancer patients in the database and miR-30a-5p in cancer and paracancerous tissues of 103 breast cancer patients in the database were analyzed using data from The Cancer Genome Atlas (TCGA) database. Pearson correlation analysis was used to analyze the correlation between miR-30a-5p and MTDH in 1 222 breast cancer patients in the database; the data were updated to August 2022. Breast cancer MDA-MB-231 cells were divided into negative control group (transfected with negative control sequence), miR-30a-5p overexpression group (transfected with miR-30a-5p mimics), siMTDH group [transfected with small interfering RNA against MTDH (siMTDH)], siMTDH+miR-30a-5p overexpression group (transfected with both siMTDH and miR-30a-5p mimics); cell proliferation ability was detected by methyl thiazol tetrazolium (MTT) assay, cell migration ability was detected by cell scratch assay, cell invasion ability was detected by Transwell assay. The relative expressions of miR-30a-5p, MTDH, matrix metalloproteinase (MMP)-2, MMP-9, vimentin and β-catenin mRNA in cells were detected by quantitative real-time fluorescence polymerase chain reaction (qRT-PCR), and the expressions of MTDH, N-cadherin (N-cad), β-catenin, Snail and MMP-9 proteins were detected by Western blotting.Results:In the TCGA database, MTDH expression level was higher and miR-30a-5p expression level was lower in breast cancer tissues compared with paracancerous tissues, and the differences were statistically significant (both P < 0.001). There was a negative correlation between MTDH and miR-30a-5p expressions in 1 222 patients with breast cancer ( r=-0.134, P < 0.001). Compared with the negative control group, the cell proliferation ability was reduced in both siMTDH group and miR-30a-5p overexpression group at 24, 48 and 72 h (all P < 0.001). The cell scratch healing rate in miR-30a-5p overexpression group and siMTDH group was lower than that in negative control group [(61.6±1.6)%, (54.7±5.9)% vs. (80.3±3.0)%] (both P < 0.05). Compared with the negative control group, The number of migrated cells in miR-30a-5p overexpression group and siMTDH group was less than that in negative control group (881±50, 725±63 vs. 1 172±66) (both P < 0.05). Compared with the negative control group, the relative expressions of MMP-2, MMP-9, vimentin and β-catenin mRNA were all down-regulated in MDA-MB-231 cells of miR-30a-5p overexpression group and siMTDH group (all P < 0.05). Compared with the negative control group, the relative expressions of N-cad, β-catenin, Snail and MMP-9 proteins were down-regulated in MDA-MB-231 cells of miR-30a-5p overexpression group and siMTDH group (all P < 0.05). There was no statistical difference in the number of migrated MDA-MB-231 cells between siMTDH+miR-30a-5p overexpression group and siMTDH group (476±5 vs. 389±46, t = 3.37, P = 0.078). There was no statistical difference in the number of migrated cells between siMTDH+miR-30a-5p overexpression group and miR-30a-5p overexpression group (476±5 vs. 477±22, t = 0.02, P = 0.983). Conclusions:The expression of miR-30a-5p is negatively correlated with the expression of MTDH in breast cancer tissues, and either overexpression of miR-30a-5p or silence of MTDH in breast cancer MDA-MB-231 cells in vitro can inhibit cell proliferation, invasion and migration, but MTDH may not be a target gene of miR-30a-5p.

Objective:To preliminary explore the potential application value of ultrasound shear wave elastography (SWE) in assessing functional defecation disorders compared with anorectal manometry and X-ray defecography.Methods:From July 2022 to December 2022, the results of SWE, anorectal manometry and X-ray defecography of 39 patients with functional defecation disorders visited Sir Run Run Shaw Hospital, School of Medicine of Zhejiang University were retrospectively analyzed. Non-parametric tests were used to analyze the changes in elastic modulus values of anorectal muscle groups at different phase.Chi-square test and Bland-Altman plots were used to assess the consistency between SWE, X-ray defecography and anorectal manometry in evaluating spastic pelvic floor syndrome, as well as the changes in the anorectal angle measured by SWE and X-ray defecography (from resting phase to contraction phase, resting phase to strain phase (Valsalval maneuver).Results:The elastic modulus values measured by SWE of the puborectalis muscle, internal anal sphincter, and external anal sphincter of patients with functional defecation disorders during strain phase were 32.4 kPa (19.1 kPa, 60.3 kPa), 25.3 kPa (17.0 kPa, 53.8 kPa), and 28.6 kPa (21.3 kPa, 55.1 kPa), respectively, which had no statistically significant differences compared to elastic modulus values in resting phase (33.5 kPa (22.1 kPa, 44.9 kPa), 28.9 kPa (22.4 kPa, 45.1 kPa), and 32.4 kPa (23.1 kPa, 49.4 kPa), all P>0.05). The consistency between SWE and X-ray defecography in the diagnosis of spastic pelvic floor syndrome was poor (Kappa=0.190). The consistency between SWE and anorectal manometry in the diagnosis of dyssynergic defecation was poor (Kappa=0.160). The differences in the changes of anorectal angle detected by SWE and X-ray defecography were within the 95% consistency limit ( P=0.429 and 0.582). Conclusion:SWE is sensitive in evaluating changes in anorectal angle, and it shows good consistency with defecography in assessing angle changes.

Objective:To compare the efficacy of double thread elastic locking intramedullary nail (ELIN) and threaded elastic intramedullary nail (TEIN) in the treatment of mid-shaft clavicular fracture.Methods:From August 2017 to September 2020, 33 patients with mid-shaft clavicular fractures were treated with ELIN (double threaded nail group), including 14 males and 19 females, age 52.09±16.32 years old; Robinson classification: 20 cases of type 2A2, 6 cases of type 2B1, and 7 cases of type 2B2. Thirty-two patients were selected as the control group with TEIN fixation (single threaded nail group) during the same period, including 13 males and 19 females; age 43.25±15.03 years old; Robinson classification: 19 cases of type 2A2 and 5 cases of type 2B1, 8 cases of 2B2 type. The operation time, intraoperative incision length, fracture healing time, internal fixation removal time, Constant-Murley shoulder joint score, disabilities of the arm, shoulder, and hand (DASH) score, fracture reduction and postoperative complications were compared between the two groups.Results:The patients in both groups were followed up after operation, the double-threaded screw group was followed up for 16-48 weeks (average, 23.7 weeks), and the single threaded nail group was followed up for 15-51 weeks (average, 22.9 weeks). The operation time of the double threaded nail group and the single threaded nail group were 19.45±6.74 min and 19.59±4.98 min, and the length of the incision was 1.70±0.79 cm and 1.73±0.84 cm. The fracture healing time were 12.12±1.29 weeks and 13.88±1.84 weeks. The internal fixation removal time was 13.09±1.31 weeks and 15.69±1.94 weeks. The Constant-Murley shoulder score was 93.18±3.78 points and 90.09±4.03 points, and the DASH scores were 1.49± 0.49 points and 3.85±1.13 points; There was no significant difference in operation time and incision length between the two groups ( t=0.01, 0.19; P>0.05), while fracture healing ( t=3.70, P<0.001), internal fixation removal time ( t=6.34, P<0.001), Constant-Murley shoulder score ( t=3.19, P<0.001), DASH score ( t=10.95, P<0.001) differences were statistically significant. The length of the clavicle on the healthy side was 16.38±1.09 cm in the double threaded nail group, and the length of the clavicle on the affected side after internal fixation removal was 16.33±1.12 cm. There was no obvious shortening deformity on the affected side, and there was no significant difference in the length of the clavicle between the two sides ( t=1.57, P=0.127). The clavicle lengths of the healthy side and the affected side after internal fixation removal in the single threaded nail group were 16.55±1.12 cm and 15.12±1.18 cm, and the difference was statistically significant ( t=8.02, P<0.001). The postoperative shortening values of the double-threaded screw group and the single-threaded screw group were 9.47±2.12 mm and 17.41±2.42 mm, and the difference was statistically significant ( t=14.07, P<0.001). Postoperatively, 5 cases of bursitis and 2 cases of skin irritation occurred in the double threaded nail group; While 6 cases of bursitis, 3 cases of skin irritation, 4 cases of shortening malunion, and 1 case of broken nail occurred in the single threaded nail group (fracture delayed union after replacement of internal fixation); the other patients did not experience screw retraction, wound infection, delayed fracture union or nonunion, neurovascular injury, and achieved osseous union. Conclusion:Both elastic intramedullary nails are effective surgical methods for the treatment of middle clavicle fractures, and the operation time is short and minimally invasive. However, compared with the TEIN, the fracture healing time of the double-threaded ELIN is shorter, the internal fixation removal time is earlier, the shoulder joint and upper limb function is better, and the shortening deformity is less likely to occur.