Objective To understand the capacity of technical support institutions for occupational disease prevention and treatment in Ningxia Hui Autonomous Region (hereinafter referred as "Ningxia"). Methods The basic data of 26 technical support institutions for occupational disease prevention and treatment in Ningxia in 2023 were collected through the "National Management Platform for Technical Support Institutions for Occupational Disease Prevention and Treatment". The status of these institutions was investigated, and their qualifications, human resources, equipment allocation, and testing capacities were analyzed. Results Among the 26 technical support institutions for occupational disease prevention and treatment in Ningxia, all were qualified occupational disease surveillance institutes, eight were qualified occupational hazard factor monitoring institutes, two were qualified occupational medical examination institutes, one was a qualified occupational diagnosis institute, one was a qualified occupational treatment institute, four were qualified for radiological health technical services, and one was qualified for occupational health technical services. A total of 168 professionals engaged in occupational diseases prevention and treatment, with the majority holding a bachelor degree and junior professional titles, accounting for 66.1% and 40.5%, respectively. The technical support institutions for occupational disease prevention and treatment of the district level,city level and county level of Ningxia were provided with 121, 68 and 32 instruments and equipment respectively on average,and the number of testing items of occupational hazard factors which the institutions of aforementioned levels are 50.0,17.0 and 1.3 respectively. Conclusion The technical support institutions for occupational disease prevention and treatment in Ningxia show insufficient qualifications and capacities, inadequate professional staff, imbalanced talent structure, incomplete equipment allocation, weak testing capacity, and an underdeveloped support system.

Objective:To analyze the results of the practice test and formal test of the annual professional proficiency test for residents in 2022, to investigate related influencing factors and the effectiveness of the practice test, and to propose the measures for improving the results of the annual professional proficiency test.Methods:The scores of the annual professional proficiency test were analyzed for 202 residents who participated in the test in 2022, and the data on sex, education background, type of personnel, whether they passed the medical licensing examination, and practice test scores were analyzed to investigate related influencing factors. SPSS 23.0 and GraphPad Prism 8 were used for the chi-square test, the t-test, the one-way of variance, and the Fisher's exact test. A multiple linear regression analysis was used to identify influencing factors, and a Pearson correlation analysis was also performed. Results:The scores of the annual professional proficiency test for 202 residents were normally distributed with the highest number of the residents with a score of 90-99 points and the lowest number of the residents with a score of <70 points. The residents who passed the medical licensing examination had a significantly higher score of the annual professional proficiency test than those who failed the examination ( t=2.87, P=0.005), and the residents who passed the three practice tests had a significantly higher score of the annual professional proficiency test than those who failed the practice tests ( P<0.05). The score of the second practice test, the score of the third practice test, and the passing of medical licensing examination were independent influencing factors for the score of annual professional proficiency test ( R2=0.236, R2=0.201, F=6.60, P<0.05). The correlation analysis showed that the scores of the three practice tests were positively correlated with the final score ( r=0.189, 0.373, and 0.311, P<0.05). Conclusions:Improving the passing rate of medical licensing examination and strengthening pre-examination practice tests can help to improve the score of annual professional proficiency test. At the same time, it is necessary to improve the quality of training through the measures such as strengthening the homogenization management of different types of students, improving the attention and enthusiasm of all levels, and accelerating the construction of question banks.

Objective:To investigate the application effect of the comprehensive innovative teaching model with "3D printed model combined with visual surgical simulation" as the core in the clinical teaching of extremity bone defects.Methods:The physicians who participated in the clinical management of patients with extremity bone defects in Department of Orthopedics, Peking University Third Hospital, from March 2019 to December 2021 were selected as subjects and were divided into standardized training group with 52 physicians and refresher physician group with 58 physicians. Teaching and training was performed for the special disease of extremity bone defects, including basic knowledge teaching, dressing change for infected wounds, multidisciplinary discussion, digital surgical simulation, and practical surgical operation. The assessment indices for teaching quality included the assessment of theoretical knowledge and clinical skills, the objective evaluation of the clinical ability of patient management, and an investigation of the degree of satisfaction. SPSS 22.0 was used for the t-test and the chi-square test. Results:After training, both groups had significant increases in the assessment scores of theoretical knowledge [(32.4±6.7）and (42.2±3.8)] and clinical practice skills [(19.6±2.0), (20.8±2.2), (20.5±2.5), (21.5±2.3)]( P<0.05). After training, the standardized training group had significant increases in the scores of six objective evaluation indicators [(8.3±0.8) vs. (6.9±1.1), (7.4±0.7) vs. (6.3±1.5), (7.2±1.3) vs. (5.0±1.4), (7.9±1.2) vs. (4.0±1.5), (8.4±0.8) vs. (6.4±1.6), (40.3±2.6) vs. (28.6±2.4)]( P<0.01), while the refresher physician group had significant improvements in four aspects, i.e., the understanding of extremity bone defects [(8.1±0.9) vs. (7.2±1.1)], the self-confidence in facing complex extremity bone defects [(8.1±1.2) vs. (6.6±0.9)], spatial thinking ability in repair surgery for bone defects [(8.6±0.8) vs. (7.3±0.9)], and overall clinical performance in actual management of patients with bone defects [(41.4±2.3) vs. (37.3±1.8)] ( P<0.01). The satisfaction score for this comprehensive innovative teaching model was (95.3±3.2) points in the standardized training group and (94.8±2.8) points in the refresher physician group. Conclusions:The comprehensive innovative teaching model with "3D printed model combined with visual surgical simulation" as the core can significantly improve the basic knowledge and clinical skills of physicians in a short period of time and meet the needs for learning surgical techniques and advanced diagnosis and treatment concepts among refresher physicians.

Objective:To investigate the effects of the "TECK" (theoretical class, experimental course, case discussion, and knowledge reinforcement) teaching model oriented by post competency in clinical pathology internship teaching.Methods:The intern students from 2015 to 2019 in the pathology direction of clinical medicine in the School of Pathology, Qiqihar Medical College, who were enrolled in the internship from 2019 to 2023, were selected as the research objects.We enrolled 32 medical students from grades 2017, 2018, and 2019 (research group) and 24 medical students from grades 2015 and 2016 (control group) who would participate in pathology internships. The control group adopted the traditional internship mode, while the research group adopted the competency-oriented "TECK" teaching mode. After the internship, the two groups were compared for internship assessment score and surveyed for post competency. With the use of SPSS 18.0 statistical software. Continuous data were presented as (mean±standard deviation) and t-test was used for comparison between groups. Count data were expressed in the number of cases, and chi-square test was used for comparison between groups.The significance level α was 0.05. Results:The research group showed significantly higher scores of skill assessment (82.81±4.20 vs. 79.58±5.09) and pathological diagnosis assessment (80.28±4.23 vs. 76.21±4.58) than the control group (both P<0.05), with no significant difference in the score of theoretical knowledge ( P>0.05). In terms of post competency, the research group was superior to the control group in clinical skills and medical care ability (12.38±0.94 vs. 11.35±0.76), disease prevention and health promotion ability (6.28±0.92 vs. 4.48±0.93), interpersonal communication and information management ability (19.81±1.09 vs. 17.00±1.28), and teamwork and scientific research ability (11.44±1.27 vs. 9.25±0.87; all P<0.05). There were no significant differences between the two groups in core values and professional literacy and medical knowledge and lifelong learning (both P>0.05). Conclusions:In undergraduate internships, the competency-oriented "TECK"teaching mode can significantly improve students' clinical operation and pathological diagnosis ability, and effectively cultivate their abilities of clinical skills and medical care, disease prevention and health promotion, interpersonal communication and information management, teamwork and scientific research.

Objective To evaluate the clinical application value of medical tissue glue in the treatment of acute hemoptysis by bronchial arterial embolization(BAE).Methods The clinical data of 78 patients who underwent emergency BAE for hemoptysis were retrospectively collected.Among them,18 patients who underwent embolization with medical tissue glue were selected as a study group,and other 18 patients who underwent embolization with absorbent gelatin sponge particles and spring coil were selected as a control group.The technical success rates,average surgical operation time,average surgical cost,postoperative hemoptysis recur-rence rate,and incidence of adverse reactions of the two groups were compared and analyzed.Results The technical success rates of the two groups were both 100％.There were no statistically significant differences in recurrence rate of postoperative hemoptysis and incidence of adverse reactions between the two groups(P＞0.05).The average surgical operation time of study group and control group were 53.4 min[(53.4±2.2)min]and 65.4 min[(65.4±2.8)min],and the average surgical cost were 3 651 yuan[(3 651±102.7)yuan]and 5 094 yuan[(5 094±136.3)yuan],respectively.Compared with the control group,the average surgical operation time and aver-age surgical cost of the study group were shorter,and the differences were statistically significant(P＜0.05).Conclusion Compared with absorbent gelatin sponge particles combined with spring coil embolization,the use of medical tissue glue for embolization is also safe and effective in the treatment of acute hemoptysis patients by BAE.The average surgical operation time is shorter,and the surgical cost for patients is lower.It is worth promoting in clinical practice.

Objective:The aim of noise quality management for ICU patients was to explore the clinical feasibility of noise quality management.Methods:A randomized controlled trial method and convenient sampling method were used to select 240 patients treated in the ICU of Shanghai Fengxian District Central Hospital from April 2021 to March 2023 as the study objects. According to the time of admission, 120 patients admitted from April 2021 to March 2022 were divided into the control group. A total of 120 patients admitted to hospital from April 2022 to March 2023 were included in the intervention group. The control group was given routine care, and noise quality management was implemented in the intervention group on the basis of routine care. The noise decibel value, sleep quality, incidence of delirium and patient satisfaction of the two groups were compared.Results:In the intervention group, there were 69 males and 51 females, aged (56.08 ± 5.74) years old. The control group included 68 males and 52 females, aged (56.11 ± 5.72) years old. The decibels of day and night in ICU of the intervention group were (42.62 ± 1.33) and (38.72 ± 1.28) dB, which were lower than those of the control group (67.49 ± 2.36) and (59.65 ± 2.37) dB, with statistically significant differences ( t=100.57, 85.12, both P<0.05). Total score of sleep quality of patients in the intervention group (78.40 ± 5.86) was higher than that of the control group (60.49 ± 6.25), with statistically significant differences ( t=24.32, P<0.05). The incidence of delirium in the intervention group 12.50%(15/120), was lower than that in the control group 26.67%(32/120) with a statistically significant difference ( χ2=7.65, P<0.05). Satisfaction of patients in the intervention group 97.50%(117/120) was higher than that in the control group 90.00%(108/120), with a statistically significant difference ( χ2=5.76, P<0.05). Conclusions:The application of noise quality management for ICU patients is conducive to improving the overall environment of the ward, improving the sleep quality of patients, reducing the occurrence of patients′ delirium and improving patient satisfaction.

Objective To investigate the predictive value of soluble growth-stimulated expressed gene 2 protein(sST2)in predicting sepsis-associated acute kidney injury(SA-AKI).Methods From January 2020 to December 2023,a total of 395 sepsis patients with sepsis from the Emergency Department,Affiliated Hospital of Nantong University were enrolled in this retrospective observational study.These patients were further categorized into two groups:AKI group(114 cases)and non-AKI group(281 cases).Clinical data and laboratory indicators were collected within 24 hours after admission.ROC curve analysis was used to evaluate the diagnostic ability of sST2 for SA-AKI.Logistic regression analysis was performed to assess independent risk factors for the development of SA-AKI.Concurrently,two predictive models for SA-AKI were constructed,and the predictive ability of sST2 for SA-AKI was assessed using the Area Under the Curve(AUC),the Net Reclassification Index(NRI)and the Integrated Discrimination Improvement(IDI).Results T The levels of sST2 were significantly higher in the AKI group compared to the non-AKI group(P＜0.001).The AUC predicted by sST2(0.839,95%CI:0.799～0.874)in sepsis patients with AKI was significantly superior to other laboratory indicators(P＜0.000 1).An sST2 concen-tration greater than 85 ng/mL independently increased the risk for SA-AKI(OR:14.315,95%CI:5.867～34.926,P＜0.001).Incorporating sST2 into the prediction model substantially improved the AUC values(0.954 vs.0.909,P＜0.000 1),NRI(21.48%,95%CI:11.48%～31.49%,P＜0.000 1)and IDI(8.62%,95%CI:5.75%～11.49%,P＜0.000 1).Conclusion sST2 has the potential to serve as a promising biomarker for prognosticating AKI in septic patients.

Objective:The transjugular or transfemoral approach is used as a common method for hepatic venous pressure gradient (HVPG) measurement in current practice. This study aims to confirm the safety and effectiveness of measuring HVPG via the forearm venous approach.Methods:Prospective recruitment was conducted for patients with cirrhosis who underwent HVPG measurement via the forearm venous approach at six hospitals in China and Japan from September 2020 to December 2020. Patients' clinical baseline information and HVPG measurement data were collected. The right median cubital vein or basilic vein approach for all enrolled patients was selected. The HVPG standard process was used to measure pressure. Research data were analyzed using SPSS 22.0 statistical software. Quantitative data were used to represent medians (interquartile ranges), while qualitative data were used to represent frequency and rates. The correlation between two sets of data was analyzed using Pearson correlation analysis.Results:A total of 43 cases were enrolled in this study. Of these, 41 (95.3%) successfully underwent HVPG measurement via the forearm venous approach. None of the patients had any serious complications. The median operation time for HVPG detection via forearm vein was 18.0 minutes (12.3~38.8 minutes). This study confirmed that HVPG was positively closely related to Child-Pugh score ( r = 0.47, P = 0.002), albumin-bilirubin score ( r = 0.37, P = 0.001), Lok index ( r = 0.36, P = 0.02), liver stiffness ( r = 0.58, P = 0.01), and spleen stiffness ( r = 0.77, P = 0.01), while negatively correlated with albumin ( r = -0.42, P = 0.006). Conclusion:The results of this multi-centre retrospective study suggest that HVPG measurement via the forearm venous approach is safe and feasible.

Objective To compare the detection rates of X-ray,ultrasound,computed tomography(CT)and cone beam CT(CBCT)for submandibular gland calculi in different positions,and to explore the auxiliary value of 3-dimensional visualization technology in diagnosis and treatment of submandibular gland calculi.Methods The X-ray,ultrasound,CT and CBCT examination data of 113 patients with submandibular gland calculi at General Hospital of Ningxia Medical University from Nov.2014 to Mar.2021 were retrospectively analyzed.The detection rates and overall detection rates of the 4 imaging methods for calculi in different positions were compared.Mimics 19.0 software and CBCT data were used for 3D reconstruction imaging,visually displaying the location,size,morphology,and number of calculi from a visual perspective.Results There was no significant difference in the total detection rate of submandibular gland calculi between CBCT and CT(98.2％[111/113]vs 95.6％[108/113],P＞0.05),but both were significantly higher than that of X-ray(65.5％,74/113)and ultrasound(73.5％,83/113).The detection rates of ultrasound for calculi in the anterior and middle ducts were the lowest(63.6％[21/33]and 72.2％[26/36],respectively),which were significantly different from those of CBCT(97.0％[32/33]and 100.0％[36/36],respectively)and CT(93.9％[31/33]and 97.2％[35/36],respectively)(all P＜0.05).The detection rate of X-ray for calculi in the posterior duct was significantly lower than that of ultrasound,CBCT,and CT(40.9％[18/44]vs 81.8％[36/44],97.7％[43/44],and 95.5％[42/44],all P＜0.01).After CBCT data were imported into Mimics 19.0 software,submandibular gland calculi with different sizes,shapes,or numbers were successfully visualized and reconstructed.The reconstructed image was clear,and anatomical position relationship between the calculi and the mandible was visualized.Conclusion CBCT has good application value in the diagnosis of submandibular gland calculi and can replace traditional CT for the diagnosis of sialolithiasis.Clinically,CBCT examination can be directly performed for accurate diagnosis of calculi in the posterior duct which are not detected by double coincidence diagnosis but are indicated by ultrasound.For calculi in the anterior and middle ducts,X-ray and CBCT are preferred.Visualization technology helps clinical patient education and the development of personalized preoperative treatment plans.

Background::There is a need for effective and safe therapies for psoriasis that provide sustained benefits. The aim of this study was to assess the efficacy and safety of tildrakizumab, an anti-interleukin-23p19 monoclonal antibody, for treating moderate-to-severe plaque psoriasis in Chinese patients.Methods::In this multi-center, double-blind, phase III trial, patients with moderate-to-severe plaque psoriasis were enrolled and randomly assigned (1:1) to receive subcutaneous tildrakizumab 100 mg or placebo at weeks 0 and 4. Patients initially assigned to placebo were switched to receive tildrakizumab at weeks 12, 16, and every 12 weeks thereafter. Patients in the tildrakizumab group continued with tildrakizumab at week 16, and every 12 weeks until week 52. The primary endpoint was the Psoriasis Area and Severity Index (PASI 75) response rate at week 12.Results::At week 12, tildrakizumab demonstrated significantly higher PASI 75 response rates (66.4% [73/110] vs. 12.7% [14/110]; difference, 51.4% [95% confidence interval (CI), 40.72, 62.13]; P <0.001) and Physician’s Global Assessment (60.9% [67/110] vs. 10.0% [11/110]; difference, 49.1% [95% CI, 38.64, 59.62]; P <0.001) compared to placebo. PASI 75 response continued to improve over time in both tildrakizumab and placebo-switching to tildrakizumab groups, reaching maximal efficacy after 28 weeks (86.8% [92/106] vs. 82.4% [89/108]) and maintained up to 52 weeks (91.3% [95/104] vs. 87.4% [90/103]). Most treatment-emergent adverse events were mild and not related to tildrakizumab. Conclusion::Tildrakizumab demonstrated durable efficacy through week 52 and was well tolerated in Chinese patients with moderate-to-severe plaque psoriasis.Trial registration::ClinicalTrials.gov, NCT05108766.