Objective: Para-aortic lymph node dissection (PALND) is a widely used treatment that causes many complications. This study is to evaluate the efficacy and safety of nerve-sparing para-aortic lymph node dissection (NSPALND) by comparing it with conventional PALND in gynecological malignancies and to prove whether locating the superior hypogastric plexus (SHP) can help reveal the para-aortic nerves. Methods: This is a retrospective study of the patients who underwent para-aortic lymphadenectomy from January 2020 to December 2022 at Zhejiang Cancer Hospital. All of them were divided into NSPALND and PALND groups according to whether or not nervesparing was performed. The surgical, functional and oncological outcomes were evaluated. Results: There were 43 patients enrolled, of which, 20 patients underwent NSPALND and 23 patients underwent PALND. The para-aortic nerves were successfully revealed by locating the SHP in all 20 cases of NSPALND. The post-operative anal exhaust time in the NSPALND group was significantly shorter than that in the PALND group (2.5 vs. 4 days, p=0.006), and the incidence of acute intestinal obstruction in the NSPALND group was significantly lower than that in the PALND group (10% vs. 39%, p=0.029). There was no difference between the two groups in terms of catheterization duration, urinary retention, dysuria, as well as the number of lymph nodes removed and the para-aortic recurrence rate. Conclusion NSPALND can significantly reduce the rate of acute intestinal obstruction and improve post-operative intestinal function. Locating the SHP and using it as an anatomical landmark to reveal the para-aortic nerves is feasible. Its exact clinical value needs to be further studied.

Acute poisoning in children is a significant global public health challenge，posing serious threats to the health and safety of infants and preschool-aged children. This review systematically summarizes recent advances in the field，including trends in epidemiology，causes，diagnostic and therapeutic techniques，and prevention strategies. Studies indicate that pediatric acute poisoning is significantly influenced by factors such as age，sex，geographic region，and type of toxic agent. Accidental ingestion of medications and household chemicals is more common in infants and young children，whereas intentional poisoning predominates among adolescents. With the emergence of novel toxic substances，pediatric poisoning has garnered increasing attention. Rapid diagnostic techniques，biomarker identification，and intelligent medical interventions have markedly improved diagnostic efficiency. Advances in antidote development，blood purification therapies，and extracorporeal membrane oxygenation have further contributed to improved clinical outcomes. This review underscores the importance of establishing a comprehensive management system encompassing prevention，early recognition，and effective treatment，aiming to enhance the efficiency and safety of pediatric poisoning care through systematic and integrated approaches.

Objective: Para-aortic lymph node dissection (PALND) is a widely used treatment that causes many complications. This study is to evaluate the efficacy and safety of nerve-sparing para-aortic lymph node dissection (NSPALND) by comparing it with conventional PALND in gynecological malignancies and to prove whether locating the superior hypogastric plexus (SHP) can help reveal the para-aortic nerves. Methods: This is a retrospective study of the patients who underwent para-aortic lymphadenectomy from January 2020 to December 2022 at Zhejiang Cancer Hospital. All of them were divided into NSPALND and PALND groups according to whether or not nervesparing was performed. The surgical, functional and oncological outcomes were evaluated. Results: There were 43 patients enrolled, of which, 20 patients underwent NSPALND and 23 patients underwent PALND. The para-aortic nerves were successfully revealed by locating the SHP in all 20 cases of NSPALND. The post-operative anal exhaust time in the NSPALND group was significantly shorter than that in the PALND group (2.5 vs. 4 days, p=0.006), and the incidence of acute intestinal obstruction in the NSPALND group was significantly lower than that in the PALND group (10% vs. 39%, p=0.029). There was no difference between the two groups in terms of catheterization duration, urinary retention, dysuria, as well as the number of lymph nodes removed and the para-aortic recurrence rate. Conclusion NSPALND can significantly reduce the rate of acute intestinal obstruction and improve post-operative intestinal function. Locating the SHP and using it as an anatomical landmark to reveal the para-aortic nerves is feasible. Its exact clinical value needs to be further studied.

Objective: Para-aortic lymph node dissection (PALND) is a widely used treatment that causes many complications. This study is to evaluate the efficacy and safety of nerve-sparing para-aortic lymph node dissection (NSPALND) by comparing it with conventional PALND in gynecological malignancies and to prove whether locating the superior hypogastric plexus (SHP) can help reveal the para-aortic nerves. Methods: This is a retrospective study of the patients who underwent para-aortic lymphadenectomy from January 2020 to December 2022 at Zhejiang Cancer Hospital. All of them were divided into NSPALND and PALND groups according to whether or not nervesparing was performed. The surgical, functional and oncological outcomes were evaluated. Results: There were 43 patients enrolled, of which, 20 patients underwent NSPALND and 23 patients underwent PALND. The para-aortic nerves were successfully revealed by locating the SHP in all 20 cases of NSPALND. The post-operative anal exhaust time in the NSPALND group was significantly shorter than that in the PALND group (2.5 vs. 4 days, p=0.006), and the incidence of acute intestinal obstruction in the NSPALND group was significantly lower than that in the PALND group (10% vs. 39%, p=0.029). There was no difference between the two groups in terms of catheterization duration, urinary retention, dysuria, as well as the number of lymph nodes removed and the para-aortic recurrence rate. Conclusion NSPALND can significantly reduce the rate of acute intestinal obstruction and improve post-operative intestinal function. Locating the SHP and using it as an anatomical landmark to reveal the para-aortic nerves is feasible. Its exact clinical value needs to be further studied.

Objective To assess the clinical indications,efficacy,and safety of ertapenem for pediatric emergency infectious disea-ses,and to analyze factors guiding its use to inform rational medication choices.Methods A retrospective cohort study was performed on 538 pediatric patients with bacterial infections treated with ertapenem in the Emergency Department of the Capital Institute of Pediatrics from January to December 2023.Patient demographics,diagnoses,infection types,and treatment data were collected.Univariate and multivariate logistic regression analyses were used to identify risk factors for hospitalization.Results Ertapenem was broadly applied across all pediatric age groups,primarily for pneumonia(25.8％),suppurative tonsillitis(18.4％),and bronchitis(14.7％).Some patients with relatively common infections switched to ertapenem due to severe clinical presentations,poor response to initial antibiotics,or cephalosporin allergy.Key indications included cephalosporin allergy(48.4％),failure of prior antibiotics(37.2％),and moderate to severe infections(12.5％).Overall,80.9％of patients improved clinically;median time to defervescence was 2days,median time for inflammatory marker normalization was 4days,and median total treatment duration was 5days.The incidence of adverse events was 9.5％,mainly mild to moderate gastrointestinal disturbances(5.2％diarrhea,2.2％nausea/vomiting).Multivariate analysis identified pneumo-nia,lymphadenitis,urinary tract infection,and underlying diseases as independent risk factors for hospitalization.Conclusion Ertapen-em demonstrates good efficacy and a favorable safety profile in pediatric emergency infectious diseases,particularly for moderate to severe infections,cephalosporin allergy,and cases unresponsive to initial antibiotic therapy.

Objective To assess the clinical indications,efficacy,and safety of ertapenem for pediatric emergency infectious disea-ses,and to analyze factors guiding its use to inform rational medication choices.Methods A retrospective cohort study was performed on 538 pediatric patients with bacterial infections treated with ertapenem in the Emergency Department of the Capital Institute of Pediatrics from January to December 2023.Patient demographics,diagnoses,infection types,and treatment data were collected.Univariate and multivariate logistic regression analyses were used to identify risk factors for hospitalization.Results Ertapenem was broadly applied across all pediatric age groups,primarily for pneumonia(25.8％),suppurative tonsillitis(18.4％),and bronchitis(14.7％).Some patients with relatively common infections switched to ertapenem due to severe clinical presentations,poor response to initial antibiotics,or cephalosporin allergy.Key indications included cephalosporin allergy(48.4％),failure of prior antibiotics(37.2％),and moderate to severe infections(12.5％).Overall,80.9％of patients improved clinically;median time to defervescence was 2days,median time for inflammatory marker normalization was 4days,and median total treatment duration was 5days.The incidence of adverse events was 9.5％,mainly mild to moderate gastrointestinal disturbances(5.2％diarrhea,2.2％nausea/vomiting).Multivariate analysis identified pneumo-nia,lymphadenitis,urinary tract infection,and underlying diseases as independent risk factors for hospitalization.Conclusion Ertapen-em demonstrates good efficacy and a favorable safety profile in pediatric emergency infectious diseases,particularly for moderate to severe infections,cephalosporin allergy,and cases unresponsive to initial antibiotic therapy.

Background Improper settings of outdoor smoking points in public places may increase the risk of secondhand smoke exposure among the population. Conducting research on air pollution in and around smoking spots and related influencing factors can provide valuable insights for optimizing the setting of outdoor smoking points. Objective To investigate the influence of the number of smokers at outdoor smoking points and the distance on the diffusion characteristics of surrounding air pollutants, in order to optimize the setting of outdoor smoking points. Methods Surrounding the exhibition halls in the China International Import Expo (CIIE), two outdoor smoking points were randomly selected, one on the first floor (ground level) and the other on the second floor (16 m above ground), respectively. At 0, 3, 6, and 9 m from the smoking points in the same direction, validated portable air pollutant monitors were used to measure the real-time fine particulate matter (PM_2.5) and carbon dioxide (CO₂) concentrations for consecutive 5 d during the exhibition, as well as the environmental meteorological factors at 0 m with weather meters including wind speed, wind direction, and air pressure. An open outdoor atmospheric background sampling point was selected on each of the two floors to carry out parallel sampling. Simultaneously, the number of smokers at each smoking point were double recorded per minute. The relationships between the number of smokers, distance from the smoking points, and ambient PM_2.5 and CO₂ concentrations were evaluated by generalized additive regression models for time-series data after adjustment of confounders such as temperature, relative humidity, and wind speed. Results The median numbers of smokers at smoking points on the first and second floors were 6 [interquartile range (IQR): 3, 9] and 9 (IQR: 6, 13), respectively. Windless (wind speed <0.6 m·s⁻¹) occupied most of the time (85.9%) at both locations. The average concentration of ambient PM_2.5 at the smoking points (0 m) [mean ± standard deviation, (106±114) μg·m⁻³] was 4.2 times higher than that of the atmospheric background [(25±7) μg·m⁻³], the PM_2.5 concentration showed a gradient decline with the increase of distance from the smoking points, and the average PM_2.5 concentration at 9 m points [(35±22) μg·m⁻³] was close to the background level (1.4 times higher). The maximum concentration of CO₂ [(628±23) μmol·mol⁻¹] was observed at 0 m, and its average value was 1.3 times higher than that of the atmospheric background [(481±40) μmol·mol⁻¹], and there was no gradient decrease in CO₂ concentration with increasing distance at 0, 3, 6, and 9 m points. The regression analyses showed that, taking smoking point as the reference, every 3 m increase in distance was associated with a decrease of ambient PM_2.5 by 24.6 [95% confidence interval (95%CI): 23.5, 25.8] μg·m⁻³ (23.2%) and CO₂ by 54.1 (95%CI: 53.1, 55.1) μmol·mol⁻¹ (8.6%). Every one extra smoker at the smoking point was associated with an average increase of PM_2.5 and CO₂ by 2.0 (95%CI: 1.7, 2.8) μg·m⁻³ and 1.0 (95%CI: 0.7，1.2) μmol·mol⁻¹, respectively. The sensitivity analysis indicated that, under windless conditions, the concentrations of PM_2.5 and CO₂ at the smoking points were even higher but the decreasing and dispersion characteristics remained consistent. Conclusion Outdoor smoking points could significantly increase the PM_2.5 concentrations in the surrounding air and the risks of secondhand smoke exposure, despite of the noticeable decreasing trend with increasing distance. Considering the inevitable poor dispersion conditions such as windless and light wind, outdoor smoking points are recommended to be set at least 9 m or farther away from non-smoking areas.

Objective:To comprehensively analyze the clinical characteristics,classification of causes,treatment methods,and outcomes of pediatric convulsions in the emergency department,providing a scientific basis for the diagnosis and treatment of pediatric convulsions and optimizing emergency management for these cases.Methods:The clinical data of 18 217 children with convulsions in the emergency department of Capital Institute of Pediatrics' Children's Hospital from January 1,2016 to December 31,2020 were retrospectively analyzed.Results:A total of 18 217 children were admitted to the emergency department due to convulsions,accounting for 2.3% of all visits.Among them,58.7% cases were male and 41.3% cases were female,with an average age of (2.00±0.03) years.The main age was 1 to 3 years old (54.2%).Generalized convulsions were the primary type (82.3%),with focal seizures accounting for 17.7%.Most convulsions lasted less than 5 minutes (82.4%),and approximately 55.2% of the patients could self-resolve.Febrile convulsions were the primary cause (69.2%),followed by benign convulsions with mild gastroenteritis (11.7%) and epilepsy (10.5%).Regarding treatment,54.0% of the children recovered without medication.In the triage system of "three zones and four levels," the usage rate of anticonvulsants in the red zone was 93.1%,with 21.6% requiring combined treatment.After treatment,48.2% of the children returned home,92.2% showed improvement or recovery,and the mortality rate was extremely low at only 0.03%.Conclusion:Febrile convulsions are the main cause of pediatric convulsions in the emergency department,and an efficient triage system play an important role in improving treatment response.Different treatment zones and outcomes vary,providing important reference for optimizing emergency management.

Objective:To analyze the effects of basic treatment of periodontal diseases combined with orthodontic treatment on periodontal pocket depth and bleeding index (BI) in patients with anterior tooth displacement caused by periodontal diseases.Methods:A total of 136 patients with anterior tooth displacement due to periodontal disease treated in the Second People′s Hospital of Yueqing from October 2020 to October 2022 were enrolled and they were divided into two groups by random number table method, and each group with 68 cases. The control group was given basic treatment for periodontal disease, while the experimental group was combined with orthodontic treatment on the basis of the control group. The clinical efficacy, masticatory efficiency, periodontal pocket depth (PD), probing BI, gingival sulcus inflammatory factors and the total incidence of complications were compared between the two groups.Results:The total effective rate in the experimental group was higher than that in the control group: 95.59%(65/68) vs. 79.41%(54/68), there was statistical difference ( P<0.05). After treatment for 3 months, the masticatory efficiency in the experimental group was higher than that in the control group, and PD, BI in the experimental group were lower than that in the control group: (70.52 ± 6.88) % vs.(61.52 ± 4.04) %, (2.12 ± 0.62) mm vs. (3.18 ± 0.85) mm, (1.26 ± 0.26) scores vs. (2.42 ± 0.33) scores, there were statistical differences ( P<0.05). After treatment, the levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-6 and IL-8 in the experimental group were lower than those in the control group: (11.16 ± 1.85) μg/L vs. (16.92 ± 2.84) μg/L, (8.16 ± 1.34) ng/L vs. (15.49 ± 2.74) ng/L, (6.18 ± 1.46) ng/L vs. (10.33 ± 1.75) ng/L, there were statistical differences ( P<0.05). The total complication rate in the experimental group was lower than that in the control group: 1.47%(1/68) vs. 11.76%(8/68), there was statistical difference ( P<0.05). Conclusions:Basic treatment of periodontal diseases combined with orthodontics can effectively improve the masticatory efficiency of patients with anterior tooth displacement caused by periodontal diseases, reduce PD,BI and alleviate gingival sulcus inflammation, and reduce the incidence complications.

Objective:To systematically synthesize qualitative research on the role expectations of nursing master student's supervisors to provide a reference for improving supervisor team development and optimizing selection and evaluation systems.Methods:A systematic search was conducted in databases such as Web of Science, PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, Wanfang, VIP, and SinoMed for qualitative studies on the role expectations of nursing master student's supervisors. The search was limited to studies published up to October 31, 2023. The quality of the included studies was evaluated using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. Meta-integration was employed to synthesize the results.Results:A total of nine studies were included, yielding 39 research findings, which were further categorized into eight new categories. These were integrated into three main themes: expectations of supervisors' comprehensive qualities, clear role positioning and exemplification, and respecting and meeting students' developmental needs.Conclusions:Educational institutions and policymakers involved in graduate education should fully understand the multi-dimensional role expectations of stakeholders regarding nursing master student's supervisors. This understanding is crucial for strengthening the development of the supervisor team, improving selection and evaluation systems, and supporting the training of advanced nursing professionals.