Randomized controlled trial(RCT)is the most rigorous scientific method of evaluating interventions and validating new techniques in nursing.Scientific research papers are not only the carrier of scientific knowledge dissemination,but also an important way of academic thoughts exchange.However,the quality of published randomized controlled studies in nursing research is uneven,and the paper writing are not standard.Based on existing literature review,CONSORT statements,and experience in writing and reviewing papers,the authors expound on the overall structure of RCTs and the essentials of each section,and summarize the common issues,to provide references for researchers to standardize the writing of RCTs in nursing.

Objective To investigate the effect and mechanism of microRNA-10b(miR-10b)on idiopathic short stature(ISS).Methods A total of 54 children with ISS and 54 healthy children were collected.The serum expression of miR-10b was detected by RT-qPCR,and the relationship between serum miR-10b expression and clinical data of children with ISS was analyzed.miR-10b inhibitor,si-TGFBR1 and their negative control transfection C28/I2 cells were used.CCK-8 experimental detection was used to detect C28/I2 cell proliferation.Western blot assay was used to detect gnome related transcription factor 2(RUNX2),collagen type X alpha 1 chain(COL10A1),transforming growth factor beta receptor 1(TGFBR1),SMAD3 and pSMAD3 protein expression.The target of miR-10b was screened in StarBase database,and the targeting relationship between miR-10b and TGFBR1 was verified by dual luciferase reporter gene assay.Results The serum expression of miR-10b was higher in the ISS group than that of the healthy control group,and the higher the miR-10b expression,the more obvious the decrease of child height,IGF-1 and alkaline phosphatase(P＜0.05).Compared with the NC group,the cell proliferation ability and RUNX2,COL10A1,TGFBR1,and pSMAD3 protein expression were up-regulated in the miR-10b inhibitor group(P＜0.05).StarBase database suggested that miR-10b had a binding site of TGFBR1,and dual luciferase reporter gene assay confirmed that TGFBR1 interacted with miR-10b(P＜0.05).Compared with the si-NC group,the expression of TGFBR1 was down-regulated and the cell proliferation ability was decreased in the si-TGFBR1 group(P＜0.05).Conclusion miR-10b inhibits chondrocyte proliferation and hypertrophy in idiopathic short stature by targeting TGFBR1/SMAD3 pathway.

Objective:To investigate respiratory virus infection in children with septic shock in pediatric care units (PICU) in China and its influence on clinical outcomes.Methods:The clinical data of children with septic shock in children′s PICU from January 2018 to December 2019 in 10 Chinese hospitals were retrospectively collected. They were divided into the pre-COVID-19 and post-COVID-19 groups according to the onset of disease, and the characteristics and composition of respiratory virus in the 2 groups were compared. Matching age, malignant underlying diseases, bacteria, fungi and other viruses, a new database was generated using 1∶1 propensity score matching method. The children were divided into the respiratory virus group and non-respiratory virus group according to the presence or absence of respiratory virus infection; their clinical characteristics, diagnosis, and treatment were compared by t-test, rank sum test and Chi-square test. The correlation between respiratory virus infection and the clinical outcomes was analyzed by logistic regression. Results:A total of 1 247 children with septic shock were included in the study, of them 748 were male; the age was 37 (11, 105) months. In the pre-and post-COVID-19 groups, there were 530 and 717 cases of septic shock, respectively; the positive rate of respiratory virus was 14.9% (79 cases) and 9.8% (70 cases); the seasonal distribution of septic shock was 28.9% (153/530) and 25.9% (185/717) in autumn, and 30.3% (161/530) and 28.3% (203/717) in winter, respectively, and the corresponding positive rates of respiratory viruses were 19.6% (30/153) and 15.7% (29/185) in autumn, and 21.1% (34/161) and 15.3% (31/203) in winter, respectively. The positive rates of influenza virus and adenovirus in the post-COVID-19 group were lower than those in the pre-COVID-19 group (2.1% (15/717) vs. 7.5% (40/530), and 0.7% (5/717) vs. 3.2% (17/530), χ2=21.51 and 11.08, respectively; all P<0.05). Rhinovirus virus were higher than those in the pre-Covid-19 group (1.7% (12/717) vs. 0.2% (1/530), χ2=6.51, P=0.011). After propensity score matching, there were 147 cases in both the respiratory virus group and the non-respiratory virus group. Rate of respiratory failure, acute respiratory distress, rate of disseminated coagulation dysfunction, and immunoglobulin usage of the respiratory virus group were higher than those of non-respiratory virus group (77.6% (114/147) vs. 59.2% (87/147), 17.7% (26/147) vs. 4.1% (6/147), 15.6% (25/147) vs. 4.1% (7/147), and 35.4% (52/147) vs. 21.4% (32/147); χ2=11.07, 14.02, 11.06 and 6.67, all P<0.05); and PICU hospitalization of the former was longer than that of the later (7 (3, 16) vs. 3 (1, 7)d, Z=5.01, P<0.001). Univariate logistic regression analysis showed that the presence of respiratory viral infection was associated with respiratory failure, disseminated coagulation dysfunction, the use of mechanical ventilation, and the use of immunoglobulin and anti-respiratory viral drugs ( OR=2.42, 0.22, 0.25, 0.56 and 1.12, all P<0.05). Conclusions:The composition of respiratory virus infection in children with septic shock is different between pre and post-COVID-19. Respiratory viral infection is associated with organ dysfunction in children with septic shock. Decreasing respiratory viral infection through respiratory protection may improve the clinical outcome of these children.

Objective:To investigate the clinical features, pathogen composition, and prognosis of septic shock in pediatric intensive care units (PICU) in China.Methods:A multicenter retrospective cohort study. A retrospective analysis was conducted on the clinical data of children with septic shock from 10 hospitals in China between January 2018 and December 2021. The clinical features, pathogen composition, and outcomes were collected. Patients were categorized into malignant tumor and non-malignant tumor groups, as well as survival and mortality groups. T test, Mann Whitney U test or Chi square test were used respectively for comparing clinical characteristics and prognosis between 2 groups. Multiple Logistic regression was used to identify risk factors for mortality. Results:A total of 1 247 children with septic shock were included, with 748 males (59.9%) and the age of 3.1 (0.9, 8.8) years. The in-patient mortality rate was 23.2% (289 cases). The overall pathogen positive rate was 68.2% (851 cases), with 1 229 pathogens identified. Bacterial accounted for 61.4% (754 strains) and virus for 24.8% (305 strains). Among all bacterium, Gram negative bacteria constituted 64.2% (484 strains), with Pseudomonas aeruginosa and Enterobacter being the most common; Gram positive bacteria comprised 35.8% (270 strains), primarily Streptococcus and Staphylococcus species. Influenza virus (86 strains (28.2%)), Epstein-Barr virus (53 strains (17.4%)), and respiratory syncytial virus (46 strains (17.1%)) were the top three viruses. Children with malignant tumors were older and had higher pediatric risk of mortality (PRISM) Ⅲ score, paediatric sequential organ failure assessment (pSOFA) score (7.9 (4.3, 11.8) vs. 2.3 (0.8, 7.5) years old, 22 (16, 26) vs. 16 (10, 24) points, 10 (5, 14) vs. 8 (4, 12) points, Z=11.32, 0.87, 4.00, all P<0.05), and higher pathogen positive rate, and in-hospital mortality (77.7% (240/309) vs. 65.1% (611/938), 29.7% (92/309) vs. 21.0% (197/938), χ2=16.84, 10.04, both P<0.05) compared to the non-tumor group. In the death group, the score of PRISM Ⅲ, pSOFA (16 (22, 29) vs. 14 (10, 20) points, 8 (12, 15) vs. 6 (3, 9) points, Z=4.92, 11.88, both P<0.05) were all higher, and presence of neoplastic disease, positive rate of pathogen and proportion of invasive mechanical ventilation in death group were also all higher than those in survival group (29.7% (87/289) vs. 23.2% (222/958), 77.8% (225/289) vs. 65.4% (626/958), 73.7% (213/289) vs. 50.6% (485/958), χ2=5.72, 16.03, 49.98, all P<0.05). Multiple Logistic regression showed that PRISM Ⅲ, pSOFA, and malignant tumor were the independent risk factors for mortality ( OR=1.04, 1.09, 0.67, 95% CI 1.01-1.05, 1.04-1.12, 0.47-0.94, all P<0.05). Conclusions:Bacterial infection are predominant in pediatric septic shock, but viral infection are also significant. Children with malignancies are more severe and resource consumptive. The overall mortality rate for pediatric septic shock remains high, and mortality are associated with malignant tumor, PRISM Ⅲ and pSOFA scores.

Objective To study the correlation between carotid bifurcation geometry and atherosclerotic plaque vulnerability using high-resolution magnetic resonance vessel wall imaging(HRMR-VWI),and to seek the potential predictor for vulnerable plaque for-mation.Methods The clinical information and imaging data of 104 patients with carotid bifurcation plaque detected by HRMR-VWI were analyzed retrospectively.Carotid bifurcation geometric parameters was measured to determine whether the carotid bifurcation plaque was vulnerable plaque,and they were divided into vulnerable plaque group(69 cases)and stable plaque group(35 cases).The difference of carotid bifurcation geometry of various groups was investigated,and the influence of common traditional risk factors to obtain independent risk factors was adjusted.Receiver operating characteristic(ROC)curve was drawn.Results Among 104 carotid artery,vulnerable plaque group had larger bifurcation angle(54.00 vs 48.80,P＜0.001),less luminal expansion(1.76 vs 1.94,P=0.002)and less outflow/inflow area ratio(0.79 vs 0.88,P＜0.001)compared with stable plaque group.After adjusting,binary logistic regres-sion indicated that bifurcation angle[odds ratio(OR)1.132 per 10° increase;95％confidence interval(CI)1.044-1.225],luminal expan-sion(OR 0.084 per 1 increase;95％CI 0.014-0.492)and outflow/inflow area ratio(OR 0.357 per 0.01 increase;95％CI 0.177-0.723)were independent risk factors of vulnerable plaque formation.Bringing them into the final model,the area under the curve(AUC)was 0.878 above the basic model(AUC=0.664).Conclusion Bifur-cation angle,luminal expansion and outflow/inflow area ratio are independently associated with vulnerable plaque formation.Carotid bifurcation geometry have the certain predictive efficiency of vulnerable plaque formation and have the incremental diagnostic value to traditional risk factors,which are expected to be effective imaging makers for the formation of vulnerable plaque.

Objective To predict the Ki-67 expression status of non-small cell lung cancer(NSCLC)by constructing a fusion model based on PET/CT radiomics features combined with clinical indicators.Methods A total of 110 NSCLC patients were enrolled,and underwent PET/CT scans and Ki-67 detection.The Mann-Whitney U test,the least absolute shrinkage and selection operator(LASSO)method,and Spearman correlation analysis were used to identify the most significant features.The PET model,CT model,PET/CT model,and fusion model were established and their efficacies were compared by the area under the curve(AUC).Results The fusion model with PET/CT radiomics features and clinical indicators outperformed the other three models,with an AUC of 0.961[95％confidence interval(CI)0.922-0.999]in the training set and an AUC of 0.893(95％CI 0.772-1.000)in the test set.Conclusion The fusion model with PET/CT radiomics features and clinical indicators provides the most effective prediction of Ki-67 expression status in NSCLC patients,which is helpful for the assessment of patient prognosis and the formulation of personalized treat-ment plans.

Objective:To analyze the research status and development trend of successful aging at home and abroad, so as to provide references for the study of population aging in China.Methods:The literatures on successful aging included in China National Knowledge Infrastructure and Web of Science core collection from the establishment of database to April 2023 were retrieved, and CiteSpace software was used to analyze.Results:A total of 199 Chinese articles and 517 English articles were included. The number of articles published at home and abroad was generally on the rise, the published journals had certain authority, and a core group of domestic authors had been formed.Conclusions:Research hotspots at home and abroad involve influencing factors, study population, cognitive function, etc. This field is in the stage of discipline development and application diffusion. Physical and mental health of the elderly, successful aging at work, and healthy aging are the future development trends. In the future, international exchanges and cooperation should be strengthened, combined with the actual situation in China, further improve the related theories of successful aging and build a more scientific and localized successful aging system, so as to provide guidance for solving the problem of population aging.

Objective To construct and validate of a nomogram predictive model for high-volume lymph node metastasis(HVM)in multifocal papillary thyroid carcinoma(MPTC).Methods Between January 2010 to January 2024,a total of 1146 and 234 patients with multifocal papillary thyroid carcinoma(MPTC)were diagnosed at Hangzhou First People's Hospital(Center A)and Hangzhou Cancer Hospital(Center B),respectively.Patients from Center A were randomly allocated to training set(n=803)and testing set(n=343)in a 7:3 ratio,while those from Center B(n=234)comprised an external validation set.Independent risk factors for HVM in MPTC patients were identified through univariate and multivariate Logistic regression analysis in training set,leading to the development of a nomogram predictive model.The generalizability of this model was subsequently assessed using both testing set and external validation set.The area under the curve(AUC)of receiver operating characteristic curve,sensitivity,and specificity evaluate the discriminative ability of the model.Results The incidence of HVM was 13.3％at center A and 12.8％at center B.Logistic regression identified male gender(OR=2.91,95％CI:1.835-4.599),maximum lesion diameter(OR=1.05,95％CI:1.021-1.070),and age(OR=0.95,95％CI:0.936-0.972)as independent risk factors for HVM.Anomogram based on these factors showed an AUC of 0.767 with 72.6％sensitivity and 70.2％specificity in training set,and 0.838 with 94.9％sensitivity and 68.4％specificity in testing set,and 0.769 with 63.3％sensitivity and 84.3％specificity in external validation set.The calibration curve demonstrated good agreement with the ideal curve.Conclusion The prediction model constructed based on clinical risk factors can effectively predict the probability of HVM in MPTC patients.

Objective To explore the value of diffusion-tensor imaging(DTI)of different gray matter nuclei in the diagnosis and assessment of prodromal Parkinson's disease(pPD)under logistic regression model.Methods A total of 20 patients with pPD were collected as case group and 28 healthy people as control group(HC group).All patients were examined by MRI plain scan and DTI.DSI studio was used to post-process the DTI images of all patients.Parameters(FA,MD,AD,RD)of basal ganglia,midbrain and brainstem of patients with pPD and HC group were automatically extracted and statistically analyzed.Logistic regression analysis was used to draw the Receiver Operating Characteristic(ROC)curve to analyze and compare the diagnostic efficacy of individual diagnosis and combined diagnosis of each parameter.And the correlation between the parameters of each group and MMSE score was analyzed.Results There were statistical differences in basal ganglia,midbrain and brain stem in PPD and HC group(P<0.05).Under Logistic regression equation model,when the optimal threshold was 0.63,the AUC of PPD was 0.964.The sensitivity and specificity of differential diagnosis were 85.0%and 100%respectively(P<0.001).There was correlation between DTI parameters and MMSE score in locus coeruleus in PPD group(P<0.05),and the correlation coefficient of FA value in locus coeruleus(r =-0.646,P = 0.002)was the highest.Conclusions The lesions of basal ganglia,midbrain and brainstem correlated gray matter nuclei in pPD were extensive and differ-ent in degree.AD value of locus coeruleus was valuable for quantitative diagnosis of pPD,FA value of locus coeruleus could be used as a characteristic sensitive index for recognition of the severity of dysfunction in pPD patients.Multi-parameter combined diagnosis of DTI under Logistic regression model could effectively improve the diagnostic efficiency,and provide valuable reference for early diagnosis and intervention of pPD.

Objective:To know the current situation of kinesiophobia in patients after cardiac surgery under cardiopulmonary bypass, and to clarify its influencing factors, so as to provide reference for developing intervention strategies to improve kinesiophobia level.Methods:This was a cross-sectional study. From February 2022 to September 2022, the patients after cardiac valve surgery under cardiopulmonary bypass in the Second Affiliated Hospital Zhejiang University School of Medicine were investigated by convenience sampling methods. The survey was conducted using the General Information Questionnaire, The Tampa Scale for Kinesiophobia Heart, Exercise Self-Efficacy Scale, Pain Catastrophizing Scale, and Adaptation, Partnership, Growth, Affection and Resolve(APGAR) as research tools, and the influencing factors were analyzed using univariate and binary Logistic regression analysis.Results:A total of 219 patients were included, of which 97 patients (44.3%) had kinesiophobia. The results of binary Logistic regression analysis showed that monthly family income level, first time out of bed after operation, fear of falling, the family APGAR, and pain catastrophizing were significant influencing factors of kinesiophobia in patients after heart valve surgery under cardiopulmonary bypass (all P<0.05). Conclusions:The prevalence of kinesiophobia is high among patients after heart valve surgery under cardiopulmonary bypass. Clinicians should pay attention to patients with low monthly family income level, late first time out of bed after surgery, and fear of falling, as well as strengthen communication with patients and families, focus on the management of acute postoperative pain. In order to reduce or avoid the occurrence of kinesiophobia and enable patients to benefit from early ambulation.