Objective: To analyze the change trends in the body shape indicators and proportions of students in Harbin from 2010 to 2024, and to investigate ergonomic compatibility of functional dimensions of school desks and chairs with current student shape indicators, so as to provide a reference for revising furniture standards of desks and chairs. Methods: Between September and November of both 2010 and 2024, a combination of convenience sampling and stratified cluster random sampling was conducted across three districts in Harbin, yielding samples of 6 590 and 6 252 students, respectively. Anthropometric shape indicators cluding height, sitting height, crus length, and thigh length-and their proportional changes were compared over the 15-year period. The 2024 data were compared with current standard functional dimensions of school furniture. The statistical analysis incorporated t-test and Mann-Whitney U- test. Results: From 2010 to 2024, average height increased by 1.8 cm for boys and 1.5 cm for girls; sitting height increased by 1.5 cm for both genders; crus length increased by 0.3 cm for boys and 0.4 cm for girls; and thigh length increased by 0.5 cm for both genders. The ratios of sitting height to height, and sitting height to leg length increased by less than 0.1 . The difference between desk chair height and 1/3 sitting height ranged from 0.4-0.8 cm. Among students matched with size 0 desks and chairs, 22.0% had a desk to chair height difference less than 0, indicating that the desk to chair height difference might be insufficient for taller students. The differences between seat height and fibular height ranged from -1.4 to 1.1 cm; and the differences between seat depth and buttock popliteal length ranged from -9.8 to 3.4 cm. Among obese students, the differences between seat width and 1/2 hip circumference ranged from -20.5 to -8.7 cm, while it ranged from -12.2 to -3.8 cm among non obese students. Conclusion Current furniture standards basically satisfy hygienic requirements; however, in the case of exceptionally tall and obese students, ergonomic accommodations such as adaptive seating allocation or personalized adjustments are recommended to meet hygienic requirements.

Infectious diarrhea is a gastrointestinal infectious disease caused by a wide range of pathogens and found throughout the world. It is one of the most important public health problems in the world and the second leading cause of death among children under five years of age. The pathogens of infectious diarrhea include viral diarrhea pathogens, bacterial diarrhea pathogens, and parasites. Viruses are the most frequent pathogens, mainly including norovirus, rotavirus, astrovirus and sapovirus. The most frequently identified organisms causing bacterial diarrhea are diarrheagenic Escherichia coli, Salmonella, Shigella, Vibrio parahaemolyticus and Campylobacter. This paper provides an overview of the epidemiological trends and changes in the pathogen spectrum of infectious diarrhea for better understanding the distribution and epidemiological features of infectious diarrhea in China, and hopes to provide reference for developing prevention and control strategies and reducing the disease burden.

Sepsis is a fatal organ dysfunction caused by the uncontrolled inflammatory response of the host to infection. Excessive inflammatory reaction is the core factor in the occurrence and development of sepsis, the degree of organ dysfunction is directly related to the prognosis of sepsis. Timely intervention of excessive inflammatory response and alleviation of organ function damage are essential to improve the prognosis of sepsis. Maresin-1 (MaR-1) is a newly discovered endogenous specific pro-inflammatory resolution mediator, which plays a role of anti-inflammatory, pro-inflammatory regression and organ protection in sepsis, and may be a new target for the treatment of sepsis. This article reviews the research progress of the role of MaR-1 in the regulation of inflammation and organ protection in sepsis, in order to provide reference for the clinical development of new drugs for the treatment of sepsis.

Objective To design a storage device for lymph node specimens of gynecological malignant tumors and to evaluate its application effect.Methods The specimen depository is composed of 3 parts,including storage frame,partition plate and marking plate.391 patients with gynecological malignant tumor surgeries requiring collection of retroperitoneal lymph nodes were selected in the operating room of a tertiary A hospital in Zhejiang Province from January to December 2022 in accordance with the operation schedule.They were randomly divided into an experimental group(n=196)and a control group(n=195).Patients in the experimental group used a newly developed storage device,while the control group was with traditional device.The incidence of additional verification specimens by doctors,the average time for disposing of lymph node specimens,and the job satisfaction survey of doctors and nurses were compared.Results Within a period of 12 months after utilizing this easily recognizable specimen storage device,the additional verification rate in the experimental group was 10.62％compared with the rate of 72.48％in the control group.The average time of disposing lymph node specimens was reduced from(8.3±0.9)to(5.2±0.3)minutes.Doctors and nurses in the experimental group reported a higher level of satisfaction for the specimen storage device(P＜0.05).Conclusion Utilizing the newly designed specimen storage device can help medical staff to alleviate their workload,enhance their work efficiency,raise their job satisfaction,and ensure the accuracy of pathological results.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To evaluate the effect of preoperative cognitive training on postoperative neurocognitive function in elderly patients undergoing coronary artery bypass grafting (CABG) and/or valve surgery.Methods:Seventy-four elderly patients of either sex, of American Society of Anesthesiologists Physical Status classification Ⅲ or Ⅳ, aged 60-90 yr, with body mass index of 19-28 kg/m 2, scheduled for elective CABG or valve surgery under general anesthesia, were divided into 2 groups ( n=37 each) using a computer-generated random number table method: cognitive training group (group CT) and control group (group C). Group CT was instructed to complete a cognitive training once 1 h per day for 5 consecutive days prior to surgery. Group C did not receive any cognitive training before surgery, and routine nursing was performed. At the 7th day after surgery, the patients′ neurocognitive function was evaluated by the Montreal Cognitive Assessment Scale(MoCA), the Postoperative Quality Recovery Scale (PQRS) was used to assess the patients′ recovery status, and the postoperative complications and morality in both groups were recorded. The patients were assessed using the Geriatric Depression Scale, MoCA and PQRS at the 1st month and 3rd month after operation. Results:The MoCA scores were significantly higher at the 7th day, 1st month and 3rd month postoperatively than in group C ( P<0.05). There was no significant difference in the postoperative case fatality rate and incidence of complications between the two groups ( P>0.05). Significant difference was observed in PQRS scores between the two groups at the 7th day after surgery ( P<0.05), but there were no significant differences in the PQRS scores and Geriatric Depression Scale scores between the two groups at the 1st month and 3rd month after operation ( P>0.05). Conclusions:The cognitive training can improve postoperative neurocognitive function in elderly patients undergoing CABG and/or valve surgery.

Objective:To study the efficacy, safety and prognostic factors affecting survival of proton radiation therapy for primary hepatocellular carcinoma (HCC).Methods:Forty-four patients with primary hepatocellular carcinoma treated at Zibo Wanjie Cancer Hospital in Shandong Province from June 15, 2005 to September 12, 2018 were enrolled and given proton radiation therapy with a single dose of 2-5 Gy and a total dose of 25-75 Gy. The overall and local control rates, factors influencing survival, and adverse effects were observed during a follow-up period of 12 to 120 months.Results:The overall survival rates of all patients were 79.5% at 1 year, 68.2% at 2 years, 50.0% at 3 years, and 45.5% at 5 years. The overall local control rate was 95.5%. Patients older than 50 years had a longer overall survival (Log Rank Chi-Square of 4.787, P = 0.029). Child-Pugh A classification had better overall survival compared with B classification (Log Rank Chi-Square 4.077, P = 0.043). The main adverse reactions were skin reactions and gastrointestinal reactions. Among the patients with adverse reactions, 23 patients had skin reactions and 9 patients had mild gastrointestinal reactions, and no serious adverse events were found. Conclusions:Proton radiation therapy has good efficacy and high safety in patients with HCC. Age and Child-Pugh classification are prognostic factors affecting survival after proton radiation therapy.

Objective:To investigate the application effect of paper review combined with situational exercise in the standardized training and teaching of ophthalmology nurses.Methods:A total of 39 ophthalmology nurses who received standardized training from September 2019 to July 2020 were selected as control group, and 42 ophthalmology nurses who received standardized training from September 2020 to July 2021 were selected as study group. The nurses in the control group received traditional teaching, and those in the study group received teaching with paper review and situational exercise. The two groups were compared in terms of the scores of theoretical knowledge and operation skills, comprehensive qualities (autonomous learning ability, independent analysis and problem-solving ability, nurse-patient communication ability, organization and coordination ability, and comprehensive first aid ability) before and after teaching, and the degree of satisfaction with teaching. SPSS 26.0 was used to perform the independent samples t-test, the paired t-test, the chi-square test, and the rank sum test. Results:After standardized training, compared with the control group, the study group had significantly higher scores of theoretical knowledge (93.29±1.82 vs. 90.36±1.51, P<0.05) and operation skills (95.14±1.34 vs. 92.62±1.26, P<0.05). After standardized training, both groups had significant increases in the scores of autonomous learning ability, independent analysis and problem-solving ability, nurse-patient communication ability, organization and coordination ability, and comprehensive first aid ability, and the study group had significantly higher scores of these comprehensive qualities than the control group ( P<0.05). There was a significant difference in the distribution of the degree of satisfaction with teaching between the two groups ( P<0.05), and the study group had a significantly higher degree of satisfaction than the control group. Conclusion:Paper review combined with situational exercise can improve the specialized theoretical knowledge, technical operational level, and comprehensive qualities of ophthalmology nurses receiving standardized training and enhance the degree of satisfaction with teaching.

Acute cor pulmonale, usually secondary to pulmonary hypertension induced from severe pulmonary diseases or pulmonary circulation disorders, is characterized by acute right heart dysfunction and right heart failure.Hypoxemia, hypercapnia and positive pressure ventilation can all lead to pulmonary hypertension.During the treatment of critically ill children, especially in the process of respiratory support, acute cor pulmonale should be identified as soon as possible to consider the implementation of "lung protection" and "circulation protection" with monitoring of right heart function and protection as the core.

Objective:To investigate the association between serum thyroid level and prognosis of critically ill children with euthyroid sick syndrome(ESS).Methods:The clinical data and serum thyroid hormone levels of 176 children with ESS who were admitted to the Department of Pediatric Intensive Care Medicine at West China Second Hospital of Sichuan University from January 2015 to April 2021 were retrospectively collected.According to the prognosis, the children were divided into improved group and invalid group, as well as basic disease group and non basic disease group, and the differences of thyroid hormone between two groups were compared.The pediatric risk of mortality Ⅲ(PRISMⅢ) scores within 24 hours of admission were assessed, and the correlation between thyroid hormone level and PRISMⅢ score was analyzed.Results:Among 176 critically ill children with ESS, the most common diseases were sepsis(31.8%), severe pneumonia (23.8%) and heart failure(10.7%), respectively.The levels of free T3(FT3), T3, free T4(FT4) and T4 in invalid group were significantly lower than those in improved group ( P<0.05), but there was no statistical difference in thyroid-stimulating hormone(TSH) level between two groups( P>0.05). The levels of FT3, T3, FT4 and T4 were negatively correlated with PRISMⅢ score( r=-0.419, -0.459, -0.341, -0.383, respectively, P<0.05), and there was no correlation between TSH level and PRISMⅢ score ( P>0.05). The common underlying diseases of severe children with ESS were malnutrition(31/98), heart disease(30/98), hematologic neoplasms(15/98), and bronchopulmonary dysplasia(10/98). The median age of children in basic disease group was younger than that in non-basic disease group(0.7 years old vs. 2.0 years old, P<0.05); The proportion of children with underlying diseases in invalid group was 24.5%, which was significantly higher than that of children without underlying diseases (6.4%), and the difference was statistically significant ( P<0.05); There were no significant differences in the levels of FT3, T3, FT4, T4 and TSH between two groups ( P>0.05). Conclusion:In critically ill children, a variety of diseases can lead to ESS, and sepsis is the most common disease.Young children with underlying diseases should be more alert to ESS.The more severe the disease, the greater the decline of FT3, T3, FT4 and T4 levels.When low T3, T4 and TSH occur simultaneously, the prognosis of the children may be worse.Thyroid hormone level could be used as an indicator to evaluate the prognosis of critically ill children, which is needed further studies to explore.