Objective:This study aims to explore the predictive value of T2-weighted imaging (T2WI), apparent diffusion coefficient (ADC), and early-delayed phases enhanced magnetic resonance imaging (DCE-MRI) radiomics prediction model in determining human epidermal growth factor receptor 2 status in breast cancer.Methods:A retrospective study was conducted, involving 187 patients with confirmed breast cancer by postsurgical pathology at Zhenjiang First People's Hospital during January 2021 and May 2023. Immunohistochemistry or fluorescence in situ hybridization was used to determine the HER-2 status of these patients, with 48 cases classified as HER-2 positive and 139 cases as HER-2 negative. The training set was used to construct the prediction models and the validation set was used to verify the prediction models. Layers of T2WI, ADC, and early-delayed phase DCE-MRI images were used to delineate the volumeof interest and 960 radiomic features were extracted from each case using Pyradiomic. After screening and dimensionality reduction by intraclass correlation coefficient, Pearson correlation analysis, least absolute shrinkage, and selection operator, the radiomics labels were established. Logistic regression analysis was used to construct the T2WI radiomics model, ADC radiomics model, DCE-2 radiomics model, DCE-6 radiomics model, and the joint sequence radiomics model to predict the HER-2 expression status of breast cancer, respectively. Based on the clinical, pathological, and MRI image characteristics of patients, univariate and multivariate logistic regression analysis wasused to construct a clinicopathological MRI feature model. The radscore of every patient and the clinicopathological MRI features which were statistically significant after screening were used to construct a nomogram model. The receiver operating characteristic (ROC) curve was used to evaluate the predictive performance of each model and the decision curve analysis wasused to evaluate the clinical usefulness.Results:The T2WI, ADC, DCE-2, DCE-6, and joint sequence radiomics models, the clinicopathological MRI feature model, and the nomogram model were successfully constructed to predict the expression status of HER-2 in breast cancer. ROC analysis showed that in the training set and validation set, the areas under the curve (AUC) of the T2WI radiomics model were 0.797 and 0.760, of the ADC radiomics model were 0.776 and 0.634, of the DCE-2 radiomics model were 0.804 and 0.759, of the DCE-6 radiomics model were 0.869 and 0.798, of the combined sequence radiomics model were 0.908 and 0.847, of the clinicopathological MRI feature model were 0.703 and 0.693, and of the nomogram model were 0.938 and 0.859, respectively. In the training set, the combined sequence radiomics model outperformed the clinicopathological features model ( P＜0.001). In the training and validation sets, the nomogram outperformed the clinicopathological features model ( P＜0.05). In addition, the diagnostic performance of the nomogram was better than that of the four single-modality radiomics models in the training cohort ( P＜0.05) and was better than that of DCE-2 and ADC models in the validation cohort ( P＜0.05). Decision curve analysis indicated that the value of individualized prediction models was higher than clinical and pathological prediction models in clinical practice. The calibration curve showed that the multimodal radiomics model had a high consistency with the actual results in predicting HER-2 expression. Conclusions:T2WI, ADC and early-delayed phase DCE-MRI imaging histology models for HER-2 expression status in breast cancer are expected to provide a non-invasive virtual pathological basis for decision-making on preoperative neoadjuvant regimens in breast cancer.

Objective:This study aims to explore the predictive value of T2-weighted imaging (T2WI), apparent diffusion coefficient (ADC), and early-delayed phases enhanced magnetic resonance imaging (DCE-MRI) radiomics prediction model in determining human epidermal growth factor receptor 2 status in breast cancer.Methods:A retrospective study was conducted, involving 187 patients with confirmed breast cancer by postsurgical pathology at Zhenjiang First People's Hospital during January 2021 and May 2023. Immunohistochemistry or fluorescence in situ hybridization was used to determine the HER-2 status of these patients, with 48 cases classified as HER-2 positive and 139 cases as HER-2 negative. The training set was used to construct the prediction models and the validation set was used to verify the prediction models. Layers of T2WI, ADC, and early-delayed phase DCE-MRI images were used to delineate the volumeof interest and 960 radiomic features were extracted from each case using Pyradiomic. After screening and dimensionality reduction by intraclass correlation coefficient, Pearson correlation analysis, least absolute shrinkage, and selection operator, the radiomics labels were established. Logistic regression analysis was used to construct the T2WI radiomics model, ADC radiomics model, DCE-2 radiomics model, DCE-6 radiomics model, and the joint sequence radiomics model to predict the HER-2 expression status of breast cancer, respectively. Based on the clinical, pathological, and MRI image characteristics of patients, univariate and multivariate logistic regression analysis wasused to construct a clinicopathological MRI feature model. The radscore of every patient and the clinicopathological MRI features which were statistically significant after screening were used to construct a nomogram model. The receiver operating characteristic (ROC) curve was used to evaluate the predictive performance of each model and the decision curve analysis wasused to evaluate the clinical usefulness.Results:The T2WI, ADC, DCE-2, DCE-6, and joint sequence radiomics models, the clinicopathological MRI feature model, and the nomogram model were successfully constructed to predict the expression status of HER-2 in breast cancer. ROC analysis showed that in the training set and validation set, the areas under the curve (AUC) of the T2WI radiomics model were 0.797 and 0.760, of the ADC radiomics model were 0.776 and 0.634, of the DCE-2 radiomics model were 0.804 and 0.759, of the DCE-6 radiomics model were 0.869 and 0.798, of the combined sequence radiomics model were 0.908 and 0.847, of the clinicopathological MRI feature model were 0.703 and 0.693, and of the nomogram model were 0.938 and 0.859, respectively. In the training set, the combined sequence radiomics model outperformed the clinicopathological features model ( P＜0.001). In the training and validation sets, the nomogram outperformed the clinicopathological features model ( P＜0.05). In addition, the diagnostic performance of the nomogram was better than that of the four single-modality radiomics models in the training cohort ( P＜0.05) and was better than that of DCE-2 and ADC models in the validation cohort ( P＜0.05). Decision curve analysis indicated that the value of individualized prediction models was higher than clinical and pathological prediction models in clinical practice. The calibration curve showed that the multimodal radiomics model had a high consistency with the actual results in predicting HER-2 expression. Conclusions:T2WI, ADC and early-delayed phase DCE-MRI imaging histology models for HER-2 expression status in breast cancer are expected to provide a non-invasive virtual pathological basis for decision-making on preoperative neoadjuvant regimens in breast cancer.

Objective:To compile a questionnaire on influencing factors of hand hygiene compliance of nursing staff, and test its reliability and validity.Methods:Based on the theory of planned behavior, the initial questionnaire was formed through literature search and semi-structured interview. A questionnaire on influencing factors of hand hygiene compliance among nursing staff was formed through expert consultation and pre-test. From March to June 2023, a total of 204 nurses from Beijing Chaoyang Hospital Affiliated to Capital Medical University were enrolled by the convenient sampling method, and the questionnaire was distributed for investigation. A total of 198 valid questionnaires were collected, with an effective recovery rate of 97.06% (198/204). Content validity, construct validity, internal consistency and retest reliability were used to evaluate the reliability and validity of the questionnaire.Results:The final questionnaire on the influencing factors of hand hygiene compliance among nursing staff was developed, consisting of four dimensions (attitude, subjective norms, perceived behavioral control, and behavioral intention) and 32 items. The content validity of the questionnaire items was 0.83 to 1.00, and the content validity of the scale was 0.98. Confirmatory factor analysis showed that the model fit well. The Cronbach's α of the questionnaire was 0.823, and the retest reliability was 0.819.Conclusions:The questionnaire has good reliability and validity, which provides a measurement tool for effectively evaluating the influencing factors of hand hygiene compliance behavior among nursing staff.

Objective:To search and summarize the evidence for the non-pharmacological management of delirium of critically ill patients in PICU, and to provide evidence-based guidance for clinical practice.Methods:According to the "6S" evidence pyramid model, we searched computerized decision support system, websites of guidelines, and databases, and obtained the guidelines, clinical decisions, systematic reviews, and evidence summaries.After screening the articles, two researchers independently appraise articles using validated tools, and finally formed the evidence summary of delirium non-pharmacological management of critically ill patients in PICU.Results:Totally six articles were included for the evidence synthesis, including three guidelines, two systematic reviews, and one expert advice.Twenty pieces of evidence including four aspects were summarized, namely delirium screening, risk prediction, non-pharmacological prevention and management strategies, health care provider education and departmental standardization.Conclusion:The evidence summarized in this study can provide a reference to health care professionals.When we apply this evidence in the clinical setting, we should adapt it accordingly to the specific clinical setting to improve the effectiveness of the evidence.

It was a retrospective cohort study. Eighty maintenance hemodialysis (MHD) patients with corona virus disease 2019 (COVID-19) were enrolled, among whom 48 patients survived and 32 died. The clinical data between the survival and death groups were compared. The Cox regression model was used to analyze the risk factors of death in MHD patients with COVID-19, and a survival prediction model was constructed. The results showed that age, lesion-cumulative number of lung segments, C-reactive protein, procalcitonin, serum ferritin, interleukin-6, D-dimer, serum phosphorus, and proportions of males, diabetes and hypoxemia in the death group were higher than those in the survival group (all P<0.05). Increased age ( HR=1.039, 95% CI 1.007-1.072, P=0.017), diabetes ( HR=2.688, 95% CI 1.018-6.991, P=0.046), increased C-reactive protein ( HR=1.006, 95% CI 1.001-1.011, P=0.012), and increased serum phosphorus ( HR=1.573, 95% CI 1.015-2.438, P=0.043) were independent influencing factors of death in MHD patients with COVID-19. The survival prediction model was established based on age, diabetes, C-reactive protein and blood phosphorus. The area under the receiver operating characteristic curve of the combined model for survival time at 7-day, 14-day, and 21-day were 0.751 (95% CI 0.690-0.811), 0.768 (95% CI 0.712-0.824), and 0.780 (95% CI 0.729-0.831), respectively. The concordance index of cross- validation as internal validation was 0.797 (95% CI 0.757-0.837). Increased age, diabetes, elevated C-reactive protein and elevated blood phosphorus are independent risk factors of COVID-19 death in MHD patients, and the survival prediction model built by those factors has good efficacy.

Objective:To investigate the effects of Jin's three needles combined with neuromuscular electrical stimulation on electromyography (EMG), muscle strength, and lower limb motor function in patients with hemiplegia after stroke.Methods:A total of 102 patients with hemiplegia after ischemic stroke who received treatment in Dongyang People's Hospital from July 2021 to August 2022 were included in this randomized controlled study. They were divided into a treatment group and a control group ( n = 51 per group) using a random number table method. The treatment group was given Jin's three needles combined with neuromuscular electrical stimulation, and the control group was given neuromuscular electrical stimulation alone. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the degree of neurological impairment. The modified Barthel Index (MBI) score was used to assess a patient's self-care ability. EMG was performed to record myoelectric signals. The Fugl-Meyer Assessment Scale was used to evaluate a patient's lower limb motor function. Manual Muscle Testing was performed to measure a patient's muscle strength. The degree of nerve defect, self-care ability, lower limb motor function, hip flexion muscle strength, knee extensor muscle strength, and ankle dorsalis extensor muscle strength were compared before treatment and after 2 weeks of treatment. Results:After treatment, the NIHSS score in the treatment and control groups significantly decreased compared with those before treatment [(10.14 ± 3.45) points vs. (3.80 ± 1.92) points, (10.10 ± 3.17) points vs. (6.18 ± 2.15) points, t = 17.31, 19.08, both P < 0.05]. After treatment, the NIHSS score in the treatment group was lower than that in the control group ( t = -5.87, P < 0.001). After treatment, the integral EMG values of the tibialis anterior muscle, gastrocnemius muscle, and quadriceps femoris in the treatment and control groups were increased compared with those before treatment [(20.43 ± 5.26) points vs. (48.14 ± 10.41) points, (16.20 ± 2.62) points vs. (24.69 ± 4.07) points, (32.62 ± 3.42) points vs. (43.40 ± 4.69) points; (20.40 ± 5.19) points vs. (35.45 ± 7.41) points, (16.32 ± 2.51) points vs. (20.91 ± 3.45) points, (32.59 ± 3.37) points vs. (37.39 ± 4.06) points, t = -23.79, -16.11, -19.89; -21.92, -10.86, -8.71, all P < 0.05]. After treatment, the integral EMG values of the tibialis anterior muscle, gastrocnemius muscle, and quadriceps femoris in the treatment group were significantly higher than those in the control group ( t = 7.09, 5.05, 6.92, all P < 0.001). After treatment, The Fugl-Meyer Assessment scale score in the treatment and control groups were significantly increased compared with that before treatment [(17.61 ± 8.93) points vs. (27.16 ± 5.84) points, (17.53 ± 7.59) points vs. (22.22 ± 6.66) points, t = -14.64, -10.72, both P < 0.05). After treatment, The Fugl-Meyer Assessment scale score in the treatment group was significantly higher than that in the control group ( t = 3.98, P < 0.001). After treatment, hip flexion muscle strength, knee extensor muscle strength, and ankle dorsalis extensor muscle strength in the treatment and control groups increased compared with those before treatment. After treatment, hip flexion muscle strength, knee extensor muscle strength, and ankle dorsalis extensor muscle strength in the treatment group were significantly higher than those in the control group [(3.75 ± 0.63) grades vs. (3.31 ± 0.65) grades, (3.51 ± 0.67) grades vs. (3.08 ± 0.87) grades, (2.98 ± 0.81) grades vs.(2.35 ± 1.06) grades, t = 3.41, 2.80, and 3.36, all P < 0.05]. Conclusion:Jin's three needles combined with neuromuscular electrical stimulation can improve EMG findings, increase muscle strength, and lower limb motor function in patients with hemiplegia after stroke

【Objective】 To analyze the impact of sporadic cases of COVID-19 on the work of Transfusion Department, so as to explore the countermeasures. 【Methods】 The admission of inpatient departments, the reception of outpatient(including emergency) departments, the workload of transfusion department(including blood typing, unexpected antibody screening and cross matching), and the consumption of blood components in the Xijing Hospital between October and November in 2021, during COVID-19 outbreak, were collected. All the above data was statistically compared to the data in same period in 2018, before the COVID-19 outbreak. 【Results】 Due to the COVID-19 epidemic, there was a significant decrease in number of inpatients(280±157.1 vs 340.4±110.2), outpatient(including emergency)(8 359±3 615 vs 10 151±3 225), the workload of blood typing(272.0±132.4 vs 341.6±110.4), unexpected antibody screening(78.26±42.22 vs 98.51±43.53) and crossmatch(237.2±99 vs 475.7±155.6), as well as the consumption(U) of all blood components(457.9±50.32 vs 579.4±62.51) in the Xijing Hospital(P<0.05). In detail, the epidemic had the most direct impact on the number of inpatients and outpatients, which shrank continuously on the 2^nd day after official announcement of the new COVID-1 cases. While the workload of blood typing, unexpected antibody screening and crossmatch decreased slightly, with a lag, usually on the 2^nd, 3^rd and 5^th day after official announcement. The decrease of the usage of red blood cells and plasma began from the 7^th day after the new epidemic to the 6^th day after the end of the epidemic. However, the usage platelets and cryoprecipitate coagulation factors decreased from the 8^th and 10^th day after the new epidemic to the 2^nd and 6^th day after the end of the epidemic, respectively. 【Conclusion】 The daily work of Blood Transfusion Department has been seriously affected by sporadic COVID-19 epidemic. The working mode, staff structure and inventory ratio of blood components should be adjusted and optimized instantly to maintain the normal conduct of medical treatments in hospitals and ensure the safety of patients.

Objective: To understand the neglect status among preschool non-only-child in Nantong, and to provide theoretical basis for the prevention and intervention of non-only child neglect. Methods: Using the method of random cluster sampling, a total of 1 141 parents of children from 9 kindergartens in the main urban area of Nantong were investigated with National Neglect Norm Scale for Children aged 3 to 6 years. Results: The neglect rate of preschool children in Nantong City was 28.6%, with neglect score being (40.21±6.67). The neglect rate of non-only-child was 32.6%, with neglect score being (41.14±6.73). The total and physical neglect rate of non-only-child were higher than that of only child, and the total neglect score and physical, emotional, educational, safety, medical neglect dimensional scores were higher than that of only-child, the difference were all statistically significant ( χ 2/ t = 6.21, 17.57; 3.95, 4.98, 3.45, 2.70, 2.01, 3.11, P <0.05). In non-only-child, univariate analysis showed that there were no significant differences in neglect rate and scores among children by gender and family types ( P >0.05); There was no significant difference in the child neglect rate between different age groups and children in different families ( χ 2 =3.59, 2.99, P >0.05), but there was a statistically significant difference in the degree of neglect ( t=2.79, 3.04, P <0.05). The neglect rate and score of non-only-child with high level of family income, parental education and parental relationship was relatively low, while the neglect rate and score in non-only-child whose grandparents serving as primary caregiver were higher ( P <0.05). Multivariate Logistic regression analysis showed that family monthly income less than 5 000 yuan was associated with 2.73 times higher risk of neglect compared to children with family monthly income more than 12 000 yuan. The risk of neglect among children whose grandparents serving as caregivers was associated with 2.17 times higher than children with parental care. The risk of neglect of children with poor parental relationship was 2.29 times higher than that of children with good parental relationship ( P <0.05). Conclusion The neglect among preschool non-only-child in Nantong City is common. Improvement in family economic status, parental care and parent relationship might help reduce neglect among preschool non-only-child.

Gallic Acid/pharmacology* ; Humans ; Senotherapeutics ; Stem Cells