Objective: To analyze the characteristics of alcohol poisoning cases among minors receiving pre hospital 120 emergency services in Zhengzhou, providing evidence for regional management strategies of alcohol poisoning among minors. Methods: A retrospective study was conducted on 1 630 alcohol poisoning cases (aged 0-18 years) from Zhengzhou s 120 emergency system during 2017-2019 and 2023. Data on gender, age, occurrence timeframes were analyzed using t-test and χ 2 test for intergroup comparisons. Results: Annual cases were 291 (2017), 353 (2018), 483 (2019), and 503 (2023). Compared with 2017, male alcohol poisoning cases increased by 66.94% while female cases surged 104.35% by 2023. The peak incidence of alcohol poisoning among minors occurred among 16-18 year olds (85.40%), followed by 13-15 year olds (13.74%). Most cases clustered between 21:01-03:00 (60.43%), with male cases peaking at 22:01-23:00 (12.73%) and female cases peaking at 02:01-03:00 ( 11.25 %). Between 00:01-03:00, male cases progressively decreased while female cases increased. Severity distribution showed 355 mild cases (21.78%), 1 035 moderate cases (63.50%), and 240 severe cases (14.72%). Conclusions Zhengzhou region has experienced sustained growth in underage alcohol poisoning cases, predominantly occurring from evening to early morning with moderate severity, female cases demonstrate faster growth rates. Multifaceted regulatory measures should be implemented to strengthen supervision of underage drinking behaviors.

ObjectiveTo adapt the Stanford Expectations of Treatment Scale（SETS） into Chinese（C-SETS） and test the feasibility， validity and reliability of its application in patients with diarrhea-predominant irritable bowel syndrome（IBS-D） with liver-constraint and spleen-deficiency syndrome treated with traditional Chinese medicine（TCM）. MethodsWe obtained authorisation from the developer of the SETS， and followed the principle of "two-way translation" to translate the SETS by literal translation and back translation to form the C-SETS. Ninety-six IBS-D patients with liver-constraint and spleen-deficiency syndrome were enrolled as respondents and filled out C-SETS before receiving treatment； the feasibility was assessed by the recall rate， completion rate and the duration of filling out the scale； the reliability was assessed by Cronbach's α； the structural validity was assessed by exploratory and confirmatory factor analysis， and the content validity was assessed by correlation analysis. ResultsThe C-SETS consists of 10 items， with the 1st， 3rd， and 5th rating items constituting the Positive Expectations subscale， and the 2nd， 4th， and 6th rating items constituting the Negative Expectations subscale， each of which is rated on a 7-point Likert Scale. The recall of C-SETS was 100%（96/96）， the completion rate was 89.58%（86/96）； Cronbach's α for the Positive and Negative Treatment Expectations subscales were 0.845 and 0.854， respectively； exploratory factor analysis showed that the coefficient of commonality for all six entries was larger than 0.4， and that the six entries could be used by both factors to explain 77.092% of the total variance； validation factor analysis showed that the goodness-of-fit index， comparative fit index， root mean square of approximation error， canonical fit coefficient， and chi-square degrees of freedom ratio took the values of 0.943， 1.003， 0， 0.943， and 0.626， respectively； and the results of Spearman's analysis suggested that the C-SETS had good content validity. ConclusionThe C-SETS has well feasibility， reliability， and validity， which initially proves that it can be used as a tool to assess the treatment expectation of patients with IBS-D with liver-constraint and spleen-deficiency syndrome before receiving TCM treatment.

Cirrhotic portal hypertension (CPH) is a manifestation of decompensated liver cirrhosis, with ascites, portal collateral circulation formation, hypersplenism and splenomegaly as the typical clinical symptoms. In recent years, the incidence of CPH has been increasing year by year, and the treatment of CPH has gradually become a hot issue in medical research. In order to further explore the diagnosis and treatment scheme of CPH. We briefly describe the pathophysiological mechanism and diagnosis of CPH, and the current situation of CPH treatment and the new progress of internal and external treatment were reviewed.

Objective:To investigate the knowledge and practice of the Sixth Chinese national consensus report on the management of Helicobacter pylori ( H. pylori) infection (treament excluded) (referred to as sixth national consensus)and 2022 Chinese national clinical practice guideline on H. pylori eradication treatment (referred to as guideline) among gastroenterologists in China, so as to provide out relevant training in the future. Methods:A questionnaire was designed according to sixth national consensus and guideline, including knowledge and practice of sixth national consensus and guideline, and the detection, indications of eradication, the relationship between infection and gastrointestinal microbiota, and eradication of H. pylori. From November 1 to 30 in 2023, the questionnaire-based survey was conducted among 1 506 gastroenterologists from secondary and tertiary hospitals of 24 provinces, autonomous regions and municipalities in China with convenience sampling method using the "Questionnaire Star" online questionnaire platform and the questionnaire link was sent by WeChat. Descriptive methods were used for statistical analysis. Results:A total of 1 442 valid questionnaires were collected. The awareness rate of sixth national consensus and guideline of gastroenterologists was 83.7% (1 207/1 442), and 47.2% (680/1 442) had read the relevant content in detail. Urea breath test (97.4%, 1 404/1 442) was the most commonly used method for diagnosing current H. pylori infection, however, more than half of the physicians chose serological test (53.3%, 769/1 442) for the diagnosis of current infection. The common indications of H. pylori eradication could be identified by 84.3%(1 215/1 442) of gastroenterologists. The most well-known eradication regimen was bismuth quadruple regimen (98.5%, 1 421/1 442), while some physicians still believed that the standard triple regimen (31.8%, 459/1 442) and sequential regimen (21.9%, 316/1 442) were recommended by the guideline. A further 20.2% (291/1 442) frequently prescribed a triple regimen combined with gastric mucosal protectants and the awareness rate of high-dose dual regimen was 59.1% (852/1 442). Amoxicillin + clarithromycin (65.4%, 943/1 442) and amoxicillin+ furazolidone (20.1%, 290/1 442) were commonly used antibiotic combinations in bismuth quadruple therapy. Potassium-competitive acid blockers and double-dose proton pump inhibitors were commonly used in bismuth quadruple therapy by 45.4% (655/1 442) and 46.0% (664/1 442) of physicians, respectively. For patients with multiple failed eradications, furazolidone was the most commonly used antibiotic for re-eradication(71.7%, 1 034/1 442). Conclusion:The knowledge and practice of gastroenterologists on H. pylori infection in China deviates from the new consensus and guideline, and more publicity and training should be carried out in future to improve the ability of gastroenterologists to standardise the diagnosis and treatment of H. pylori infection.

Objective:To describe the status and influencing factors of the empowerment of caregivers after gastrointestinal tumor.Methods:From March 2019 to October 2019, using convenience sampling method, 124 pairs of gastrointestinal tumor patients and caregivers who were hospitalized in the general surgery and anorectal surgery of the department of Shandong Tai′an City Central Hospital and the Second Affiliated Hospital of Shandong First Medical University were selected as the subjects. A general information questionnaire, Main Caregivers′Empowerment Measurement were used as research tools. To investigate the empowerment ability of caregivers of patients with gastrointestinal tumors after operation.Results:The total caregiver′s empowerment score was 168.81 ± 19.49. The scores of each dimension ranged from high to low: relationship with caregivers (3.83 ± 0.43), expectation of care outcomes (3.80 ± 0.43), awareness of caregiving roles (3.70 ± 0.51), caregivers′ subjectivity (3.37 ± 0.60), caregiving beliefs (3.34 ± 0.67), caregiving knowledge and skills (3.27 ± 0.73), personal resources (2.94 ± 0.65), goodwill caregiving (2.85 ± 0.65) , the scruples around (2.75 ± 0.88). Multiple linear regression results showed that, patient gender, whether the disease is first attack, whether the patient is aware of the disease, the caregiver marriage, and the caregiver working status were the influencing factors of the caregiver′s empowerment ability after gastrointestinal tumor operation ( t values were -8.15-8.72, R2=0.62, all P<0.05). Conclusions:There is room for further improvement in the empowerment of caregivers after gastrointestinal tumor surgery, especially in personal resources, goodwill care and scruples around. The results suggest that medical staff should guide caregivers to emancipate their minds, enhance the breadth of empowerment, and promote self care and fast rehabilitation of patients.

Objective:To investigate the incidence of acute kidney injury (AKI) following pancreaticoduodenectomy and related risk factors in elderly patients.Methods:The clinical data of elderly patients who underwent pancreaticoduodenectomy in Henan Provincial People′s Hospital from January 2017 to June 2020 were collected retrospectively. According to the changes of serum creatinine within 48 h or 7 days after operation, the patients were divided into AKI group and non-AKI group. The basic clinical characteristics of the two groups were compared, and the incidence of AKI was calculated. Multivariate logistic regression model was used to analyze the risk factors of postoperative AKI.Results:A total of 322 elderly patients were enrolled, with age of (67.1±5.2) years old (60-85 years old) and 186 males (57.76%). Among 322 elderly patients, there were 41 patients (12.73%) suffering from AKI following pancreaticoduodenectomy. Compared with the non-AKI group, the level of bilirubin in AKI group was higher ( Z=-2.012, P=0.044), and the level of hemoglobin in AKI group was lower ( Z=-2.111, P=0.035). Multivariate logistic regression analysis showed that increased preoperative total bilirubin ( OR=1.003, 95% CI 1.000-1.006, P=0.027) and postoperative exploratory laparotomy ( OR=3.936, 95% CI 1.071-14.460, P=0.039) were the independent influencing factors for AKI after pancreaticoduodenectomy in elderly patients. Conclusions:The incidence of AKI after pancreaticoduodenectomy in elderly patients is 12.73%. Preoperative high bilirubin and postoperative exploratory laparotomy may be the independent risk factors for AKI after pancreaticoduodenectomy in elderly patients.

Immunotherapy has been one of the most promising approaches in tumor-treating fields, including immune checkpoint inhibitors, bispecific antibodies, and CAR-T therapy, etc. It has achieved major breakthroughs in the treatment of hematological and other malignancies. However, related safety management issues are becoming increasingly prominent, especially the diagnosis and treatment of coagulopathy deserves the attention of clinical and laboratory physicians. Therefore, this review summarizes immunotherapy-related coagulopathy from the perspectives of epidemiology, pathogenesis and laboratory indicators and provides guidance for early clinical identification, diagnosis and intervention.

Objective:To analyze the influencing factors of death in patients with acute respiratory distress syndrome (ARDS) combined with acute kidney injury (AKI) in intensive care unit (ICU) after continuous renal replacement therapy (CRRT).Methods:The demographic and clinical data of ICU patients with ARDS combined with AKI after CRRT at Henan Provincial People's Hospital from January 1, 2018 to December 31, 2018 were collected. According to the final treatment results of this hospitalization, the patients were divided into death group and survival group. Survival was defined as the improved patient's condition and hospital discharge. Death was defined as the patient's death during the ICU hospitalization or confirmed death after abandoning treatment and automatically being discharged from the hospital in the follow-up. The basic clinical characteristics and CRRT status between the two groups were compared. Multivariate logistic regression method was used to analyze the influencing factors of death in patients.Results:A total of 132 patients were enrolled, of which 90 patients (68.2%) died, with 84 males (63.6%) and median age of 59(45, 73) years. Compared with the survival group, the death group had higher age, proportion of malignant tumors, sequential organ failure assessment (SOFA) score, number of organ dysfunction and proportion of positive balance of fluid accumulation at 72 hours, longer time from entering ICU to CRRT, and lower mean arterial pressure (minimum value) and oxygenation index (all P<0.05). Multivariate logistic regression analysis results showed that the age≥60 years old ( OR=4.382, 95% CI 1.543-12.440, P=0.006), large number of organ dysfunction ( OR=1.863, 95% CI 1.109-3.130, P=0.019), high SOFA score ( OR=1.231, 95% CI 1.067-1.420, P=0.004) and long time from ICU admission to CRRT ( OR=1.224, 95% CI 1.033~1.451, P=0.020) were independent influencing factors of death in patients with ARDS combined with AKI after CRRT, and high oxygenation index ( OR=0.992, 95% CI 0.986-0.998, P=0.010) was an independent protective factor for patients' prognosis. Conclusions:The mortality of patients with ARDS combined with AKI after CRRT is still high. The age≥60 years old, large number of organ dysfunction, high SOFA score and long time from ICU admission to CRRT are independent influencing factors for death, and high oxygenation index is an independent protective factor for prognosis in patients with ARDS combined with AKI after CRRT.

Objective To evaluate the diagnostic efficacy of mDIXON Quant for vertebral metastasis. Methods We retrospectively analyzed MRI images of 152 patients with clinically diagnosed malignant tumors and vertebral metastases. Scanning sequence included T1WI, STIR, mDIXON Quant and enhanced T1WI. We compared the diagnostic efficiency between T1WI and FF images for vertebral metastases. FF values between normal vertebral body and vertebral metastases were quantitatively compared, and the diagnostic efficacy of FF value was evaluated by ROC curve. Results The sensitivity, false positive rate, false negative rate, negative predictive value and accuracy of FF images in the diagnosis of vertebral metastases were all higher than those of T1WI images. The FF value of vertebral metastasis was significantly lower than that of normal vertebral body (Z=-21.792, P < 0.05), and the area under ROC curve was 0.987 and the cutoff value was 9.87%. The diagnostic sensitivity and specificity of vertebral metastasis were 99.6% and 92.0%. Conclusion mDIXON Quant can quantitatively determine the fat content of vertebral metastasis and has a high diagnostic efficiency for vertebral metastases.

Objective:To establish a method for the determination of bisphenol S in urine using dispersive liquid-liquid microextraction (DLLME) coupled with high performance liquid chromatography (HPLC) .Methods:The acetonitrile, octanol were used as extraction solvent, dispersive solvent respectively, for the preconcentration of bisphenol S. The optimal extraction conditions were optimized by single factor rotations, and methodological performance index were tested.Results:The linear correlation coefficient of bisphenol S in the range of 0.0-160 μg/L is greater than 0.999. The detection limit of this method was 0.76 μg/L, and the recovery rates were 88.06%-103.81%. The intra-and inter-day precisions were 1.78%-2.85% and 2.65%-4.25%, respectively.Conclusion:The method is reliable and sensitive. It is suitable for the determination of bisphenol S in urine samples for occupational exposure populations and non-professional.