Objective To construct a nomogram risk prediction model for symptomatic cerebrovas-cular ischaemia based on intra-plaque neovascularisation in carotid arteries in patients with ische-mic cerebrovascular disease(ICVD).Methods A retrospective study was conducted on 320 ICVD patients who were consecutively admitted to Wuhan Fourth Hospital from April 2020 to April 2024.In a ratio of 3∶1,240 cases were assigned into a training set and 80 cases into a validation set.The patients in the training set were further divided into 147 cases in the symptomatic sub-group and 93 cases in the asymptomatic subgroup according to the presence or absence of relevant symptoms or signs.Multifactorial logistic regression analysis was used to identify the risk factors for symptomatic ischemia in ICVD patients,and a nomogram risk prediction model was construc-ted and the prediction efficacy of the model was evaluated.Results The proportions of plaque multiplicity,ulcerated plaque,stenosis ≥70％,and intra-plaque neovascularization were signifi-cantly higher in the symptomatic subgroup than the asymptomatic subgroup(P＜0.05,P＜0.01).Multifactorial logistic regression analysis showed that plaque multiplicity(OR=1.261,95％CI:1.088-1.539,P=0.003),ulcerated plaque(OR=1.458,95％CI:1.132-1.661,P=0.001),and stenosis ≥70％(OR=2.023,95％CI:1.458-2.561,P=0.001),and intra-plaque neovasculariza-tion(OR=1.206,95％CI:1.057-1.489,P=0.002)were independent risk factors for the occur-rence of symptomatic cerebral ischemia in ICVD patients.H-L deviation test showed that the con-structed nomogram risk prediction model had a good fit(x2=9.362,P=0.295).Internal and ex-ternal validation showed that the calibration curves for both the training and validation sets were consistent with the original curves,and the AUC value was were 0.871 and 0.864,respectively.De-cision curve analysis showed that the model had a significant standardized clinical net benefit when the predicted risk threshold exceeded 0.01.Conclusion Ultrasonography is instructive in as-sessment of the presence or absence of intra-plaque neovascularization in carotid atherosclerotic plaques.And our constructed nomogram risk prediction model has good predictive value for the development of symptomatic cerebral ischemia.

Steatotic liver diseases (SLD) are the principal worldwide cause of cirrhosis and end-stage liver cancer, affecting nearly a quarter of the global population. SLD includes metabolic dysfunction-associated alcoholic liver disease (MetALD) and metabolic dysfunction-associated steatotic liver disease (MASLD), resulting in asymptomatic liver steatosis, fibrosis, cirrhosis and associated complications. The immune processes include gut dysbiosis, adiposeliver organ crosstalk, hepatocyte death and immune cell-mediated inflammatory processes. Notably, various immune cells such as B cells, plasma cells, dendritic cells, conventional CD4+ and CD8+ T cells, innate-like T cells, platelets, neutrophils and macrophages play vital roles in the development of MetALD and MASLD. Immunological modulations targeting hepatocyte death, inflammatory reactions and gut microbiome include N-acetylcysteine, selonsertib, F-652, prednisone, pentoxifylline, anakinra, JKB-121, HA35, obeticholic acid, probiotics, prebiotics, antibiotics and fecal microbiota transplantation. Understanding the immunological mechanisms underlying SLD is crucial for advancing clinical therapeutic strategies.

Objective:To construct an evaluation index system for the core competence of hospital specialist service operation assistants and provide reference for the evaluation of such competence.Methods:From January to March 2022, literature analysis and behavioral event interviews were used to initially establish a core competence evaluation index system of hospital specialist service operation assistants, based on the Donabedian model. Subsequently, the Delphi expert consultation method was applied to conduct correspondence consultation, inviting experts to evaluate the contents and importance of the index system, using analytic hierarchy process to determine the weights of the indexes at all levels.Results:Two rounds of expert consultation were carried out, and the valid recovery rate of the questionnaire was 100%. The familiarity coefficient of the second round of correspondence was 0.87, the basis of judgment coefficient was 0.90, and the authority coefficient was 0.89. The final evaluation index system for core competence of hospital specialist service operation assistant consisted of 3 first-level indexes, 13 second-level indexes and 81 third-level indexes. The weight of the first-level index structure index was 0.266, and the highest weight among the second-level indexes was the operational development ability (0.083), while the highest weight among the third-level indexes of operational development ability was the comprehensive coordination ability (0.193); The weight of the first-level index process index was 0.405, and the corresponding second-level and third-level indexes with the highest weight were department operation practice work (0.157) and reasonable resource allocation (0.303), respectively; The weight of the first-level index result index was 0.329, and the corresponding second-level and third-level indexes with the highest weight were the weight of medical quality and safety (0.103) and drug adverse reaction reporting rate (0.237), respectively.Conclusions:The evaluation index system constructed in this study proves scientific and reasonable in weight assignment, proving a reference for the management of the specialist service operation assistants.

Background Most metro system are underground, airtight, with inadequate ventilation and massive gatherings, posing health risks to metro riders. Objective To evaluate air quality of Metro Line 1 in a city, and provide suggestions and basis for preventing harmful factors and protecting the health of passengers. Methods Station halls, station platforms, and metro carriages of Metro Line 1 in a city were monitored in summer (from July to August in 2021) and winter (from January to February in 2022). Six metro stations were selected by stratified sampling. Each station and carriage were monitored for three consecutive days in rush hours (9:00–11:00 and 19:00–21:00) and non-rush hours (11:00–13:00), with the same monitoring frequency. The monitored indicators were physical factors (temperature, relative humidity, wind speed, illumination, and noise), chemical factors (carbon monoxide, carbon dioxide, inhalable particles, formaldehyde, benzene, toluene, xylene, ammonia, and ozone), biological factor (airborne total bacterial count), and radiation factor (radon). The monitoring results were compared by location, time period, and season. Results According to the Hygienic indicators and limits for public places (GB 37488—2019), the selected physical factors did not meet the standard, especially the temperature and relative humidity of station hall and platform, and wind speed and noise of carriage. The results of physical factors varied significantly by location (P<0.05). In summer, the temperature of carriage [M (P₂₅, P₇₅), 23.9 (23.3, 24.6)℃] was the lowest, and the wind speed [0.78 (0.37, 1.11) m·s⁻¹] and noise [76.0 (72.0, 80.3) dB] of carriage were the highest; in winter, the temperatures of station hall and platform were the lowest [16.2 (13.2, 17.2)℃ and 16.2 (13.4, 17.0)℃, respectively], the relative humidity of carriage [26.4% (24.2%, 27.9%)] was the lowest, and the wind speed and noise of carriage were the highest [0.83 (0.47, 1.18) m·s⁻¹ and 74.5 (70.1, 78.3) dB, respectively]. The physical factors varied significantly by time period (P<0.05). In summer, the temperature was the lowest during morning rush hours [24.0 (23.0, 24.8)℃] and non-rush hours [24.2 (23.2, 24.9)℃], and the relative humidity during evening rush hours was the lowest [41.9% (37.0%, 47.8%)]; in winter, the temperature was the lowest during morning and evening rush hours [16.8 (13.4, 19.7)℃ and 16.5 (15.1, 19.4)℃, respectively], the relative humidity during the non-rush period was the lowest [26.8% (24.7%, 28.6%)], and the wind speed during evening rush hours was the highest [0.28 (0.19, 0.51) m·s⁻¹]. All measured chemical factors, biological factor, and radiation factor met the national standard (GB 37488—2019). Conclusion The chemical, biological, and radiative factors are complied with the national standard (GB 37488—2019) except physical factors such as temperature, relative humidity, wind speed, and noise. We suggest that the metro operators make full use of air conditioning system in combination with humidifiers to better regulate temperature and relative humidity, and .arrange working hours reasonably and provide noise-proof earplugs for carriage staff to protect against noise hazard.

Objective To investigate the relationship between exposure to famine in early life stage and hypertension phenotype and grade in middle and old age. Methods People born between 1951 and 1965 in the 2015 China Health and Elderly Care Follow-up Survey were included in the study, and were divided into unexposed group, fetal exposed group, childhood exposed group and adolescent exposed group according to the time of famine occurrence and birth year of the participants. Logistic regression model was used to explore the effects of different famine exposure periods in early life stage on hypertension classification （including normal high value, grade I, grade II and grade III） and phenotype （including isolated systolic hypertension[ISH], isolated diastolic hypertension [IDH] and combined systolic and diastolic hypertension [SDH]）. Results Compared with unexposed group, fetal famine exposure （OR=1.59, 95% CI :1.10-2.30）, childhood famine exposure （OR=1.67, 95% CI :1.04-2.70） and adolescent famine exposure （OR=3.42, 95% CI : 2.51-4.66） were the risk factors for ISH. Only famine exposure during adolescence （OR=1.54, 95% CI: 1.07-2.21） was a risk factor for SDH. In addition, fetal famine exposure （OR=1.41, 95% CI: 1.05-1.89） and adolescent famine exposure （OR=2.22 , 95% CI: 1.71-2.88） were risk factors for developing grade I hypertension. Famine exposure in childhood （OR=2.45, 95% CI: 1.21-4.94） and famine exposure in adolescence （OR=2.45, 95% CI: 1.44-4.19） were risk factors for grade 2 hypertension. Conclusion Famine exposure in early life stage was associated with the phenotype and grade of hypertension. Therefore, balanced nutrition in early life is important to prevent hypertension in adulthood.

OBJECTIVE To determine the content of free lanolin alcohol and residual pesticides in lanolin by gas chromatography, and to evaluate the feasibility of the established method. METHODS Gel permeation chromatography(GPC) was used for pretreatment, and the contents of free lanolin alcohol and residual pesticides were determined by GC-FID and GC-MS, respectively. And the qualitative analysis was conducted based on the retention time and quantitative analysis was conducted by total peak area. RESULTS The recovery of GPC pretreatment system met the requirements. Under the two established methods, the determinand were well separated; the satisfactory linearity with good correlation coefficients >0.999 5 were obtained; and the average recoveries were in the range of 90.49%-102.78%(n=6). The content of free lanolin alcohol in 3 batches of lanolin was <2.84%, cis-permethrin and trans-permethrin were determined in lanolin and the other residual pesticides were not detected. CONCLUSION The GPC-GC/FID and GPC-GC/MS method established in the study have good specificity, high precision, accuracy and robustness, which can be used for the separation and determination of free lanolin alcohol and six organophosphorus and pyrethroid residual pesticides in lanolin. At the same time, this study can provide reference for the quality control of lanolin.

Objective:To explore the effect of umbilical vein catheterization (UVC) on portal vein blood flow velocity (PBFVe) and its relationship with gastrointestinal (GI) complications in neonates.Methods:A prospective study was conducted on neonates with indications for UVC and achieving one-time successful catheterization at Gansu Provincial Women and Child-care Hospital from March 2019 to March 2021. Successful UVC was defined as the umbilical catheter reaching the entrance of the inferior vena cava and right atrium through the ductus venosus. PBFVe was measured by bedside ultrasound before and after UVC. All subjects were divided into two groups as those with GI complications anytime from insertion to withdrawal (complication group), and those with no GI complications (no complication group) to compare the PBFVe value before UVC and the percentage of decrease in PBFVe after UVC. Multivariate logistic regression analysis and receiver operating characteristic (ROC) curve were used to analyze the risk factors of GI complications and the predictive value of the percentage of decrease in PBFVe after UVC.Results:Of 91 subjects included, 59.3% (54/91) had no GI complications, and 40.7% (37/91) had. After UVC, PBFVe was decreased than before in neonates both with and without GI complications [(11.3±1.8) vs (14.7±2.4) cm/s; (12.4±1.7) vs (14.2±1.8) cm/s, t=－16.92 and－17.62, respectively, both P<0.05]. PBFVe before UVC were similar between the two groups. However, the complications group had a lower PBFVe after UVC ( t=－2.98, P=0.004) and a higher percentage of decrease in PBFVe [(22.5±6.0)% vs (12.6±4.9)%, t=8.65, P<0.001] when compared with the no complications group. Multivariate logistic regression analysis showed that the body weight was the protector of GI complications ( OR=0.294, 95% CI:0.089-0.974, P=0.045), and the percentage of decrease in PBFVe was the risk factor ( OR=1.478, 95% CI:1.249-1.749, P<0.001). The area under the curve of the percentage of decrease in PBFVe for predicting GI complications was 0.919 (95% CI:0.843-0.966, P<0.001). The cut-off value was 16.9% with a sensitivity of 89.2% and a specificity of 85.2%. Conclusions:UVC can reduce the PBFVe of neonates. The more the PBFVe decreases, the greater the possibility of GI complications.

Objective: To investigate correlations between motor skills with focused and shifting attention among preschool children, and to provide basis for the overall development of preschool children aged 4-6 years. Methods: During March to June 2020, a total of 165 preschool children aged 4-6 years were selected and investigated with subscales of the Bruininks Oseretsky Test of Motor Proficiency 2nd Edition (BOT-2) for agility and limb bilateral coordination assessment, and subscales of the Movement Assessment Battery for Children test 2nd Edition (MABC-2) for throwing and catching skill assessment, as well as balance subscale for the assessment of limb movement coordination, hand eye coordination, agility, and balance. The Kansas Reflection Impulsivity Scale for Preschoolers for Pre schoolers (KRISP) and Dimensional Change Card Sort (DCCS) were used to assess focused and shifting attention levels. Correlation and linear regression analyses were performed for statistical analysis. Results: Except for one handed throwing skills and shifting attention, there were statistically significant gender differences between boys and girls in total score of body movement coordination, total score of hand to eye coordination, hand to hand connection, total score of agility of movement, total score of movement balance, static support, walking on tiptoe, foot to foot jump and focused attention( t =-6.86, -2.00 ,-3.15,-3.75,-3.00,-2.95,-2.18,-2.11,-3.21, P ＜0.05), and girls were better than boys; children s total score of body movement coordination, total score of hand to eye coordination, hand to hand connection, agility of movement, walking on tiptoe and focused attention improves with age( r =0.47,0.41,0.47,0.51,0.16,0.31, P ＜0.05); After excluding the interference of gender and age, total score of body movement coordination was significantly correlated with preschool children s focused attention( β=0.31,95%CI =0.08-0.39, P ＜0.01). Conclusion Limb movement coordination and focused attention are significantly and positively correlated among preschool children aged 4-6 years. Therefore, preschool education and family activities should focus on designing and developing limb movement coordination related games and courses to enhance the focused attention of and form favorable attention quality in preschool children aged 4-6 years.

Osteoporotic thoracolumbar fracture in the elderly will seriously reduce their quality of life and life expectancy. For osteoporotic thoracolumbar fracture in the elderly, spinal reconstruction is necessary, which should comprehensively consider factors such as the physical condition, fracture type, clinical characteristics and osteoporosis degree. While there lacks relevant clinical norms or guidelines on selection of spinal reconstruction strategies. In order to standardize the concept of spinal reconstruction for osteoporotic thoracolumbar fracture in the elderly, based on the principles of scientificity, practicality and progressiveness, the authors formulated the Clinical guideline for spinal reconstruction of osteoporotic thoracolumbar fracture in elderly patients ( version 2022), in which suggestions based on evidence of evidence-based medicine were put forward upon 10 important issues related to the fracture classification, non-operative treatment strategies and surgical treatment strategies in spinal reconstruction after osteoporosis thoracolumbar fracture in the elderly, hoping to provide a reference for clinical treatment.

Objective:To investigate the effect of O-arm navigation assisted posterior pedicle screw reduction and internal fixation of atlantoaxial fractures.Methods:A retrospective case-control study was conducted to analyze 37 patients with atlantoaxial fractures admitted to Third Hospital of Hebei Medical University from January 2016 to June 2018, including 22 males and 15 females, aged from 29 to 68 years [(50.9±9.8)years]. The posterior pedicle screw reduction and internal fixation was performed under O-arm navigation system (navigation group, n=24), and using free-hand technique (free-hand group, n=13). The operation time and blood loss were compared between the two groups. The Japanese Orthopaedic Association (JOA) score and neck disability index (NDI) were used to evaluate the clinical efficacy before operation, 7 days operation and at the last follow-up. The complications were detected. A total of 86 screws were placed in navigation group (Neo grade 0: 83 screws, grade 1: 2 screws, grade 2: 1 screw ), and 44 screws were inserted in free-hand group (Neo grade 0: 36 screws, grade 1: 5 screws, grade 2: 2 screws, grade 3: 1 screw)( P<0.05). Classification of screw positions proposed by Neo et al was used to evaluate the position relationship between the screw and the bone cortex and the incidence of screw penetration. Results:All patients were followed up 24-38 months [(27.7±4.0)months]. The operation time in navigation group was (189.8±35.4)minutes, significantly shorter than (221.5±48.6)minutes in free-hand group ( P<0.05). The bleeding volume in navigation group was 300.0 (250.0, 537.5)ml , significantly less than 500.0 (425.0, 625.0)ml in free-hand group ( P<0.05). Both groups showed significantly enhanced JOA and decreased NDI after operation and at last follow-up, compared with those before operation ( P<0.05). However, there was no significant difference in JOA and NDI between the two groups ( P>0.05). No severe complications such as neurovascular injury occurred during operation. The incidence of cortical penetration was 3% (3/86) in navigation group and 18% (8/44) in free-hand group ( P<0.05). Conclusions:In the process of posterior atlantoaxial pedicle screw placement, the application of O-arm navigation can significantly reduce the operation time and amount of bleeding, and enhance the accuracy of pedicle screw implantation.