Objective To investigate the effect of intravertebral labor analgesia nursing intervened by anesthesia nurse on labor analgesia and delivery outcome.Methods Two hundreds cases of parturients who received intravertebral labor analgesia in The First Affiliated Hospital of Kunming Medical University from July to December 2022 were selected as research objects and randomly divided into observation group and control group by drawing lots,with 100 cases in each group.The control group was given routine nursing by midwives,and the observation group was given anesthesia nursing by an anesthesia nurse.The degree of labor pain,the outcome of labor,the incidence of anesthesia-related complications,and the satisfaction of labor analgesia nursing were compared between the two groups.Results The degree of labor pain in the observation group was significantly lower than that in the control group(P<0.05).The duration of labor in the observation group was longer than that in the control group(P<0.05).The incidence of anesthesia-related complications in the observation group was significantly lower than that in the control group(P<0.05).The satisfaction of parturient analgesic care in the observation group was higher than that in the control group(P<0.05).Conclusion Labor analgesia care intervened by anesthesia nurses can effectively reduce labor pain,shorten the labor process,reduce the incidence of anesthesia-related complications,improve the satisfaction of labor analgesia nursing,and provide a safe,comfortable,and effective labor process for women,which is worthy of clinical promotion.

Glioblastoma (GBM) is one of the most threatening diseases of the central nervous system, and the prognosis has not improved despite the constant updating of therapeutic approaches. However, the introduction of tumor treating fields (TTFields) has changed the treatment of newly diagnosed and recurrent GBM. TTFields is a novel non-invasive therapy for the treatment of tumors using mid-frequency and low-intensity alternating electric fields, which is important for the treatment of central nervous system diseases such as GBM. TTFields has fewer side effects and greater local efficacy than traditional treatment modalities. In addition, the combination of chemotherapeutic drugs and radiotherapy with TTFields has shown significant advantages and may become one of the future clinical treatment strategies. Despite the potential of TTFields in the treatment of GBM, a number of limitations remain, including issues of device dependency, discomfort during use and tolerability in some patients. Therefore, the use of TTFields needs to be further optimized to maximize their therapeutic potential in patients with GBM and to provide more effective treatment options for patients.

Objective To investigate the application efficiency and potential of CT radiomics in differentiating malignant and benign sub-centimeter solid pulmonary nodules. Methods A retrospective study was performed on the sub-centimeter ( ≤ 10 mm) solid pulmonary nodules detected by enhanced CT in our hospital from March 2020 to January 2023. Malignancy was confirmed by surgical pathology, and benignity was confirmed by surgical pathology or follow-up. Lesions were manually segmented and radiomic features were extracted. The feature dimension was reduced via feature correlation analysis and least absolute shrinkage and selection operator (LASSO). The 5-fold cross validation was used to validate the model. Support vector machine, logistic regression, linear classification support vector machine, gradient boosting, and random forest models were established for CT radiomics. Receiver operating characteristic curves were drawn. Delong test was used to compare the diagnostic performance of the five classifiers. The optimal model was selected and compared to radiologists with medium and high seniority. Results A total of 303 nodules, 136 of which were malignant, were examined. Radiomics models were established after feature extraction and selection. On test set, the areas under the receiver operating characteristic curves of support vector machine, logistic regression, linear classification support vector machine, random forest, and gradient boosting models were 0.922 (95%CI: 0.893, 0.950), 0.910 (95%CI: 0.878, 0.942), 0.905 (95%CI: 0.872, 0.938), 0.899 (95%CI: 0.865, 0.933), and 0.896 (95%CI: 0.862, 0.930), respectively. Delong test indicated no significant differences in the performance of the five radiomics models, and the support vector machine model showed the highest accuracy and F1 score. The support vector machine model showed significantly higher diagnostic accuracy as compared to radiologists (83.8% vs. 55.4%, P < 0.001). Conclusion The radiomics models achieved high diagnostic efficiency and may help to reduce the uncertainty in diagnosis of malignant and benign sub-centimeter solid nodules by radiologists.

Objective We aimed to investigate the mechanism of Tianma(tall gastrodia tuber)-Hongjingtian(rose root)medicinal pair in regulating tumor necrosis factor-α(TNF-α)/nuclear factor-κB(NF-κB)to protect the endothelial cell barrier in mice with hypoperfused-cerebral small vessel disease.Methods Seventy male C57BL/6 mice were assigned to the sham operation group,model group,Tianma-Hongjingtian groupⅠ,Ⅱ,and Ⅲ(the mass ratio of Tianma to Hongjingtian were 1:1,2:1,and 1:2),with 14 mice in each group.A unilateral common carotid artery occlusion mouse model was established.The mice of each group were gavaged once at six hours after the surgery then once every 24 h thereafter.The doses of Tianma-Hongjingtian groupⅠ,Ⅱ,and Ⅲ were 1.30,1.95,and 1.95 g/(kg·d),and the sham operation and model groups were administered with the same volume of saline.Cerebral blood flow detection and behavioral post and sampling were performed on the 3rd day(acute phase)and 7th day(subacute phase)of the experiment.Laser diffuse linear ratio imaging was used to observe changes in cerebral blood flow.A gait analyzer was used to evaluate motor coordination.Hematoxylin-eosin staining combined with light microscopy was used to observe pathological and morphological changes in brain tissue.Western blotting was used to detect the expression level of albumin.Immunofluorescence and Western blotting were used to detect the expression levels of tight junction proteins(Occludin and ZO-1).The expression levels of TNF-α,NF-κB,IL-β,and IL-6 were detected through RT-PCR and Western blotting.Results Compared with the sham operation group,cerebral blood flow was reduced on the 3rd day and 7th day in the model group(P<0.05);gait abnormalities of prolonged swing duration,reduced stride frequency,and reduced gait equilibrium(P<0.05)were observed;severe pathological damage was observed in brain tissues,with increased level of albumin expression,decreased protein expression levels of Occludin and ZO-1(P<0.05);mRNA and protein expression levels of TNF-α,NF-κB,IL-β,and IL-6 increased(P<0.05).Compared with the model group,the cerebral blood flow of mice on the 3rd and 7th day in the three Tianma-Hongjingtian groups was elevated(P<0.05);swinging duration was shortened,step frequency increased,gait equilibrium was elevated(P<0.05);brain histopathological damage was reduced,albumin expression level decreased(P<0.05),and the expression levels of Occludin and ZO-1 proteins were elevated(P<0.05);the mRNA and protein expression levels of TNF-α,NF-κB,IL-β,and IL-6 were decreased(P<0.05).Among them,the combined efficacy was better on the 3rd day of Tianma-Hongjingtian group Ⅱ;the combined efficacy was better on the 7th day of Tianma-Hongjingtian groupⅢ.Conclusion Tianma-Hongjingtian can increase cerebral blood flow,improve gait abnormalities,reduce pathological damage to brain tissue,and protecte the function and structure of the endothelial barrier in mice with hypoperfused cerebral small vessel disease,and the mechanism may be related to decreasing the expression of inflammatory factors.

Objective:To evaluate the diagnostic efficacy and practicality of the Jaundice color card (JCard) as a screening tool for neonatal jaundice.Methods:Following the standards for reporting of diagnostic accuracy studies (STARD) statement, a multicenter prospective study was conducted in 9 hospitals in China from October 2019 to September 2021. A total of 845 newborns who were admitted to the hospital or outpatient department for liver function testing due to their own diseases. The inclusion criteria were a gestational age of ≥35 weeks, a birth weight of ≥2 000 g, and an age of ≤28 days. The neonate′s parents used the JCard to measure jaundice at the neonate′s cheek. Within 2 hours of the JCard measurement, transcutaneous bilirubin (TcB) was measured with a JH20-1B device and total serum bilirubin (TSB) was detected. The Pearson′s correlation analysis, Bland-Altman plots and the receiver operating characteristic (ROC) curve were used for statistic analysis.Results:Out of the 854 newborns, 445 were male and 409 were female; 46 were born at 35-36 weeks of gestational age and 808 were born at ≥37 weeks of gestational age. Additionally, 432 cases were aged 0-3 days, 236 cases were aged 4-7 days, and 186 cases were aged 8-28 days. The TSB level was (227.4±89.6) μmol/L, with a range of 23.7-717.0 μmol/L. The JCard level was (221.4±77.0) μmol/L and the TcB level was (252.5±76.0) μmol/L. Both the JCard and TcB values showed good correlation ( r=0.77 and 0.80, respectively) and agreements (96.0% (820/854) and 95.2% (813/854) of samples fell within the 95% limits of agreement, respectively) with TSB. The JCard value of 12 had a sensitivity of 0.93 and specificity of 0.75 for identifying a TSB ≥205.2?μmol/L, and a sensitivity of 1.00 and specificity of 0.35 for identifying a TSB ≥342.0?μmol/L. The TcB value of 205.2?μmol/L had a sensitivity of 0.97 and specificity of 0.60 for identifying TSB levels of 205.2 μmol/L, and a sensitivity of 1.00 and specificity of 0.26 for identifying TSB levels of 342.0 μmol/L. The areas under the ROC curve (AUC) of JCard for identifying TSB levels of 153.9, 205.2, 256.5, and 342.0 μmol/L were 0.96, 0.92, 0.83, and 0.83, respectively. The AUC of TcB were 0.94, 0.91, 0.86, and 0.87, respectively. There were both no significant differences between the AUC of JCard and TcB in identifying TSB levels of 153.9 and 205.2 μmol/L (both P>0.05). However, the AUC of JCard were both lower than those of TcB in identifying TSB levels of 256.5 and 342.0 μmol/L (both P<0.05). Conclusions:JCard can be used to classify different levels of bilirubin, but its diagnostic efficacy decreases with increasing bilirubin levels. When TSB level are ≤205.2 μmol/L, its diagnostic efficacy is equivalent to that of the JH20-1B. To prevent the misdiagnosis of severe jaundice, it is recommended that parents use a low JCard score, such as 12, to identify severe hyperbilirubinemia (TSB ≥342.0 μmol/L).

Objective To investigate the effect of autophagy activation on cell proliferation in human umbilical vein endothelial cells(HUVECs).Methods HUVECs were treated with rapamycin(Rapa).Western blot assay was performed to examine the expression of protein of microtubule associated protein 1 light chain 3(LC3),Beclin 1 and unc-51-like kinase 1(ULK1).Autophagosomes were detected by transmission electron microscopy(TEM),and autophagy fluorescence was detected by monodansylcadaverine staining(MDC)assay.The effect of autophagy activation on cell proliferation was assessed by CCK-8 assay and EdU assay.Vascular formation experiments were used to detect vasculogenic ability.Results After Rapa treatment,LC3,Beclin1 and ULK1 expressions were en-hanced,while the green autophagy fluorescence expression in the experimental group was stronger than that in the control group,and autophagosomes were visible by TEM;CCK-8 and EdU results showed that compared with the control group,the cell proliferation ability was weakened and tubes formation ability was reduced after the activation of autophagy in experimental cells.Conclusion Rapa upregulates autophagy activity in HUVECs to inhibit cell proliferation under certain time.

Objective To compare the clinical efficacy between a direct aspiration first-pass technique(ADAPT)and stent-retriever thrombectomy(SRT)in the treatment for acute ischemic stroke(AIS)caused by intracranial atherosclerotic stenosis related large vessel occlusion(ICAS-LVO).Methods We retrospectively included patients with AIS caused by ICAS-LVO who received endovascular treatment in The First Affiliated Hospital of Xi'an Jiaotong University or The Second Affiliated Hospital of Shaanxi University of Chinese Medicine between January 2020 and January 2023.They were divided into ADAPT group and SRT group according to the first-selected device for thrombectomy.We compared the baseline data,test and examination results,operation process,clinical prognosis and follow-up data of the two groups.Results A total of 117 patients were recruited,including 48 patients in the ADAPT group and 69 patients in the SRT group.There was no significant difference in the baseline data between the two groups.The success rate of both the first-time thrombectomy(P=0.014)and the first-selected device of thrombectomy(P＜0.001)was significantly higher in the SRT group than in the ADAPT group.Meanwhile,the incidence of iatrogenic dissection(P＜0.001)and vasospasm(P=0.003)was significantly lower in the SRT group than in the ADAPT group.The proportion of patients for whom the device of thrombectomy was changed for remedial treatment in the ADAPT group was significantly higher than that in the SRT group(P＜0.001).However,the two groups did not differ significantly in the rate of successful vascular recanalization,incidence of symptomatic/asymptomatic intracranial hemorrhage or the rate of 90-day favorable prognosis.Conclusion For patients with AIS caused by ICAS-LVO of MCA,SRT has a higher rate of immediate successful vascular recanalization with a lower rate of secondary vascular injury compared with ADAPT,but the two techniques have similar efficacy on the 90-day prognosis.

Background: Platform work offers flexibility and autonomy to workers, but there are concerns about the impacts of excessive labor control exercised by digital platforms using algorithmic management. This study assessed the level of labor control exerted by digital platforms and explored its associations with psychosocial work conditions and workers' mental well-being. Methods: A total of 487 location-based platform workers in Taiwan, encompassing ride-hailing, delivery, and house chore services, participated in this questionnaire survey. A 5-item scale was created to assess platform-mediated labor control. Psychosocial work conditions, including demands, job control, work rewards, and mental well-being, including burnout and self-rated mental health status, were assessed using validated instruments. Cronbach's α and principal component analysis were employed to assess the validity of the labor control scale. Logistic regression analysis and path analysis were conducted to investigate the relationship between labor control and workers' mental health. Results: Exploratory factor analyses confirmed the structural validity and the internal consistency of the scale. Logistic regression models revealed that higher levels of labor control were associated with an increased risk of burnout and poorer mental health. Path analyses further indicated that higher labor control through digital platforms raised mental health risks by increasing job demands. Conclusion Algorithmic management is associated with increased stress among platform workers as they try to meet the platform's performance metrics.

Background: Platform work offers flexibility and autonomy to workers, but there are concerns about the impacts of excessive labor control exercised by digital platforms using algorithmic management. This study assessed the level of labor control exerted by digital platforms and explored its associations with psychosocial work conditions and workers' mental well-being. Methods: A total of 487 location-based platform workers in Taiwan, encompassing ride-hailing, delivery, and house chore services, participated in this questionnaire survey. A 5-item scale was created to assess platform-mediated labor control. Psychosocial work conditions, including demands, job control, work rewards, and mental well-being, including burnout and self-rated mental health status, were assessed using validated instruments. Cronbach's α and principal component analysis were employed to assess the validity of the labor control scale. Logistic regression analysis and path analysis were conducted to investigate the relationship between labor control and workers' mental health. Results: Exploratory factor analyses confirmed the structural validity and the internal consistency of the scale. Logistic regression models revealed that higher levels of labor control were associated with an increased risk of burnout and poorer mental health. Path analyses further indicated that higher labor control through digital platforms raised mental health risks by increasing job demands. Conclusion Algorithmic management is associated with increased stress among platform workers as they try to meet the platform's performance metrics.

Background: Platform work offers flexibility and autonomy to workers, but there are concerns about the impacts of excessive labor control exercised by digital platforms using algorithmic management. This study assessed the level of labor control exerted by digital platforms and explored its associations with psychosocial work conditions and workers' mental well-being. Methods: A total of 487 location-based platform workers in Taiwan, encompassing ride-hailing, delivery, and house chore services, participated in this questionnaire survey. A 5-item scale was created to assess platform-mediated labor control. Psychosocial work conditions, including demands, job control, work rewards, and mental well-being, including burnout and self-rated mental health status, were assessed using validated instruments. Cronbach's α and principal component analysis were employed to assess the validity of the labor control scale. Logistic regression analysis and path analysis were conducted to investigate the relationship between labor control and workers' mental health. Results: Exploratory factor analyses confirmed the structural validity and the internal consistency of the scale. Logistic regression models revealed that higher levels of labor control were associated with an increased risk of burnout and poorer mental health. Path analyses further indicated that higher labor control through digital platforms raised mental health risks by increasing job demands. Conclusion Algorithmic management is associated with increased stress among platform workers as they try to meet the platform's performance metrics.