Intravitreal injection of anti-vascular endothelial growth factor(VEGF)agents has become the primary treatment for macular edema associated with retinal vascular disease such as diabetic retinopathy and retinal vein occlusion, but there are limitations such as variable treatment efficacy and insufficient durability of therapeutic effects. As the first bispecific antibody applied in ophthalmic treatment, Faricimab achieves favorable outcomes by simultaneously targeting both VEGF-A and angiopoietin-2(Ang-2)pathways. Based on evidence from recent clinical trials and real-world studies, this article reviews the research progress on Faricimab for the treatment of diabetic macular edema(DME), retinal vein occlusion-associated macular edema(RVO-ME)and refractory macular edema compared to the therapeutic effects of other agents. Additionally, based on Faricimab's safety characteristics and future potential, its therapeutic prospects for macular edema associated with retinal vascular diseases are discussed. This review aims to provide evidence-based references for optimizing clinical treatment strategies, thereby contributing to mitigating the risk of vision loss due to macular edema.

【Objective】 To explore the correlation between the severity of jaundice in ABO hemolytic disease of fetus and newborn (HDFN) and multiple indicators, in order to achieve accurate diagnosis, timely treatment, and prevent complications in ABO HDFN. 【Methods】 From March 2020 to February 2023, a total of 283 ABO HDFN in our hospital were classified into mild, moderate and severe groups based on total bilirubin levels. The differences in basic data, relevant laboratory indicators and the agglutination intensity of the three hemolysis tests were analyzed and compared. 【Results】 In the severe group, 75% (12/16) were male infants, which was significantly higher compared to 37.5% (57/152) in the moderate group (P<0.05). The values (mg/dL) of transcutaneous jaundice in the mild, moderate and severe groups were:forehead 9.88±1.93 vs 12.34±2.01 vs 15.56±2.69, face 10.25±2.27 vs 13.28±2.32 vs 15.99±2.86, chest 9.67±2.16 vs 12.51±2.11 vs 15.33±2.36, respectively. The values(µmol/L) of direct bilirubin (DBIL) and indirect bilirubin (IBIL) were 9.87±2.06 vs 11.90±2.59 vs 16.12±4.73, and 159.36±37.55 vs 252.98±30.52 vs 353.76±55.68, respectively, and the differences between the mild, moderate and severe groups were statistically significant (all P<0.05) . The creatine kinase (CK) values(unit/L) of mild, moderate and severe groups were 664.15±498.26 vs 500.51 ±451.63 vs 402.63±224.27, and the difference between the mild group and the other two groups was statistically significant (P<0.05) . There was no statistically significant difference in the agglutination intensity of the three hemolysis tests among HDFN with different severity of jaundice. 【Conclusion】 Clinicians can predict the severity of jaundice in light of gender, transcutaneous jaundice, DBIL, IBIL and CK of ABO HDFN, for further and graded treatment, so as to avoid the sequelae or even life-threatening consequences caused by ABO HDFN.

Traumatic cerebrospinal fluid leakage commonly presents in traumatic brain injury patients, and it may lead to complications such as meningitis, ventriculitis, brain abscess, subdural hematoma or tension pneumocephalus. When misdiagnosed or inappropriately treated, traumatic cerebrospinal fluid leakage may result in severe complications and may be life-threatening. Some traumatic cerebrospinal fluid leakage has concealed manifestations and is prone to misdiagnosis. Due to different sites and mechanisms of trauma and degree of cerebrospinal fluid leak, treatments for traumatic cerebrospinal fluid leakage varies greatly. Hence, the Craniocerebral Trauma Professional Group of Neurosurgery Branch of Chinese Medical Association and the Neurological Injury Professional Group of Trauma Branch of Chinese Medical Association organized relevant experts to formulate the " Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults ( version 2023)" based on existing clinical evidence and experience. The consensus consisted of 16 recommendations, covering the leakage diagnosis, localization, treatments, and intracranial infection prevention, so as to standardize the diagnosis and treatment of traumatic cerebrospinal fluid leakage and improve the overall prognosis of the patients.

Objective:To survey the working status of outpatient nurses in general practice departments of general hospitals.Methods:From March to April 2021, personal in-depth interviews were conducted with outpatient nurses from general practice residency training bases in Beijing. The thematic framework analysis method was used to analyze the interview data and refine the themes.Results:Fourteen nurses working in general practice outpatient clinics were interviewed in this study. Four themes were extracted from the interview data: (1) inadequate staffing of full-time outpatient nurses in general practice departments of comprehensive hospitals; (2) unclear job functions for outpatient nurses in general practice departments; (3) no standardized patient health education in the department; (4) no relevant training received systematically.Conclusion:General practice departments in general hospitals should setup full-time general practice nurse positions, clarify the job responsibilities, strengthen the relevant training and enhance core competency for nurses working in general practice department.

Adaptation, Psychological ; Adolescent ; COVID-19 ; Child ; China ; Cross-Sectional Studies ; Female ; Humans ; Male ; SARS-CoV-2

Objective:To explore the effect of evidence-based nursing best practice in postoperative pain management of neurosurgery patients.Methods:From January to June 2019, a cluster sampling method was used to select 146 neurosurgery patients from Huashan Hospital, Fudan University as the control group. We examined the patient's postoperative pain management status, and applied evidence-based nursing methods to obtain best practice evidence. From July to December 2019, the clinical evidence practice application model of the Australia Joanna Briggs Institute (JBI) Evidence-Based Health Care Center was used to apply evidence to postoperative pain management in neurosurgery patients. From January to June 2020, a cluster sampling method was used to select 146 neurosurgery patients as the observation group for re-examination after the application of evidence. The Modified American Pain Society Patient Outcome Questionnaire (APS-POQ-Modified) was used to investigate the postoperative pain perception beliefs and postoperative pain degree of the two groups of patients. The qualification rate of 146 pain nursing records before and after the application of the evidence was checked and the differences were compared.Results:The scores of 7 items regarding pain perception beliefs in control group were (3.45±1.42) , (3.21±1.21) , (3.58±1.53) , (3.37±1.26) , (3.63±1.34) , (3.55±1.06) , (3.45±1.35) , and those of observation group were (2.44±1.31) , (2.35±1.21) , (2.34±1.35) , (3.06±1.17) , (2.57±1.25) , (3.05±1.02) , (3.12±1.42) , the differences between the two groups were statistically significant ( t=6.346, 6.057, 7.350, 2.166, 6.994, 4.108, 2.027; P<0.05) . In control group, the current pain degree score was (2.34±0.89) , the most severe pain degree score within 24 hours after operation was (4.44±1.17) , and the average pain degree score within 24 hours after operation was (3.21±0.75) , and the scores in observation group were (1.98±0.96) , (3.54±1.10) , (2.46±0.70) , and the differences were statistically significant ( t=3.355, 6.731, 8.808; P<0.01) . The qualification rate of pain nursing record sheet before and after the application of the evidence was 67.12% (98/146) and 82.88% (121/146) respectively, the difference was statistically significant (χ 2=9.662, P=0.002) . Conclusions:The evidence-based nursing best practice can improve neurosurgery patients' pain perception beliefs, reduce the degree of postoperative pain of patients, and increase the qualification rate of nurses' pain nursing records.

Objective:To investigate the characteristics of consonant among children with speech sound disorder (SSD) and to provide an empirical basis for the subsequent clinical evaluation and evidence-based intervention.Methods:In this retrospective research a total of 1 395 children diagnosed with SSD from the Language-Speech Clinic of the Department of Children Health Care, Children′s Hospital, Capital Institute of Pediatrics from January 2007 to December 2018 were enrolled and underwent the phonological examination on the lexical level with picture naming, according to phoneme development in Chinese mandarin. The Chi-square trend test was applied to analyze the differences and trends of the proportion of consonant error subtypes in children of different age groups. The Chi-square test was conducted to compare the proportion of consonant error subtypes in different gender.Results:The 1 395 children diagnosed with SSD included 1 044 boys and 351 girls, with an age of (5.1±0.8) years. The occurrence of consonant errors in different locations of articulation was the highest for blade-alveolar /l/ (71.8%, 1 002/1 395) and the lowest for labial/b/(9.3%, 130/1 395). The occurrence of consonant errors of labial/p/f/, supra-dental/z/c/s/, blade-alveolar/t/l/, blade-palatal/ch/r/, velar/k/h/, and lingua-palatal/q/decreased with age (all P<0.05). The occurrence of consonant errors of labial/b/m/, supra-dental/z/c/, blade-alveolar/n/l/, blade-palatal/sh/, velar/h/, and lingua-palatal/x/were higher in boys than those in girls (10.3% (108/1 044) vs. 6.3% (22/351), 11.4% (119/1 044) vs. 6.0% (21/351), 64.8% (676/1 044) vs. 51.9% (182/351), 67.8% (708/1 044) vs. 59.8% (210/351), 16.7% (174/1 044) vs. 8.8% (31/351), 73.7% (769/1 044) vs. 66.1% (232/351), 58.0% (606/1 044) vs. 47.6% (167/351), 24.0% (251/1 044) vs. 14.2% (50/351), and 39.9% (417/1 044) vs. 27.6% (97/351); χ2 =5.167, 8.533, 16.889, 7.447, 12.863, 7.412, 11.650, 14.900, and 17.099, all P<0.05). The error types of consonant were substitution, omission, and distortion. Omission was the main error type of blade-alveolar/l/(53.3%, 743/1 395), distortion was the main error type of velar/h/(11.8%, 165/1 395), and substitution was the main error type of all other consonants. Substitution with blade-palatal/ch/having the highest occurrence of error (60.2%, 840/1 395). Conclusions:The occurrence of the blade-alveolar/l/error is the highest in children with SSD, with boys demonstrating more serious articulation problems. The main error type of consonant is substitution, with blade-palatal/ch/having the highest occurrence of error. These results suggest the necessity of attending to preschoolers′ articulation development. Phonological training targeting blade-alveolar/l/and blade-palatal/ch/should be carried out as early as possible.

Objective For the second children diagnosed as ABO hemolytic disease of the newborn(ABO-HDN),we made a comprehensive analysis of the related indicators of prenatal and postpartum,so as to achieve early prevention,early diagnosis and early treatment.Methods Prenatal microcolumn gel assay was used to detect the father and mother's blood type and mother's irregular antibody,mother serum IgG anti A(B)anti-body titer.Microcolumn gel assay was used to detect hemolysis three tests after the production of pregnant women.The results were divided into five groups according to the results of hemolysis three tests:group A[di-rect antiglobulin test(+),free antibodies test(+)and antibody releasing test(+)],group B[direct antiglobu-lin test(-),free antibodies test(+)and antibody releasing test(+)],group C[direct antiglobulin test(+), free antibodies test(-)and antibody releasing test(+)],group D[direct antiglobulin test(-),free antibod-ies test(-)and antibody releasing test(+)]and group E[direct antiglobulin test(+),free antibodies test (-)and antibody releasing test(-)].Total bilirubin,unbound bilirubin,hemoglobin,reticulocyte percentage and lactate dehydrogenase were detected by automatic analyzer.Results ABO-HDN children hemolysis three tests,in the 5 groups,the higher the titer of the mother's IgG anti A(B)antibody,the more serious the child' s condition was,the difference was statistically significant(P<0.05).Reticulocyte percentage and lactate de-hydrogenase in the five groups,the difference was statistically significant(P<0.05).Conclusion A combina-tion of antenatal and postnatal multiple laboratory test parameters is more accurate in predicting the second child ABO-HDN.At the same time,it helps to master the state of the disease and reduce the occurrence of complications and sequelae.

Objective To perform a questionnaire survey on patients with cerebrovascular disease, so as to find problems in the fall-preventing education and provide scientific evidence for health education improvement. Methods From October 2015 to December 2016, a self-designed "Let's mitigate falling danger"questionnaire was applied to investigate a total of 193 patients with cerebrovascular disease from geriatric department, neurology department and neurosurgical department, and analyzed the resules. Results The average score of the 193 patients was (25.05±4.63). The three items with lowest score were "Using fall-leading drugs" (1.30±0.86), "Getting-up behavior" (1.32±0.88) and "Feeling embarrassed seeking help"(1.35±0.64) in the questionnaire. Besides, the fall-preventing score were different in patients with different gender, education level, diagnosis, history of fall and whether received fall-preventing education or not, and the differences were statistical significant (t=2.013, 11.638, 10.750, 5.238, 2.147;P< 0.05). Generalized linear regression analysis showed that receiving fall health education, gender, education level and disease type were the influencing factors of fall prevention cognition in patients with cerebrovascular disease (P< 0.05). Conclusions Cerebrovascular patients are lack of awareness of fall risks in hospital. The nursing management should take risk control on these patients. The responsible nurse should choose personalized education mode and content according to relevant awareness deficits.

Cancer is a serious threat to human health at present,so it is an important task in the medical field to overcome it.The first step is to recognize cancer.Metaphor is a universal cognitive mode.This paper analyzed the metaphorical phenomenon which the tumor growth process was described as plant growth.The results showed that in modern medicine,growth pattern,tumor shape characteristics,growth velocity and diffusion were using plant metaphors to illustrate.Tumor growth is the growth of stems and leaves of plants,plant root growth,plant fruit growth,plant growth in four seasons,special types of plant growth.The tumor metastasis is the seed spreading of the plant.The result implied that tumor in modern medicine was a metaphorical cognition of plants.This metaphor showed the vitality of tumor.