Objective:To explore the role of conducting a"thematic morning report"based on post-competency in the standardized residents training in hospital in the Intensive Care Unit(ICU).Methods:A total of 60 resident training physicians who participated in the standardized residents training in hospital in the ICU of this hospital from January 2020 to December 2022 were included,and randomly divided into an observation group and a control group,with 30 in each group.The observation group adopted an interactive teaching method of themed morning report based on post-competency,while the control group adopted the traditional teaching method.The assessment results of clinical theoretical knowledge and operational skills of the two groups of resident training physicians under different teaching methods were compared.The 360°assessment method was used to record the multi-directional evaluation of patients or their families,nurses,colleagues,and teaching teachers on the post-competence of resident training physicians(self-learning ability,team collaboration ability,effective communication ability,and learning interest).Results:The assessment scores of clinical theoretical knowledge and practical skills in the observation group after teaching were higher than those in the control group,with statistically significant differences(theoretical assessment:t=2.101,P＜0.05;practical assessment:t=9.647,P＜0.05).The post-competence scores of nurses,colleagues,and teaching teachers on resident training physicians in the observation group were higher than those in the control group after one-month regular training,and the differences were statistically significant(nurses'evaluation of self-learning ability:t=3.182,P=0.002,team collaboration ability:t=3.978,P＜0.05,effective communication ability:t=2.180,P=0.0335,learning interest:t=3.884,P＜0.05;colleagues'evaluation of self-learning ability:t=2.888,P=0.005,team cooperation ability:t=6.816,P＜0.05,effective communication ability:t=3.833,P＜0.05,learning interest:t=4.086,P＜ 0.05;teaching teacher's evaluation of self-learning ability:t=3.429,P=0.001,team cooperation ability:t=3.086,P=0.003,effective communication ability:t=3.493,P=0.001,learning interest:t=3.126,P=0.003).There was a statistically significant difference in the satisfaction scores of patients or their familymembers towards the two groups of resident training physicians(t=3.126,P=0.003).Conclusion:The use of the interactive teaching method of thematic morning report based on post-competency in the standardized residents training in hospital in the ICU can not only improve the theoretical practice and case analysis test scores of resident training physicians,but also improve the post-competence and the satisfaction of patients and their families.

Objective:To explore the correlation between grip strength promotion and improvement of body composition and metabolic disorders in health examination population of different genders.Methods:In this retrospective cohort study, clinical data of 600 people who received health examination and grip strength check-up two times or more in the Medical Examination Center of Peking University Third Hospital from January 2018 to November 2022 were selected. The general data, physical examination, biochemical parameters, body composition and grip strength results were collected. After the first physical examination, the grip strength test was conducted, appropriate resistance strength exercises were given based on individual evaluation results. A health lecture was held, and the information related to health exercise was pushed through WeChat official account every week. The grip strength test was completed at the same time at the second physical examination, and the difference between the two test results was calculated before and after the second physical examination. The generalized estimation equation was used to analyze the correlation between the improvement of grip strength and the improvement of body composition and metabolic disorders in different gender health-check population.Results:In man and women, the body mass index [(25.50±3.66) vs (25.33±3.74) kg/m 2, (22.41±3.55) vs (22.25±3.46) kg/m 2] and grip strength [(42.71±7.30) vs (41.77±7.36) kg, (25.28±5.30) vs (23.98±4.87) kg] at the second health check-up were all significantly higher than those at the first time, and the diastolic blood pressure [(72.79±10.30) vs (74.47±9.85) mmHg (1 mmHg=0.133 kPa), (66.93±8.90) vs (68.92±9.42) mmHg] and serum homocysteine [(17.96±14.09) vs (19.27±14.26) μmol/L, (9.47±3.91) vs (10.26±3.90) μmol/L] were all significantly lower than those at the first time (all P<0.05). Among man, the low-density lipoprotein cholesterol (LDL-C) at the second physical examination was significantly lower than that at the first time [(2.94±0.78) vs (3.00±0.69) mmol/L] (all P<0.05). Among women, the systolic blood pressure and uric acid at the second health check-up were both significantly lower than those at the first time [(109.34±12.85) vs (110.54±12.32) mmHg, (276.91±62.46) vs (287.16±68.78) μmol/L], and the waist-hip ratio was significant higher (85.8%±5.1% vs 85.4%±5.0%) (all P<0.05). In males, the decreased aspartate aminotransferase ( OR=0.932, 95% CI: 0.888-0.978) and the increased skeletal muscle index ( OR=75.370, 95% CI: 29.012-195.806) were both positively correlated with the elevation of grip strength (all P<0.05); and in females, the decreased homocysteine ( OR=0.876, 95% CI: 0.782-0.982) and glycosylated hemoglobin ( OR=0.423, 95% CI: 0.222-0.805) and increased skeletal muscle index ( OR=22.918, 95% CI: 11.114-47.256) were all positively correlated with the elevation of grip strength (all P<0.05). Conclusion:There is a positive correlation between the improvement of grip strength and the improvement trend of body composition and metabolic disorders in in health examination population of different genders.

Objective:To evaluate the value of CEA, CYFRA21-1 and CA125 tests in opportunistic screening of non-small cell lung cancer (NSCLC) based on meta-analysis.Methods:The original research literatures on the diagnostic value of CEA, CYFRA21-1 and CA125 in Chinese NSCLC patients were searched from databases of PubMed, Embase, The Cochrane Library, CNKI, VIP, Database and Wanfang database from establishment to June 2023. The literature screening, data extraction and quality evaluation were carried out independently by two researchers. The quality evaluation tool of diagnostic accuracy studies was used to evaluate the quality of the literature. A summary receiver operating characteristic (SROC) curve was used to assess the overall effectiveness of the tests. The outcome stability and publication bias were detected by using sensitivity analysis and Deeks′ test.Results:A total of 23 studies met the inclusion and exclusion criteria were included. The results of meta-analysis showed that the overall sensitivity of CEA, CYFRA21-1 and CA125 alone in the diagnosis of NSCLC was relatively low, it was 0.49(95% CI: 0.43-0.55), 0.56(95% CI: 0.49-0.63) and 0.41(95% CI: 0.33-0.49), respectively. The overall sensitivity of the combined detection of the three markers for the diagnosis of NSCLC increased to 0.83(95% CI: 0.69-0.91), but the overall specificity decreased to 0.76(95% CI: 0.69-0.83). Conclusions:The single detection of CEA, CYFRA21-1 and CA125 is not recommended for screening NSCLC in population receiving physical examination. Although the sensitivity of the combined detection of CEA, CYFRA21-1 and CA125 for screening NSCLC is improved, but the specificity is decreased, the misdiagnosis rate is increased, so the screening effect is limited.

Objective Action research methodology was used in a constructed self-management program for diabetic foot amputees to continuously improve the program and ensure the smooth implementation of the program.Methods Using the action research method,from February to June,2023,the self-management program constructed by the author was continuously revised and improved through the cyclic process of"planning-action-observation-reflection"for patients with diabetic foot amputation.Results After 2 rounds of action research,the action research refined the delivery of the program and the timing of the intervention,and the level of patient self-management behaviors increased significantly(P＜0.05).Conclusion Using the action research method,the researchers conducted a comprehensive analysis of the problems that existed in the process of patients'behavioral health interventions,and adjusted the program through feedback from the patients'hospitalization period,transition period,and home period,to ensure that the corresponding indexes at each stage could basically satisfy the patients'self-management needs,and to improve the smooth implementation of the self-management program for patients with diabetic foot amputation.

Objective To explore the efficacy and safety of the Huoxue Tongluo recipe iontophoresis(HTRI)combined with butylphthalide sequential therapy(BST)in patients with cerebral ischemic stroke(CIS)hemiplegia.Methods 87 patients with CIS hemiplegia treated in Chuzhou Chinese and Western Medicine Hospital affiliated to Anhui University of Chinese Medicine from January 2020 to January 2023 were retrospectively selected as study subjects,and were divided into the BST group(BST treatment)and the combination group(BST in combination with HTRI treatment)according to the treatment regimens.The main observation indicators were total treatment response rate and incidence of adverse reactions after 4 weeks of treatment;the secondary observation indicators were cerebral artery flow velocity[anterior cerebral artery(ACA),middle cerebral artery(MCA)and posterior cerebral artery(PCA)],neurological function[National Institutes of Health Stroke Scale(NIHSS)score,Chinese Stroke Scale(CSS)score]and limb function[Fugl-Meyer Motor Function Scale(FMA)score,Barthel index(BI)score].Results A total of 87 patients were included,including 43 patients in the BST group and 44 patients in the combination group.The total response rate in the combination group was significantly higher than that in the BST group(P<0.05),and no adverse reactions were observed in both groups.Before treatment,there were no significant differences in cerebral artery blood flow velocity,nerve function and limb function between the two groups(P>0.05).After treatment,the flow velocity of ACA,PCA and MCA,and the scores of FMA and BI were significantly higher than those before treatment(P<0.05),while the scores of NIHSS and CSS decreased significantly(P<0.05).Conclusion Compared with BST therapy,HTRI combined with BST has a more significant effect in CIS patients with hemiplegia,with no increase in the incidence of adverse reactions,and has higher safety.

【Objective】 To analyze the basic characteristics of whole blood donors from blood stations before and after the outbreak of COVID-19. 【Methods】 After excluding invalid data, data related to the basic characteristics of whole blood donors collected from 26 blood stations in China during 2018 to 2021 were statistically analyzed, including the trend of total whole blood donors, the number of repeated blood donors, the frequency of blood donation, the average age of donors and the recruitment of first-time blood donors. 【Results】 Affected by the epidemic, 8 out of 14 indicators were with large variations, accounting for 57%. The overall growth rate of total whole blood donors during the epidemic was higher than before the epidemic (P<0.05).The number of repeated blood donors has shown an increased trend, with a higher number during the epidemic than before (P<0.05). The frequency of blood donation was lower during the epidemic than before(P<0.05).Average ages of blood donors and female blood donors fluctuated widely during the epidemic, both higher than those before the epidemic(P<0.05).The donation rate of first-time blood donors <25 years old and ≥25 years old varied widely and irregularly during the epidemic (both P<0.05). The percentage of first-time blood donors fluctuated irregularly during the epidemic, with overall percentage lower than that before the epidemic(P<0.05). 【Conclusion】 Whole blood donors from 26 blood stations increased after the outbreak of COVID-19, and some indicators in certain areas showed significant fluctuations during the epidemic.

Acromicric dysplasia(AD) is a rare skeletal dysplasia characterized by severe short stature, short hands and feet, normal intelligence, mild facial dysmorphism, and radiological characteristics. The clinical data and genetic test results of one patient with AD in our hospital were analyzed, and the clinical characteristics of this case were summarized. The main manifestations of the child were short stature, short hands and feet, mild facial dysmorphism, short and stubby metacarpals and phalanges on hand X-ray. One mutation, FBN1: c.5141T>G(p.Met1714Arg), was identified in this child, the mutation is inherited from her short mother and grandfather. AD is a rare congenital skeletal dysplasia disorder associated with mutations in the FBN1 gene. It conforms to the pathogenesis of autosomal dominant genetic disease.

Objective:To screen differentially expressed proteins(DEPs)in the hippocampus of epileptic rats,pro-viding ideas for further exploring the pathogenesis and drug therapeutic targets of epilepsy.Methods:The epileptic rat model(PTZ group)induced by pentylenetetrazol(PTZ).The protein profiles of hippocampal tissues of the PTZ group and control groups were detected by isobaric tag for relative and absolute quantitation(iTRAQ)combined with LC-MS/MS technology,and the fold changes in the protein expression of the PTZ group versus the control group was considered to be more than 1.5 or less than 0.67,and P＜0.05 was taken as the criteria for screening DEPs.Then DEPs were subjected to bioinformatics analyses such as Gene Ontology(GO)functional annotation and Kyoto encyclopedia of genes and genomes(KEGG)pathway enrichment analysis.Results:A total of 80 proteins showed significantly different expression,which included 39 up-regulated and 41 down-regulated.GO analysis showed that the up-regulated DEPs were mainly involved in biological processes such as cellular response to nerve growth factor stimulus,axon develop-ment,cell surface receptor signaling pathway,neuron migration,actin filament depolymerization,and signal transduc-tion,while down-regulated DEPs were mainly involved in biological processes such as tricarboxylic acid cycle,citrate metabolism process,acetyl-CoA biosynthetic process from pyruvate,oxaloacetate metabolism process,and regulation of focal adhesion assembly.KEGG pathway enrichment analysis showed that up-regulated DEPs were mainly involved in five signaling pathways,including AMPK signaling pathway,regulation of actin cytoskeleton,sphingolipid signaling pathway,phenylalanine metabolism,and insulin signaling pathway;The down-regulated DEPs were mainly involved in six signaling pathways,including the citric acid cycle,carbon metabolism,acetate and dicarboxylate metabolism,meta-bolic pathways,amino acid biosynthesis and amyotrophic lateral sclerosis signaling pathways.Conclusion:DEPs from epileptic hippocampal tissues were screened by iTRAQ proteomics,and the metabolic pathways enriched by bioinformat-ics methods for DEPs may be closely related to the pathogenesis of epilepsy.

Objective: To understand the current situation of suicide attempts in middle school students and to explore its relation with adolescent parent attachment, to provide a basis for the prevention and control of middle school students suicidal behavior. Methods: A total of 4 419 students from grades 7 to 12 in Ezhou City and Xiaogan City, Hubei Province were selected by stratified cluster random sampling. The Inventory of Parent and Peer Attachment, Rosenberg Self Esteem Scale, Kessler Psychological Distress Scale were used to conduct a questionnaire Survey, and evaluated the suicide attempts of middle school students. Results: The detection rate of attempted suicide among middle school students was 6.8%. The detection rate of attempted suicide varies among different grades, family types, parental relation, parenting style, family income, self esteem level, and psychological distress( χ 2/ t =3.88, 10.12, 18.00, 52.54, 13.90 , 2.37, 8.99, P <0.05). The scores of paternal attachment and maternal attachment ( 14.64 ±13.45, 14.77±12.26) in the group with attempted suicide were lower than those without attempted suicide(22.05±16.08, 23.79±14.93)( t =-9.07, -12.11, P <0.05). Logistic regression analysis showed that both paternal attachment and maternal attachment were associated with lower rate of suicide attempts among middle school students(paternal attachment, OR=0.99, 95%CI = 0.98 -0.99; maternal attachment OR=0.97, 95%CI =0.96-0.98), with paternal attachment for girls only( OR=0.98, 95%CI= 0.97 -0.99)(P <0.05). Conclusion Adolescent parent attachment may be a protective factor for middle school students suicide attempts. Sex specific effects are observed in adolescent father attachment in girls. Parents should pay attention to cultivating a good attachment relationship with their children and promote the healthy growth of middle school students.

Neuroblastoma (NB) is one of the most common malignant solid tumors in children, ranks fourth in the incidence of pediatric tumors, and accounts for 15% of pediatric tumor deaths in children in China. Despite the development of new treatment options, the prognosis for high-risk patients is still poor. An animal model that can replicate the tumorigenesis of NB is an important tool for the prevention and treatment of NB. However, there are currently no animal models that can simulate all features of human NB. To provide a reference for the construction of animal models and treatment of NB, this article introduced several animal models of NB that have been extensively researched: the mouse, chick embryo chorioallantoic membrane, and zebrafish models. At the same time, it elaborated on the species, construction methods, characteristics, advantages and disadvantages, and research progress in NB.