Objective:To analyze the clinical symptoms and laboratory characteristics of patients with brucellosis combined with osteoarthritis.Methods:A retrospective analysis was conducted on the medical records of 168 patients with brucellosis who were hospitalized at the Jining Public Health Medical Center, Shandong Province from January 2021 to December 2022. Based on the imaging examination results, they were divided into combined osteoarthritis group and non combined osteoarthritis group. The demographic characteristics, clinical symptoms, and laboratory test results of the two groups of patients were compared and analyzed.Results:Among 168 patients with brucellosis, there were 83 patients with concurrent osteoarthritis, 85 patients without concurrent osteoarthritis, the males and females ratio was 2.73 ∶ 1.00 (123 ∶ 45), and the age was 56 (46, 64) years old. The median age of patients in combined osteoarthritis group was higher than that of patients in non combined osteoarthritis group (58 years vs 53 years, Z = - 2.89, P = 0.004). In clinical symptoms, the incidence of back pain, fatigue, and joint muscle pain in patients of combined osteoarthritis group was significantly higher than that in the non combined osteoarthritis group [75.9% (63/83) vs 56.5% (48/85), 30.1% (25/83) vs 15.3% (13/85), 47.0% (39/83) vs 17.6% (15/85), χ 2 = 7.07, 5.27, 16.58, P < 0.05]. In laboratory tests, the erythrocyte sedimentation rate (ESR) and hypersensitive C-reactive protein (hs-CRP) levels in patients of combined osteoarthritis group were higher than those in the non combined osteoarthritis group [27.0 (17.0, 34.0) mm/h vs 21.0 (10.5, 34.0) mm/h, 22.7 (14.3, 43.4) mg/L vs 17.9 (10.8, 34.2) mg/L, Z = - 2.51, - 2.00, P < 0.05]. Among patients with combined osteoarthritis, combined spondylitis accounted for the highest proportion (55.4%, 46/83), followed by peripheral arthritis (51.8%, 43/83). Conclusion:Osteoarthritis is a common complication of brucellosis, and patients of brucellosis with concurrent osteoarthritis have clinical features such as lower back pain, fatigue, and joint muscle pain, with significantly elevated of ESR and hs-CRP level.

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 explore the effectiveness of the comprehensive healthcare management model for children with bacterial meningitis after discharge.Methods:This study was a retrospective cohort study that included 268 children with bacterial meningitis who were discharged from the infectious medicine ward of Beijing Children′s Hospital from September 2018 to September 2023. The children were managed with a multidisciplinary collaborative comprehensive healthcare management model after discharge. Outpatient data at 1 month and 6, 12 and 24 months after discharge were collected, including (height, weight, body mass index, nutritional feeding status, hearing and vision screening results, Gesell developmental assessment results and intervention guidance services. The follow-up interval or frequency was dynamically adjusted or increased according to the child′s situation. The paired sample t-test and chi square test were applied to compare the differences in Gesell developmental quotient (DQ) and developmental delay rate between the first and last assessments to preliminarily explore the effectiveness of the comprehensive healthcare management model for children with bacterial meningitis after discharge. Results:All the 268 children completed their first assessment one month after discharge, and 37 children were found to have abnormal physical growth, mainly obesity (28 children), and another 9 children were malnutrition. Nutritional intervention and feeding guidance services were provided to all the 37 children, and as of the last follow-up, 20 children′s physical growth evaluations had turned normal. A total of 188 children completed at least 2 developmental assessments, with an interval of (14.2±9.4) months between the first and last assessments (range: 3.1-49.5 months). The DQ values of in the energy region of adaptability, gross motor skills, fine motor skills, language, and personal social skills at the last assessment were significantly higher than those at the first assessment [(91.93±13.28) vs (80.73±15.96) points, (91.69±12.96) vs (78.31±16.58) points, (89.32±16.11) vs (80.68±15.63) points, (90.10±16.65) vs (82.04±18.43) points, (92.01±14.05) vs (77.82±17.42) points]; moreover, the rates of developmental delay in each energy region were significantly lower than those at the initial assessment (9.6% vs 35.1%, 9.6% vs 42.0%, 18.1% vs 33.0%, 13.3% vs 31.9%, 9.6% vs 42.0%) (all P<0.05). Among the 200 children who completed the hearing screening, 18 were found with hearing abnormalities, and 2 were diagnosed with hearing loss in the Otolaryngology Department. Among 217 children who completed vision screening, 23 had abnormalities, and 5 were diagnosed with ophthalmic abnormalities in Ophthalmology Department (2 with strabismus, 2 with refractive errors, and 1 with optic nerve injury). Two children were found to have autism-like behavior during monitoring, and were referred to a developmental behavior clinic to be diagnosed with autism spectrum disorder and were given early diagnosis and intervention guidance. Conclusion:The comprehensive healthcare management model for children with bacterial meningitis after discharge can integrate clinical and healthcare resources, which is beneficial for improving the prognosis and enhancing the quality of life for children with special health status.

Objective:To explore the application effect of the modified presentation assimilation discussion combined with heuristic clinical medicine teaching in training of extracorporeal membrane oxygenation specialist nurses.Methods:The convenient sampling method was used to select 62 nurses who participated in training of extracorporeal membrane oxygenation specialist nurses in the Second Affiliated Hospital of Zhengzhou University from January to June 2023 as the research objects. A total of 30 nurses who participated in the 25th training session from January to March 2023 were selected as the control group, and 32 nurses who participated in the 26th training session from April to June 2023 were selected as the observation group. The control group received conventional training method, while the observation group received modified presentation assimilation discussion combined with heuristic clinical medicine teaching. The theoretical knowledge and operational skills of nurses, core competence of extracorporeal membrane oxygenation specialist nurses and training satisfaction were compared between the two groups after training.Results:After training, the scores of theoretical knowledge and operational skills, core competence of extracorporeal membrane oxygenation specialist nurses and training satisfaction in observation group were higher than those in control group, and the differences were statistically significant ( P<0.05) . Conclusions:The modified presentation assimilation discussion combined with heuristic clinical medicine teaching can improve the theoretical knowledge and operational skills of extracorporeal membrane oxygenation specialist nurses, and the nurses' training satisfaction is higher.

Immune checkpoint inhibitors(ICIs)have become the most widely used drugs in tumor immunotherapy, with ipilimumab and nivolumab as their representatives.However, the use of immune checkpoint inhibitors has brought about many immune-related adverse events, of which myocarditis is one of the most fatal adverse reactions.The pathogenesis of immune checkpoint inhibitor-associated myocarditis is not fully understood, mainly involving autoimmune T lymphocyte infiltration, regulatory T-cell dysfunction, cytokines, autoantibody production, genetic factors, the gut microbiome, etc.The treatment and management of immune checkpoint inhibitor-associated myocarditis require concerted efforts of multidisciplinary experts.

Objective To optimize the supercritical CO₂ extraction conditions of volatile oil from Wenjing Huoxue cataplasm. Methods On the basis of single factor investigation on the comprehensive score of extraction yield , osthole content and isoimperatorin, the effects of extraction temperature, pressure and time on the comprehensive score of extracted volatile oil were optimized by orthogonal design. Results In the single factor experiment, the factors that had a great influence on the comprehensive score of the extracted volatile oil were extraction temperature, extraction pressure and extraction time. The orthogonal experiment results showed that the extraction temperature and extraction pressure had a significant influence on the comprehensive score of volatile oil. The optimized extraction process was as follows: extraction temperature at 55 ℃, extraction pressure as 30 MPa, and extraction time as 2 h. Conclusion The extraction process optimized in this experiment is stable and feasible, which could be used for the extraction and preparation of the volatile oil.

Objective:To explore the effect of scenario simulation combined with problem-based learning (PBL) teaching method in extracorporeal membrane oxygenation training for Intensive Care Unit (ICU) nurses.Methods:From July to December 2021, ICU nurses who participated in extracorporeal membrane oxygenation training in the Second Affiliated Hospital of Zhengzhou University were selected by convenience sampling as the research object. A total of 38 ICU nurses who participated in the tenth training session from July to September 2021 were set as the control group, and 40 ICU nurses who participated in the eleventh training session from October to December 2021 were set as the observation group. The control group used the conventional training method, while the observation group used scenario simulation combined with PBL teaching method. We compared the training effectiveness, job competency, and training satisfaction of two groups of ICU nurses before and after the training.Results:After training, the theoretical knowledge, clinical operational skills, case analysis, and Job Competency Questionnaire scores of ICU nurses in observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . The score of the Training Satisfaction Questionnaire of ICU nurses in the observation group was higher than that in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:The combination of scenario simulation and PBL teaching method can improve nurses' theoretical knowledge, clinical operation skills, case analysis, and job competency, and increase their satisfaction with training.

【Objective】 To investigate the status quo and existing problems of quality control laboratory of blood stations in Hebei province, and to provide reference for the capacity building of quality control laboratory in the future. 【Methods】 The data of routine blood collection and supply, blood component preparation, blood sampling ratio/frequency, and sampling results among 12 blood stations in Hebei in 2020 were collected. The monitoring effect of blood component quality in Hebei province, combined with the indicator changes of main blood components, were analyzed. 【Results】 Blood component preparation from blood stations in Hebei are different. The requirements for the number and frequency of routine sampling in each apartment are not standardized, and retrospective analysis was not conducted basically. Although the frequency and sampling of blood component quality monitoring can meet the minimum requirements of the Quality Monitoring Guidelines of Whole Blood and Blood Components 2017 and Technical Operating Regulations of Blood Stations (2019 Edition), but does not match the actual collection and preparation units. The qualification rate and reliability are unstable due to the small sample size. Monthly quality inspection can result in judgment errors, which is not conducive to systematic analysis and continuous improvement of blood collection and supply process. 【Conclusion】 In the context of continuous enhancement of blood collection and supply standardization in Hebei Province, the blood quality monitoring mechanism based on intra-province consistency can be further studied to standardize intra-province homogenization of blood quality monitoring in multiple links including sampling rules, statistical analysis and data comparison calibers.

【Objective】 To investigate the effects of one-stage additional posterior pedicle screws （PPS） internal fixation on early Cage subsidence after oblique lateral interbody fusion （OLIF）. 【Methods】 We made a retrospective analysis of 118 patients with lumbar degenerative diseases treated with OLIF at the Department of Orthopedics， Sir Run Run Shaw Hospital， School of Medicine， Zhejiang University， from January 2016 to December 2019. We divided the patients into OLIF stand-alone group （58 ones） and OLIF with PPS fixation group （60 ones） according to the surgical procedure. All the patients had preoperative frontal and lateral radiographs of the lumbar spine， and CT and MR scans were performed. The clinical outcomes and reoperation rates of the two groups were compared at immediate postoperative follow-up and at 1， 3， 6 and 12 months. X-ray and CT examinations were performed to assess Cage subsidence in both groups at each postoperative follow-up. 【Results】 There was no statistical difference between the two groups in baseline data and surgical segmentation. Of the 118 patients with 141 discs who underwent OLIF surgery， 58 patients with 68 discs received OLIF stand-alone surgery and 60 ones with 73 discs received OLIF with PPS fixation. There were no significant differences in intraoperative bleeding， complications， or postoperative clinical outcomes between the two groups （P>0.05）， and the Cage subsidence rate was 22.4% in OLIF stand-alone group and 5% in OLIF with PPS fixation group， with significant difference between the two groups （P<0.01）. 【Conclusion】 Both OLIF stand-alone and OLIF additional PPS fixation can achieve good early clinical outcomes， and first-stage additional PPS fixation can significantly reduce the occurrence of Cage subsidence in the early postoperative period after OLIF.

Objective:Health education program based on information-motivation-behavioral skills model (IMB model) was developed, and its application effect in functional exercise after autogenous arteriovenous fistula (AVF) in hemodialysis patients was explored.Methods:Using the convenient sampling method, 100 patients undergoing AVF surgery in hemodialysis center of Qingdao Municipal Hospital from June 2020 to June 2021 were selected as the study objects. The patients were numbered according to the order of visit. The single number was the observation group, and the double number was the control group. There were 50 patients in each group. The control group was given routine AVF function exercise education, and the observation group was given AVF function exercise education based on the IMB model. Patients′ compliance with functional exercise, cephalic vein diameter, fistula maturation time, and the incidence of complications were compared between the two groups.Results:Finally, 49 cases in the control group and 50 cases in the observation group finished the research. The compliance of function exercise of the observation group was 94.0%(47/50), which was higher than 73.5%(36/49) in the control group, and the difference was statistically significant ( χ2=7.70, P<0.05). The maturation time of plasty in the observation group was (5.18 ± 1.14) weeks, shorter than that in the control group (5.94 ± 1.39) weeks, and the difference was statistically significant ( t=2.98, P<0.05). The cephalic vein diameter and blood flow controlled by hemodialysis pump in the observation group were (5.19 ± 0.28) mm and (218.40 ± 24.19) ml/min, respectively, higher than those in the control group (4.99 ± 0.34) mm and (200.41 ± 23.89) ml/min, the differences were statistically significant ( t=-3.21, -3.72, both P<0.05). The incidence of fistula complications in the observation group was 6.0%(3/50), lower than 22.4%(11/49) in the control group, and the difference was statistically significant ( χ2=5.52, P<0.05). Conclusions:The application of IMB model in hemodialysis patients with functional exercise after AVF plasty can effectively improve patients′ compliance, increase the diameter of cephalic vein and the blood flow controlled by dialysis pump, shorten the maturation time of internal fistula, and reduce the incidence of complications of AVF.