Objective:To investigate the clinical value of multiparameteric quantitative ultrasound combined with a non-invasive prediction model for assessing high-risk steatohepatitis.Methods:One hundred and ninety-four cases with metabolic-associated fatty liver disease (MAFLD) who underwent liver biopsy in Huashan Hospital, Fudan University, from June 2021 to September 2022 were selected. Shear wave elastography (SWE), shear wave dispersion (SWD) imaging, and attenuation imaging (ATI) examinations were conducted in all patients before biopsy. High-risk steatohepatitis was defined as a total activity score of ≥4 in patients with steatohepatitis, hepatocellular ballooning, and liver lobular inflammation based on pathological hepatic steatosis, inflammatory activity, and fibrosis scoring system (SAF), and fibrosis stage≥F2. Binary logistic regression analysis was used to identify the factors influencing high-risk steatohepatitis. A predictive model for diagnosing high-risk steatohepatitis was constructed using R language. The DeLong test was used to compare the area under the curve between groups. Measurement data was compared between groups using the t-test or rank-sum test, and count data were compared between groups using the χ2 test. Results:There were 46 cases (23.7%) with high-risk steatohepatitis. The quantitative ultrasound parameters included elastic modulus ( OR=2.958, 95% CI: 1.889-4.883, P<0.001), dispersion coefficient ( OR=1.786, 95% CI: 1.424-2.292, P<0.001) and attenuation coefficient ( OR=42.642, 95% CI: 3.463-640.451, P=0.004). Serological indexes of fasting blood glucose ( OR=1.196, 95% CI: 1.048-1.392, P=0.011), alanine aminotransferase ( OR=1.012, 95% CI: 1.006-1.019, P<0.001), aspartate aminotransferase ( OR=1.027, 95% CI: 1.014-1.042, P<0.001), γ-glutamyl transferase ( OR=1.008, 95% CI: 1.001-1.017, P=0.041) and HDL cholesterol ( OR=0.087, 95% CI: 0.016-0.404, P=0.003) were the factors influencing its progression. The AUCs of elastic modulus, dispersion coefficient, attenuation coefficient, multiparametric ultrasound model, serological index model, and ultrasound combined with serology model for the diagnosis of high-risk steatohepatitis were 0.764, 0.758, 0.634, 0.786, 0.773 and 0.825, respectively. The results of the DeLong test showed that the ultrasound combined with the serological model was significantly better than the serological index model and the elastic modulus, dispersion coefficient, and attenuation coefficient alone ( P=0.024, 0.027, 0.038 and <0.001). Conclusion:The combination of multiparametric quantitative ultrasound is helpful for the non-invasive diagnosis of high-risk steatohepatitis and possesses great clinical significance.

Objective:To explore the effect of comprehensive moxibustion with Huolong cupping in patients with lung-spleen qi deficiency type allergic rhinitis.Methods:This study was a randomized controlled trial. From October 2022 to April 2023, convenience sampling was used to select 66 patients with lung-spleen qi deficiency type allergic rhinitis who visited the Otolaryngology Head and Neck Clinic of Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine as the research subject. The patients were randomly divided into an experimental group ( n=33) and a control group ( n=33). Both groups received routine oral Chinese medicine treatment. On the basis of routine treatment, the experimental group performed comprehensive moxibustion with Huolong cupping on the meridians of the Du meridian and bladder meridian. This study compared the scores of Nasal Airway Resistance (NAR), Total Nasal Symptom Score (TNSS), Visual Analogue Scale (VAS), and Chinese version of Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) between two groups of patients before and after intervention. Results:Eventually 30 patients in each of the experimental group and control group completed the study. After intervention, the NAR score of the experimental group was lower than that of the control group, and the difference was statistically significant ( P<0.05). Repeated measures analysis of variance showed that with the increase of treatment time, the TNSS, VAS, and RQLQ scores of the experimental group were lower than those of the control group with statistical differences ( P<0.05), and the time effect, inter group effect, and interaction effect were statistically significant ( P<0.05) . Conclusions:Huolong cupping comprehensive moxibustion can reduce nasal resistance, meliorate nasal symptoms and accompanying nasal symptoms, and improve the quality of life of patients.

Objective To observe the optimal target areas for shear wave velocity(SWV)evaluation on stages of chronic kidney disease(CKD)in different sides(left,right),different parts(upper pole,middle part and lower pole)and different tissue(renal cortex,renal medulla,renal sinus)of kidney.Methods Sixty-five CKD patients(130 kidneys)were retrospectively collected.SWV were compared between different sides,among different parts and tissue of kidney.The optimal regions for evaluating CKD stages were screened.Results No significant difference of SWV was found between left and right kidneys in same parts for same tissue(all P＞0.05),while significant differences of SWV of the same tissue were noticed among upper pole,middle part and lower part of kidney on the same side(all P＜0.05),i.e at upper pole＞at middle part＞at lower pole.Significant differences of SWV were also observed among renal cortex,medulla and sinus of kidney in the same side and parts(all P＜0.05),and the sinus had the highest SWV.Intraclass correlation coefficient analysis showed that the repeatability of the measurements of SWV was the best at the middle part of kidney.Besides,significant differences of SWV were found between renal cortex and medulla at the middle part of kidney among patients with stages 1,2,3 and 4-5 CKD(all P＜0.05),while the highest SWV were observed in patients with 4-5 stage CKD(all P＜0.05).SWV of renal cortex and medulla at middle part were positively correlated with CKD stages(both P＜0.01),the area under the curve of them for evaluating stage of CKD was 0.802 and 0.774,respectively.Conclusion The optimal target areas for SWV evaluation on stages of CKD were renal cortex and medulla at middle part of kidney.

Objective:To construct a hypoglycemia nursing information system and explore its application effects in the nursing quality management of the Department of Endocrinology.Methods:Based on the existing blood glucose information management system of Peking University First Hospital, a hypoglycemic nursing information system with evaluation, alarm, record, remind, and management functions was designed. We compared the number of cases of standardized correction of hypoglycemia in inpatients by nurses, the complete and accurate cases of hypoglycemia records, and the monthly time spent on the quality control by nursing special managers before the application of the system (from February to December 2017) and after the application (from January 2018 to December 2019) .Results:After the application of the hypoglycemia nursing information system, the complete and accurate cases of hypoglycemia records, and the cases of standardized correction of hypoglycemia were statistically different from those before the application of the system ( P<0.001) . The quality control time of nursing special managers decreased from (7.55±1.01) hours a month to (0.41±0.21) hours a month. Conclusions:Application of the hypoglycemia nursing information system adapts to the hospital's management requirements for hypoglycemia, which not only promotes the standardization of nurses' handling of hypoglycemia events, improves the completeness and accuracy of written records, but also saves time for managers to perform the quality control and promotes the scientific and digitalization of nursing special management.

Objective To carry out quality assessment and content analysis on guidelines on arteriovenous fistula (AVF) dysfunction monitoring in hemodialysis patients so as to provide a reference for building the localized clinical practice plan. MethodsDocuments were retrieved in guideline websites, professional society websites and electronic databases at home and abroad by computer. Quality assessment was carried out with the appraisal of guidelines for research and AGREEⅡ and JBI quality assessment tool on consensuses, and the recommendations of included guidelines were summarized. ResultsTotals of 4 evidence-based guidelines and one consensus were included with three of them in the level A and one in the level B of overall quality evaluation. A total of 12 items in 7 aspects were extracted including policy-making, team building, monitoring technology, training of personnel, continuous quality improvement, risk assessment and health education. Intraclass correlation coefficients of 4 evidence-based guidelines ranged from 0.866 to 0.935. Conclusions The guidelines have high levels of overall quality, but applicability needs to be improved. The recommendations are in general accord with each other, which can provide a basis for building the localized clinical practice plan.

This paper reviewed the development status of education, practice, certification and management of American Clinical Nursing Specialists (CNS). Drawing on the experiences of foreign countries, suggestions were made to provide reference for the training of CNS in China.

Objective To estimate the prevalence and distribution of metabolic syndrome (MS) in Chinese adults.Methods Cross-sectional data on 104 098 men and women aged 18 years or above was gathered from 150 monitoring sites from 31 provinces,autonomous regions,and municipalities from the China National Health and Nutrition Surveillance (2010-2012) Project.Data was randomly selected by multi-stage stratified and Probability Proportionate to Size (PPS) cluster random sampling method.Prevalence of MS was defined under the diagnostic criteria of China Diabetes Society (CDS).Complex sampling weighing method was used with demographic data released by the National Bureau of Statistics of China in 2009,when calculating the prevalence and its 95％CI of MS.Results The overall prevalence rate of the MS among adults was 11.0％,more seen in urban than in rural areas,and in men than in women.The prevalence showed a parallel increasing trend with age.As was observed in the comparison between the prevalence of four components of MS,the prevalence rates of dyslipidemia (33.7％) and overweight or obesity (32.3％) showed more serious than in hypertension (22.4％) or hyperglycemia (16.2％).Conclusion The prevalence of MS among adults in China showed an increasing trend which had already become a significant public health problem,in the country.

Objective: To invesigate the epidemic status of the metabolic syndrome (MS) among mainland Chinese adolescents aged 10-17 in 2010-2012. Methods: Data were collected from Chinese Nutrition and Health Surveillance in 2010-2012. Multi-stage stratified proportion to the population cluster random sampling method was conducted to determine 16 872 adolescents in 150 counties from 31 provinces in mainland China. The epidemic status of metabolic syndrome was analyzed by China criterion (defined by Chinese Pediatric Society, Chinese Medical Association) and Cook criterion, respectively. The prevalence of MS and 95%CI were calculated through weighted complex sampling processing by population data released by the National Bureau of Statistics in 2009. Results: Based on China criterion, the weighted prevalence of MS was 2.4% (95% CI: 2.1%-2.6%) among Chinese adolescents aged 10-17. Prevalence in urban was higher than in rural (2.8%, 95%CI: 2.4%-3.2% and 1.9%, 95%CI:1.6%-2.3%, respectively). Prevalence in boys and girls were 2.7% (95% CI: 2.3%-3.0%), and 2.0% (95% CI: 1.7%-2.4%), respectively. Based on Cook criterion, the weighted prevalence was 4.3% (95% CI: 4.0%-4.7%) . The highest weighted prevalence of the components of the metabolic syndrome was low high-density lipoprotein cholesterol (26.8%, 95% CI: 26.0%-27.5%), followed by high fasting glucose (11.5%, 95% CI: 11.0%-12.0%), abdominal obesity (11.1%, 95%CI: 10.6%-11.7%) , hypertriglyceridemia (8.8%, 95%CI: 8.4%-9.3%) , and high blood pressure (6.4%, 95% CI: 6.0%-6.8%). Conclusion Among the five indicators of metabolic syndrome, the prevalence of central obesity and hypertriglyceridemia were relative high in Chinese adolescents aged 10-17 years, though the prevalence of metabolic syndrome was not high.

Objective To design and create a C/S-J type of biliary self-releasing stent,and to study its safety and efficacy in preventing post-ERCP complications.Methods 118 patients with common bile duct stones treated in our hospital were enrolled into this study from October 2013 to May 2015.These patients were randomly divided into two groups:the experimental group who underwent ERCP + EST + C/S-J type of self-releasing biliary stent drainage,while the control group underwent ERCP + EST + ENBD.The incidences of post-ERCP acute pancreatitis (PEP) and cholangitis in the two groups and the time the self-releasing stent was dislodged from the biliary system in the experimental group were recorded.Results The incidence of PEP was 6.4％ (5/78) and 7.5％ (3/40) in the experimental and the control group,respectively (P ＞ 0.05).There were no patients who developed postoperative acute cholangitis in the two groups.The stents were dislodged from the biliary system on the first day after the procedure in 2 patients in the experimental group without any complications.One stent failed in self-releasing but was removed successfully with endoscopy 3 months later.In the other 75 patients,the stents were successfully dislodged and were excreted outside the patient's body through the intestinal tract (mean 11.4,range 9 ～ 14) days,without any complications.Conclusion The C/S-J type of biliary self-releasing stents is safe and efficacious in preventing post-ERCP pancreatitis and cholangitis.

Objective To evaluate the association between C-reactive protein (CRP) blood levels and specific survival time of non-small cell lung cancer (NSCLC) patients treated with chemotherapy.Methods Data from 96 advanced (stage ⅢB/Ⅳ) NSCLC patients were analyzed.All patients were divided into two groups based on the enrolled time as follows the initial treatment group (48 cases) and retreatment group (48 cases).According to 0.6 mg/L and 7.3 mg/L of CRP which were the 1/3 and 2/3 of CRP concentrations,respectively,the 96 patients were divided into low,intermediate and high groups.Kaplan-Meier and Cox proportional-hazard models were used to evaluate the relationship between the CRP level and survival time.Results After adjusting for age,sex,smoking history,histological type and stage of lung cancer,a significant relationship between CRP and survival time was observed (P ＜ 0.05).Such significant differences of survival time were also observed in both of the adenocarcinoma (P ＜ 0.001) and squamous with poorly differentiated (P =0.032) subtypes.On stratification analysis by chemotherapy status,the circulating CRP level in retreatment group was correlated well with survival time (P ＜ 0.001).However,the influence of circulating CRP levels on survival time in initial group did not reach statistical significance (P =0.296).For all patients,the hazard ratio with high CRP levels for NSCLC-specific survival was 1.15 (95 ％ CI 0.82-1.61) compared with that of low CRP levels.The hazard ratio for the initial treatment group and retreatment group were 0.52 (95 ％ CI 0.16-1.74) and 1.77 (95 ％ CI 0.73-4.26),respectively.Patients with high circulating CRP level also responded poorly to chemotherapy.Conclusion A high level of circulating CRP is associated with an inferior response and survival outcome in NSCLC patients treated with chemotherapy.