Objective To explore the predictive value of cognitive function trend after ACI for the recurrence risk of cerebral infarction.Methods A total of 256 ACI patients admitted to our hospi-tal from January 2021 to December 2023 were enrolled retrospectively.Based on their MoCA score at 3 months after onset,they were assigned into 96 cases of no PSCI,51 cases of improved PSCI,17 cases of delayed PSCI and 92 cases of persistent PSCI.According to the results of MoCA at 2 weeks after onset,they were divided into 133 cases of PSCI group and 123 cases of non-PSCI group.The clinical data of the ACI patients were compared between the two groups,and their cog-nitive function trends were analyzed.Results Advanced age,and larger proportions of female,du-al antiplatelet therapy and PSQI＞5 were observed in the PSCI group than the non-PSCI group(P＜0.05,P＜0.01).There were significant differences in the incidences of recurrence and poor prognosis in the ACI patients with different cognitive function trends(P＜0.01).The persistent PSCI was associated with the increased risk of recurrence of cerebral infarction and poor prognosis(P＜0.05).The AUC value of persistent PSCI in predicting the recurrence and poor prognosis of cerebral infarction was 0.703(95％CI:0.631-0.767)and 0.595(95％CI:0.521-0.666),respec-tively.Conclusion Persistent PSCI can be used as a predictor of recurrence of cerebral infarction,and it also increases the risk of cognitive dysfunction in ACI patients.

Objective To compare the effects of two exercise intensities on metabolic syndrome(MS).Methods Forty-nine MS patients hospitalized in Taiyuan Central Hospital from December,2022 to January 2024 were selected and randomly divided into two groups:a standard group(n=24)and individual group(n=25).All patients underwent cardiopulmonary exercise test(CPET)before and after treatment,collecting major indexes including body parameter,body component,and metabolic indicator for prescribing exercise programs.The standard group was trained with exercise intensity prescribed on heart rate reserve,while the individual group received the exercise with intensity prescribed on ventilatory threshold.Both groups received equal energy consumption exercise intervention with the same exercise frequency for 12 weeks.Results The two groups demonstrated significant improvements in waist circumference(WC),body mass index(BMI),body fat related indexes,and systolic blood pressure after intervention(P<0.05).The individual group showed significant improvements inWC,BMI and body fat related indexes as compared to the standard group(P<0.05).Both groups showed significant improvements in peak oxygen uptake,(PeakVO2),peak load power(Peak WR),peak metabolic equivalent(PeakMets),and peak respiratory exchange ratio(Peak RER)after intervention(P<0.05).The individual group presented significant improvements in peak heart rate(HRpeak),peak oxygen pulse(Peak VO2/HR),and maximum voluntary ventilation(MVV)(P<0.05)after intervention.Before intervention,the standard group demonstrated significantly higher levels in PeakVO2 and Peak MET compared to the individual group(P<0.05),but after intervention the two groups showed no significant differences in the two indexes.After the intervention,the individual group demonstrated insignificant improvements in all indexes compared to the standard group(P>0.05).Conclusions Both exercise prescriptions based on CPET can effectively improve the health-related indicators of MS patients on condition of moderate exercise intensity.However,the program prescribed based on individualized ventilatory threshold shows superiority to the program prescribed based on maximum physiological value in improving these indicators.

Patients with metabolic syndrome(MS)are at potential risk for cardiovascular disease and have received increasing public and medical attention.Studies have shown that regular physical exercise can effectively regulate meta-bolic indicators such as blood pressure,blood sugar and blood lipids,and play a positive role in reducing the risk of cardio-vascular disease and improving the prognosis of patients.Exercise intensity has been identified as the most important as-pect in reducing the risk of cardiovascular death and all-cause mortality in exercise intervention.Therefore,the design of exercise prescription which is both scientific and satisfying individual differences has become the focus of research.Most of the current clinical studies are based on the percentage of exercise intensity as the basis for the formulation of standard-ized exercise prescription for MS patients,while the studies on the individualized threshold of exercise intensity based on cardiopulmonary exercise test(CPET)are still few.CPET has shown that individualized exercise prescription can effec-tively reduce body composition index,blood pressure and blood glucose,improve cardiorespiratory function,exercise en-durance and quality of life in MS patients.This paper reviewed the development of individualized exercise programs with different intensification according to threshold indexes in CPET,analyzed the intervention effects and possible mechanisms for MS patients and subgroups,and provided certain reference for the formulation and implementation of personalized exer-cise prescriptions for MS patients,and also provided references for in-depth research on individualized exercise intervention for MS.

Objective:To explore the effect of communication competence and psychological resilience on job burnout among Operating Room nurses.Methods:From March to June 2023, randomized clustering sampling was used to select 138 registered Operating Room nurses from four ClassⅢ Grade A hospitals in Taizhou for investigation. The survey was conducted using the general information questionnaire, Operating Room Nurses' Job Stressor Scale, Chinese version of the Connor-Davidson Resilience Scale, Nurses' Clinic Communication Competence Scale, and Maslach Burnout Inventory-General Survey. Hierarchical linear regression analysis was used to explore the effects of communication competence and psychological resilience on job burnout among Operating Room nurses.Results:A total of 138 questionnaires were sent out, and 133 valid questionnaires were collected, with a valid response rate of 96.38% (133/138). Among 133 Operating Room nurses, the job burnout score was (56.35±9.28), and the communication competence, psychological resilience, and work stress scale scores were (196.71±18.92), (78.09±18.31), and (96.37±22.47), respectively. Pearson correlation showed that job burnout among Operating Room nurses was negatively correlated with psychological resilience ( r=-0.475, P<0.01) and communication competence ( r=-0.241, P<0.01), and positively correlated with work stress ( r=0.360, P<0.01). Hierarchical linear regression analysis showed that, after controlling for other variables, psychological resilience and communication competence were the influencing factors of job burnout among Operating Room nurses ( P<0.01), which could explain 17.70% of the variation. Conclusions:The level of job burnout among Operating Room nurses is relatively high, and psychological resilience and communication competence are independent influencing factors. Managers can provide psychological counseling and support services for Operating Room nurses, offer communication competence training programs, and prevent and reduce job burnout among Operating Room nurses.

Objective To analyze and discuss the medication rule of professor Ruan Yan in the treatment of children with allergic rhinitis by using data mining method,and to provide reference for the clinical research and patented drugs development for the treatment of children with allergic rhinitis.Methods The outpatient medical records of professor Ruan Yan for the treatment of children with allergic rhinitis were collected.Microsoft Excel 2010 software was used for frequency statistics.SPSS Clementine 12.0 software was used for association rule analysis,cluster analysis and factor analysis to obtain the data.The frequency of use of various drugs and the association rules between drugs were obtained.Then the medication rules in professor Ruan Yan's prescription were analyzed.Results A total of 308 Chinese medicine compounds were included,involving 80 kinds of Chinese medicines,among which relieving drugs and qi-invigorating herbs were high-frequently used.The distribution of traditional Chinese medicine syndrome types was mainly characterized by lung-qi deficiency-cold syndrome and lung-spleen qi deficiency syndrome.The medicinal properties were mainly spicy,warm and sweet,and most of them belonged to the lung,spleen and stomach meridians.Five core prescriptions were extracted by factor analysis.Four drug combinations were obtained by systematic cluster analysis.Conclusion Ventilating lung and opening the orifices,expelling wind and removing cold,strengthening the spleen and replenishing qi are basic therapeutic principles for professor Ruan Yan in the treatment of children with allergic rhinitis.The treatment mainly focused on dispelling evil,ventilating lung and opening the orifices,expelling wind and removing cold during the acute stage of allergic rhinitis.In the remission period,according to the principle of"treating disease must be based on its origin",the treatment should enhance children's physical fitness,tonify lung and strengthen spleen,thereby reducing recurrence.

Objective:To explore an applicative value of a 5-type precise diagnostic technique in integrated precise repair and reconstruction of digit-tip injuries.Methods:From March 2012 to June 2022, 45 digit-tip injuries (38 patients, with an average age of 33 years old) were classified under microscope on the basis of effectiveness of blood vessels remained in the severed tissue. Among the injured digits, there were 15 thumbs, 9 index fingers, 16 middle fingers, 4 ring fingers and 1 little finger. The diagnosis was categorised into 5 types according to involvement of blood vessels: Type I, injury of proper palmar digital artery (10 digits) ; Type II, injury of small artery (5 digits) ; Type Ⅲ, injury of whole vein (4 digits) ; Type IV, injury of superficial palmar arch (4 digits) ; and Type V, vessels missing (22 digits). The timing and therapeutic method of surgery were selected based on the precise classification of 5 types of diagnosis: (1) For type Ⅰ-Ⅳ injuries, 16 patients (23 digits) received in situ tissue replantation after emergency classification. Of which, type Ⅰ-Ⅱ injuries received conventional replantation, type Ⅲ injuries had replantation with arterialised vein, and type IV injuries received replantation with artery-vein shunt. (2) For the type V injuries, 22 patients (22 digits), staged and categorised flap reconstruction with toe flaps were performed. Of which, 7 were performed in emergency surgery, 12 in subemergency surgery and 3 in elective surgery. Based on the severity of defects, small tissue flaps of toe were used in reconstruction of type V injuries and following toe flaps were employed: 9 hallux nail flaps, 3 hallux nail flaps (for reconstruction of distal phalanx), 5 hallux fibular flaps, 3 hallux abdominal flaps and 2 compound tissue flaps with nail bed of the second toe. The sizes of the 45 replanted/transferred tissues flaps were 1.0 cm×0.6 cm×0.4 cm-2.2 cm×1.5 cm×0.8 cm. Donor sites directly sutured. Medical APP was applied in the rehabilitation exercises. Functions of digits were assessed by scheduled follow-ups at outpatient clinic and via remote medical APP to evaluate the clinical efficacy.Results:All small tissue blocks and (or) tissue flaps survived after replantation and (or) flap reconstruction of 45 injured digits. Postoperative follow-up lasted for 6 months to 7 years, with 36 months in average. The appearances of the reconstructed digit-tips were close to normal digits, with TPD at 3-7 mm. According to the Michigan Hand Outcomes Questionnaire (MHQ), 32 patients (37 digits) were in excellent, 5 patients (7 digits) in good, and 1 patient (1 digit) in poor, with 97.78% of excellent and good rate.Conclusion:Five-type precise diagnostic technique is the key to the integrated and precise reconstruction of digit-tip injuries. This method has been clinically validated and achieved realistic recovery from the injured digits.

Objective:To investigate the exposure level of ionizing radiation in medical radiation workers in Guangdong province, as well as their abnormality in the lens of the eye, and to analyze associated influence factors.Methods:In this study, 1 501 radiation workers from 60 hospitals were selected by using convenient sampling method for retrospecotive analysis of absorbed doses ( DL) to the lens of the eye, health examination information and the relevant influence factors. Results:The median value M and the 25 th and 75 th percentile values ( P25, P75)of the distribution of absorbed doses were 4.86, 2.99 and 7.90 mGy, respectively. The median values for male and female were 5.14 and 3.94 mGy, respectively. The median values for the Levels I, Ⅱ and Ⅲ medical institutions were 2.95, 3.51 and 5.06 mGy, respectively. The median values were radiotherapy 4.05 mGy, radiodiagnosis 4.84 mGy, interventional radiology 5.39 mGy and nuclear medicine 6.71 mGy, as well as nurses 3.48 mGy, physicians 5.03 mGy and technologists 5.03 mGy, respectively. There were statistically significant differences in dose distribution for different gender, age, length of radiation service, age at the beginning of radiation exposure, level of medical institution, occupational category and post ( Z=-6.72, H=389.64, 511.17, 70.29, 53.29, 49.06, 39.89, P<0.05). The detectable rate for increased cortical density of lens was 22.45% (337/1 501) and for lens turbidity was 8.19% (123/1 501). The detectable rate of increased cortical density showed a linear increasing trend with the increase in age, age of radiation service, age at the beginning of exposure to radiation, level of medical institution and dose ( χ2=366.36, 313.77, 15.18, 21.61, 92.13, P<0.05). The detectable rate of lens opacity increased linearly with the increase in age, length of radiation service, level of medical institution and dose( χ2=69.64, 67.65, 67.65, 37.37, P<0.05), and decreased linearly with the increase in age at the beginning of radiation exposure ( χ2=4.25, P<0.05). Logistic regression analysis showed that age was the influencing factor of increased cortical density ( χ2=165.98, P<0.05), and the risk of cortical densification increased with age ( OR=1.33, 95% CI: 1.27-1.39). Age, length of radiation service and occupation were the influencing factors of lens opacity ( χ2=25.78, 4.99, 6.88, P<0.05). The risk of lens opacity increased with age ( OR=1.17, 95% CI: 1.10-1.24). The risk of lens opacity increased with age of radiation service ( OR=1.06, 95% CI: 1.01-1.12). The risk of ocular opacity was higher in interventional radiology than that in diagnostic radiology, radiotherapy and nuclear medicine ( OR=2.59, 95% CI: 1.27-5.25). Conclusions:Long-term exposure to low dose ionizing radiation has a certain correlation with the abnormal lens detectable rate of medical radiation workers. Age, length of radiation service and occupation are the influencing factors of lens opacity.

Objective:To explore the clinical features, diagnosis, treatment and prognosis of rectal neuroendocrine tumor with lymphatic metastasis.Method:There were 153 case who were diagnosed with RNET, among them, there were 10 patients(6.5%) with lymphatic metastasis in Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science & Technology from January 2012 to December 2020, including 4 males and 6 females, aged from 32 to 71 years old, and the median age was 56.5 years.Results:Of the 10 patients, 3 had tumors < 1 cm in diameter, 4 had 1 to 2 cm, and 3 had > 2 cm. Preoperative CT examination was performed in 10 patients, of which 9 suggested lymphatic metastasis; preoperative MRI examination was performed in 7 patients, of which 6 suggested lymphatic metastasis. All patients were received radical resection, in which Miles operation was performed in 2 cases, Dixon operation in 6 cases, and additional Dixon operation after endoscopic submucosal dissection in 2 cases.All patients were followed up for 51 months (ranged from 14 to 118 months). Nine patients had no recurrence or metastasis, and one patient had abdominal metastasis 40 months after surgery and died after 31 months of comprehensive treatment.Conclusions:Lymphatic metastasis is rare in rectal neuroendocrine tumor. Imaging examination has important reference value for judging the status of lymphatic metastasis. For rectal neuroendocrine tumor with lymphatic metastasis, radical resection is effective.

Objective:To review the incidence and treatment status of perioperative anemia in patients with gastric cancer.Methods:The clinicopathological data of gastric cancer patients who underwent surgery at Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from Jan to Dec 2019 were collected. Univariate analysis and multivariate Logistic regression analysis were used to explore the risk factors of preoperative anemia in gastric cancer.Results:A total of 879 patients were included in this study. The incidence of preoperative anemia in patients with gastric cancer was 35.6%. The incidence of postoperative anemia was 63.5%. The proportion of patients with preoperative anemia receiving treatment was 17.3%, and the proportion of patients with postoperative anemia receiving treatment was 17.4%. Univariate analysis showed that age, nutritional risk screening 2002, T stage, M stage, tumor stage and lymph node metastasis were associated with preoperative anemia (all P<0.05). Multivariate Logistic regression analysis showed that age >60 years , nutritional risk screening 2002 ≥3, T 3-4 stage and M 1 stage were independent risk factors for preoperative anemia in patients with gastric cancer (all P<0.05). Conclusions:The incidence of perioperative anemia in patients with gastric cancer is high. At present, the proportion of patients with perioperative anemia receiving treatment is low. High nutritional risk, advanced age, late tumor T stage and distant metastasis are independent risk factors for preoperative anemia in patients with gastric cancer.

Objective:To evaluate the efficacy and safety of SPOT (GI Supply, USA), a new carbon-based permanent marker approved by the Food and Drug Administration (FDA), in the endoscopic marking for gastrointestinal lesions.Methods:A total of 115 patients with gastrointestinal lesions who underwent endoscopic treatment or surgery in Beijing Friendship Hospital or Beijing Chao-Yang Hospital from April 2019 to November 2019 were enrolled in the study. SPOT was used to mark the lesions, and marking points were found during endoscopic treatment or surgery to calculate the effective marking rate by single-group target value method. Adverse events after marking were recorded, and the changes of blood routine test, liver and kidney functions before and after marking were compared.Results:The effective rate of endoscopic marking with SPOT was 99.13% (114/115). The longest marking time was 57 days. There was no puncture of intestinal wall or injection into abdominal cavity during the marking process. One patient developed mild fever after marking. The incidence of adverse events was 23.48% (27/115), which were all unrelated to the test equipment. There was no significant difference in blood routine tests or liver and kidney functions before and after marking ( P>0.05). Conclusion:SPOT produced by GI Supply can effectively mark gastrointestinal lesions without serious adverse events, which meets the requirements of clinical use.