Objective To investigate the consistency between colonoscopic Boston bowel preparation score and the bowel cleanliness evaluated by pre-endoscopy naked eye faecal observation,so as to provide a guidance on bowel preparation.Methods From September 2018 to June 2019,convenience sampling method was used to select 150 inpatients who underwent colonoscopy in the Department of Gastroenterology of a tertiary hospital in Guangzhou as the research objects.Before colonoscopy,the compound polyethylene glycol electrolyte powder was taken orally according to the bowel preparation plan for cleaning the colorectum.Before the colonoscopic examination,the naked eye observation method by nurses was used to observe the transparency of the excreta to evaluate the cleanliness of colorectum.Then the colorectal cleanliness was evaluated by endoscope by the operator using the Boston bowel preparation assessment scale(BBPS)during colonoscopy.Results A total of 145 patients completed the study.The cleanliness of bowel preparation was 93.1%with the naked eye observation and 88.27%with colonoscopy.There was no significant difference between the two assessment methods in judging the effectiveness of bowel preparation(P<0.05).The sensitivity of naked eye observation in judging bowel preparation was 96.10%with a 29.41%of specificity.The positive predictive value was 91.11%,and the negative predictive value was 50%(Kappa=0.310,P<0.001).Conclusion The naked eye observation and evaluation method for bowel preparation has advantages in high sensitivity,low specificity,high positive predictive value and low negative predictive value.It can be used as a preliminary evaluation method for cleanliness of colorectum before colonoscopy.

Optical coherence elastography (OCE) is a novel technique developed in recent years to investigate the biomechanical properties of tissues, similar to optical coherence tomography angiography, a functional version of optical coherence tomography.OCE utilizes load excitation to detect the mechanical response of ocular tissues, facilitating quantitative analysis of stress-strain curves, Young's modulus, and other biomechanical indicators.It also generates two-dimensional/three-dimensional elastic maps of the tissues.With its noninvasive, high-resolution, real-time, rapid, and three-dimensional imaging capabilities, OCE provides both structural and mechanical information about ocular tissues, opening up new dimensions in ocular disease diagnosis and pathogenesis research.This article introduced the technical classification and research status of OCE, and highlighted its research progress in ophthalmology, including its applications in assisted refractive surgery design, keratoconus patient screening, assessment of corneal cross-linking surgery efficacy, cataract diagnosis and grading, measurement of retinal biomechanics, and research into myopia pathogenesis.The challenges and opportunities for clinical translation of OCE in ophthalmology were also discussed.

Objective:To analyze the detection rate and related factors of depressive and anxious symptoms comorbidity in 2021 and 2022.Methods:Based on the results of the Seventh National Population Census in 2021,the residents of 32 provinces,municipalities,and autonomous regions were sampled by gender and age.The gender and age of the samples were in line with the characteristics of China's population.A face-to-face interview survey was conducted in community residents in each province in 2021(n=11 005)and 2022(n=30 421)with the Gen-eralized Anxiety Questionnaire-7 and Patient Health Questionnaire-9.Results:The detection rates of depressive and anxious symptoms comorbidity were 10.67％in 2021 and 11.72％in 2022.The prevalence of depressive and anxi-ety comorbidity were higher in male,younger(age≤17 years),divorced,lower BMI(BMI＜18.5 kg/m2),higher education(graduate),students,and residents with chronic medical history(Ps＜0.001).In 2022,32.06％of people with depressive symptoms had anxious symptoms and 47.62％of people with anxious symptoms had depressive symptoms.Conclusion:In 2021 and 2022,the detection rates of depressive and anxious symptoms comorbidity were both about 10％,and half of patients with anxious symptoms were accompanied by depressive symptoms,So atten-tion should be paid to the comorbidity of depression and anxiety symptoms.

Background: Postherpetic neuralgia (PHN) is the most common complication of acute herpes zoster. The treatment of PHN remains a challenge for clinical pain management. Despite the effectiveness of anticonvulsants, antidepressants, and lidocaine patches in reducing PHN, many patients still face intractable pain disorders.In this randomized controlled study, we evaluated whether hydromorphone through intravenous patient-controlled analgesia (IV PCA) was effective in relieving PHN. Methods: Patients with PHN were randomly divided into two groups, one group received oral pregabalin with IV normal saline, another group received oral pregabalin with additional IV PCA hydromorphone for two weeks. Efficacy was evaluated at 1, 4, and 12 weeks after the end of the treatments. Results: Two hundred and one patients were followed up for 12 weeks. After treatment, numerical rating scale (NRS) score of patients in the hydromorphone group was significantly lower than that of the control group, and the difference of NRS scores between the two groups was statistically significant at 4 and 12 weeks after treatment. The frequency of breakthrough pain in the hydromorphone group was significantly lower than that in the control group 1 and 4 weeks after treatment.After treatment, the quality of sleep in the hydromorphone group was significantly improved compared with the control group. The most common adverse reactions in the hydromorphone group were dizziness and nausea, with no significant respiratory depression. Conclusions IV PCA hydromorphone combined with oral pregabalin provides superior pain relief in patients with PHN, which is worthy of clinical application and promotion.

Objective:To understand the etiology and clinical characteristics of hospitalized severe community-acquired pneumonia(SCAP) in Changchun, and provide scientific basis for its etiology diagnosis and targeted treatment.Methods:The study subjects included 618 children with clinical diagnosis of SCAP who were hospitalized from January 2016 to December 2019.We collected pharyngeal swabs and alveolar lavage fluid from children.Virus isolation, bacterial culture, time-of-flight mass spectrometry, PCR/RT-PCR, colloidal gold method and Optochin test were used to detect the antigen, nucleic acid and protein profiles in the specimen.Results:There were more boys than girls in hospitalized children with SCAP.The peak age of onset was 7 to 12 months.Most cases occurred in winter and spring.The highest detection rate of SCAP virus was 56.15%(347/618); 73.49%(255/347) were positive for one virus, among which the top five were respiratory syncytial virus (27.8%), influenza A virus (23.9%), influenza B virus (16.1%), rhinovirus (12.2%) and metapneumovirus (10.2%). Two viruses were positive for 19.88%(69/347); three viruses were positive for 4.32%(15/347); four viruses were positive for 2.31%(8/347). Atypical microbial infections were 29.77%(184/618), of which Mycoplasma pneumoniae accounted for 95.65%(176/184). Bacterial infections were 17.31%(107/618), mainly Streptococcus pneumoniae(39.25%, 42/107) and Staphylococcus aureus(24.30%, 26/107). The mixed infection of multiple pathogens was 7.61%(47/618), among which the mixed infection rates of Mycoplasma pneumonia with Streptococcus pneumoniae, virus were 40.43% and 34.04%, respectively.High fever, faster breathing, and perioral cyanosis were risk factors for SCAP, with OR and 95% CI of 7.71 and 4.56-13.04, 2.43 and 2.02-2.93, 3.53 and 2.56-4.86, respectively.Viral co-infection occurred in 36.96%(34/92) of complications such as heart failure, toxic encephalopathy, and myocardial damage; Mycoplasma pneumoniae and other pathogens co-infected 35.29% of children with pleural effusion. Conclusion:The pathogens of SCAP in Changchun are mainly viruses notably, respiratory syncytial virus is the dominant pathogen, followed by Mycoplasma pneumoniae.The bacterial pathogen is mainly Streptococcus pneumoniae.High fever, faster breathing, and cyanosis around the mouth are risk factors for severe pneumonia.Multi-pathogen mixed infection is prone to serious complications.

Background: Postherpetic neuralgia (PHN) is the most common complication of acute herpes zoster. The treatment of PHN remains a challenge for clinical pain management. Despite the effectiveness of anticonvulsants, antidepressants, and lidocaine patches in reducing PHN, many patients still face intractable pain disorders.In this randomized controlled study, we evaluated whether hydromorphone through intravenous patient-controlled analgesia (IV PCA) was effective in relieving PHN. Methods: Patients with PHN were randomly divided into two groups, one group received oral pregabalin with IV normal saline, another group received oral pregabalin with additional IV PCA hydromorphone for two weeks. Efficacy was evaluated at 1, 4, and 12 weeks after the end of the treatments. Results: Two hundred and one patients were followed up for 12 weeks. After treatment, numerical rating scale (NRS) score of patients in the hydromorphone group was significantly lower than that of the control group, and the difference of NRS scores between the two groups was statistically significant at 4 and 12 weeks after treatment. The frequency of breakthrough pain in the hydromorphone group was significantly lower than that in the control group 1 and 4 weeks after treatment.After treatment, the quality of sleep in the hydromorphone group was significantly improved compared with the control group. The most common adverse reactions in the hydromorphone group were dizziness and nausea, with no significant respiratory depression. Conclusions IV PCA hydromorphone combined with oral pregabalin provides superior pain relief in patients with PHN, which is worthy of clinical application and promotion.

Objective:To explore the effect of the resection of the primary lesion on the prognosis for patients with stage Ⅳ breast cancer.Methods:A total of 132 breast cancer patients who were first diagnosed as stage Ⅳ in the Hebei Cancer Hospital from June 2008 to June 2015 were divided into two groups: the primary resection group ( n=85) and the unresection group ( n=47). The influences of primary resection, timing of operation, lymph node removal or dissection and radiotherapy on the prognosis of stage Ⅳ breast cancer patients were analyzed. Results:Multivariate Logistic regression analysis showed that visceral metastasis was an independent influencing factor for primary lesion resection in stage Ⅳ breast cancer patients ( OR=2.590, 95% CI: 1.090-6.159). Multivariate Cox regression analysis showed that primary resection was an independent factor for the improvement of prognosis in stage Ⅳ breast cancer patients ( OR=0.582, 95% CI: 0.400-0.847). The median overall survival (OS) was 37.20 months in the resection group, which was higher than 24.10 months in the unresection group ( χ2=8.108, P=0.004). Among patients aged ≥50 years old, the median OS was 39.30 months in the resection group and 23.03 months in the unresection group, and the difference was statistically significant ( χ2=14.191, P<0.001). The median OS was 38.00 months in the 66 patients with the operation time from diagnosis to resection of primary lesion<6 months ( n=66), and 35.20 months for ≥6 months ( n=19) ( χ2=4.430, P=0.035), the difference was statistically significant ( χ2=4.430, P=0.035). The median OR of axillary lymph node dissection and axillary lymph node excision group were 45.37 months and 33.44 months, respectively, the difference was statistically significant ( χ2=7.832, P=0.005). The median OS of postoperative radiotherapy group and non-radiotherapy group were 44.80 months and 33.20 months, respectively, the difference was not statistically significant ( χ2=2.950, P=0.086). Conclusion:Resection of the primary lesion may prolong the survival time of some advanced breast cancer patients.

Objective:To explore the effect of the resection of the primary lesion on the prognosis for patients with stage Ⅳ breast cancer.Methods:A total of 132 breast cancer patients who were first diagnosed as stage Ⅳ in the Hebei Cancer Hospital from June 2008 to June 2015 were divided into two groups: the primary resection group ( n=85) and the unresection group ( n=47). The influences of primary resection, timing of operation, lymph node removal or dissection and radiotherapy on the prognosis of stage Ⅳ breast cancer patients were analyzed. Results:Multivariate Logistic regression analysis showed that visceral metastasis was an independent influencing factor for primary lesion resection in stage Ⅳ breast cancer patients ( OR=2.590, 95% CI: 1.090-6.159). Multivariate Cox regression analysis showed that primary resection was an independent factor for the improvement of prognosis in stage Ⅳ breast cancer patients ( OR=0.582, 95% CI: 0.400-0.847). The median overall survival (OS) was 37.20 months in the resection group, which was higher than 24.10 months in the unresection group ( χ2=8.108, P=0.004). Among patients aged ≥50 years old, the median OS was 39.30 months in the resection group and 23.03 months in the unresection group, and the difference was statistically significant ( χ2=14.191, P<0.001). The median OS was 38.00 months in the 66 patients with the operation time from diagnosis to resection of primary lesion<6 months ( n=66), and 35.20 months for ≥6 months ( n=19) ( χ2=4.430, P=0.035), the difference was statistically significant ( χ2=4.430, P=0.035). The median OR of axillary lymph node dissection and axillary lymph node excision group were 45.37 months and 33.44 months, respectively, the difference was statistically significant ( χ2=7.832, P=0.005). The median OS of postoperative radiotherapy group and non-radiotherapy group were 44.80 months and 33.20 months, respectively, the difference was not statistically significant ( χ2=2.950, P=0.086). Conclusion:Resection of the primary lesion may prolong the survival time of some advanced breast cancer patients.

Objective: To understand the clinical features and pathogenic spectrum of encephalitis and meningitis syndrome in children. Methods: A total of 667 cases of children with encephalitis or meningitis diagnosed and documented at Changchun Children′s Hospital from May 2012 to July 2015 were enrolled.A variety of samples in diffe-rent types were collected and presented, including 335 cerebrospinal fluid specimens, 530 blood samples, and 332 stool samples.All the samples were collected from the patients within 72 hours on admission.Moreover, these samples are analyzed and tested, including PCR for enterovirus(EV), herpesvirus(HSV), mycobacterium tuberculosis(TB) and Mycoplasma pneumoniae(MP) nucleic acid in cerebrospinal fluid samples; fecal specimens were tested for EV, enterovirus 71 (EV71), coxsackievirus A6 (CA6), coxsackievirus A16 (CVA16), coxsackievirus A10 (CVA10) nucleic acids; degenerate primers to amplify Echovirus 30 (Echo30). Clinical data of children were collected. Results: The peak incidence of encephalitis and meningitis syndrome was from June to August, age distribution was from 0 to 15 years old, the proportion of children aged from 0-6 accounted for 81.41%; the highest proportion was among 0-1 years old infants, occupying 32.38%; 408 males and 259 females; the main symptoms were fever(586 cases), apathy(337 cases), vomiting (307 cases) and headache(203 cases). And clinical signs included drowsiness (103 cases), neck stiffness (71 cases), meningeal irritation (12 cases), and pathological reflex (313 cases), etc.The clinical diagnosis included 272 cases of viral encephalitis, 332 cases of severe hand, foot and mouth disease complicated by encephalitis, 30 cases of bacterial meningitis, and 33 other cases; the etiological detection included: the positive rates of EV, EBV and Echo30 in cerebrospinal fluid specimens were 59.72%, 3.16% and 70.00%, respectively.And EV71, CVA16, CVA6, EV71+ CA16 and EV71+ CVA16+ CVA6 nucleic acids were detected in fecal samples, in which the highest detection rate was EV71(98.96%). Conclusions In Changchun Children′s Hospital, the children with encephalitis and meningitis are mainly viral encephalitis.The main symptoms were fever, apathetic, drowsiness, vomiting and headache.Signs included, neck stiffness, meningeal irritation, and pathological reflexes, etc.The main pathogen of the disease is EV71.

Objective: To investigate the effect of cough assist on sputum excretion and the outcome of withdrawal of mechanical ventilation after mechanically ventilated chronic obstructive pulmonary disease (COPD) patients with cough weakness. Methods: From January 2017 to December 2018, 74 patients with cough and weakness COPD after extubation of mechanical ventilation in the Department of Respiratory Critical Care Medicine of Hunan Provincial People's Hospital were divided into control group(n=37) and observation group (n=37) according to the random number table method. The patients in the control group were treated routinely after weaning and extubation, and the observation group was treated with cough assist after withdrawal of mechanical ventilation and extubation on the basis of the control group. The differences in drainage effect, blood gas index, reintubation rate and early prognosis index between the two groups were compared. Results: After the intervention treatment, the first active sputum excretion and the total sputum volume on the first day were (5.6±3.4) ml and (33.1±5.2) ml in the observationgroup, and (4.2 ±2.0) ml and (29.1±7.4) ml in the control group, the difference was statistically significant (t=-2.10, 2.875, P<0.05). The number of significant cases of respiratory sound improvement in the observation group and the control group was 21 and 14 cases, respectively, and the difference between the two groups was statistically significant (Z=-1.974, P < 0.05). The oxygen partial pressure (PaO₂) and oxygenation index (PaO₂/FiO₂) carbon dioxide partial pressure (PaCO₂) values of the observation group were (80.0±8.4), (345.9±19.2), (46.7±6.6)mmHg, and (74.8±9.1), (310.7±21.9), (50.9±7.1)mmHg in the control group. The difference was statistically significant (t=-2.504,-2.710, 2.579, all P<0.05). The reintubation rate, noninvasive ventilation time, and hospitalization days after the initial extubation in the observation group were as follows: 5.6%(2/36), (64.1±18.9)h, (6.0±1.7)d, and 22.2%(8/36), (76.7±15.3)h, (7.2±2.8)d in the control group. The difference was statistically significant (χ²=4.181, t=2.528, 2.438, all P<0.05). The non-invasive ventilation rate within 72h in the observation group and the control group were 63.9% (23/36) and 75.0% (27/36), the difference was not statistically significant (χ²=0.222, P>0.05). Conclusions The application of cough assist in RICU patients with cough weakness after extubation by mechanical ventilation can improve the expectoration efficiency of cough, improve oxygenation, reduce carbon dioxide retention, reduce the rate of re-intubation, shorten the time of noninvasive ventilation and hospitalization after extubation, and improve the curative effect.