Evaluation of Sleep Quality in Undergraduated Medical Students

Objective: The aim of this study was to evaluate the sleep quality of medical students to identify the main factors that affect sleep patterns. Methods: According to the methodology, 154 students participated in the research, attending from the first to the sixth year of the course. The Pittsburg Sleep Quality Index questionnaire and the Epworth sleepiness scale were applied. Descriptive statistics techniques were applied and demonstrated in the form of tables and graphs. The comparison of variables was carried out using statistical tests. Results: The results showed that most students do not sleep very well. It was observed that 68.83% of a total of 106 students are bad sleepers. Conclusion: It is concluded that medical students sleep a low number of hours by period, which could interfere in impairment of attention, learning and memory formation, interfering in academic performance. On the other hand, they showed greater daytime sleepiness compared to the general population.

Construction of a New Model of Contactless Medical Services for Outpatients Based on the Project-Achieving Quality Control Circle

Objective: To carry out empirical research on the role of project-achieving quality control circle (QCC) in constructing a new model of contactless medical service for outpatients. Methods: A QCC, consisting of information office members from a grade A tertiary hospital in Wenzhou, was established to conduct a research project with the theme “Constructing a new model of contactless medical service based on outpatients’ experience.” According to the ten steps and PDCA cycle, an analysis was carried out before and after the QCC activities, focusing on improving pre-consultation services, providing steward-like services, and facilitating post-consultation management. Results: After the QCC activities, the mobile appointment rate, missed appointment rate, the proportion of smart check-ins, and the average check-in time were 55.68%, 4.02%, 39.75%, and 8.24 ± 3.66 min, respectively;in contrast, before the activities, they were 32.00%, 7.88%, 0.00%, and 14.96 ± 4.98 min, respectively;the difference between the two groups was statistically significant (χ2 = 3480.112, 4994.496;Fisher’s exact probability = 963788.570;t = 5.323, P < 0.001). Many experts have also visited the hospital to learn about this system, thus rendering social and economic benefits. Conclusion: Project-achieving QCC activities are suitable for complex situations, such as constructing a new model of contactless medical service, and can significantly improve outpatient service quality, enhance patients’ experience, and improve the abilities of circle members.

Reconstruction of Knowledge and Medical Images in the Convergence of Chinese and Western Medicine:Taking “Sweet Meat” as an Example

The pancreas is neither part of the five Zang organs(五脏) nor the six Fu organs(六腑).Thus,it has received little attention in Chinese medical literature.In the late 19th century,medical missionaries in China started translating and introducing anatomical and physiological knowledge about the pancreas.As for the word pancreas,an early and influential translation was “sweet meat”(甜肉),proposed by Benjamin Hobson(合信).The translation “sweet meat” is not faithful to the original meaning of “pancreas”,but is a term coined by Hobson based on his personal habits,and the word “sweet” appeared by chance.However,in the decades since the term “sweet meat” became popular,Chinese medicine practitioners,such as Tang Zonghai(唐宗海),reinterpreted it by drawing new medical illustrations for “sweet meat” and giving new connotations to the word “sweet”.This discussion and interpretation of “sweet meat” in modern China,particularly among Chinese medicine professionals,is not only a dissemination and interpretation of the knowledge of “pancreas”,but also a construction of knowledge around the term “sweet meat”.

Process,Material,and Regulatory Considerations for 3D Printed Medical Devices and Tissue Constructs

Three-dimensional(3D)printing is a highly automated platform that facilitates material deposition in a layer-by-layer approach to fabricate pre-defined 3D complex structures on demand.It is a highly promising technique for the fabrication of personalized medical devices or even patient-specific tissue constructs.Each type of 3D printing technique has its unique advantages and limitations,and the selection of a suitable 3D printing technique is highly dependent on its intended application.In this review paper,we present and highlight some of the critical processes(printing parameters,build orientation,build location,and support structures),material(batch-to-batch consistency,recycling,protein adsorption,biocompatibility,and degradation properties),and regulatory considerations(sterility and mechanical properties)for 3D printing of personalized medical devices.The goal of this review paper is to provide the readers with a good understanding of the various key considerations(process,material,and regulatory)in 3D printing,which are critical for the fabrication of improved patient-specific 3D printed medical devices and tissue constructs.

Mitochondrial dysfunction and quality control lie at the heart of subarachnoid hemorrhage

The dramatic increase in intracranial pressure after subarachnoid hemorrhage leads to a decrease in cerebral perfusion pressure and a reduction in cerebral blood flow.Mitochondria are directly affected by direct factors such as ischemia,hypoxia,excitotoxicity,and toxicity of free hemoglobin and its degradation products,which trigger mitochondrial dysfunction.Dysfunctional mitochondria release large amounts of reactive oxygen species,inflammatory mediators,and apoptotic proteins that activate apoptotic pathways,further damaging cells.In response to this array of damage,cells have adopted multiple mitochondrial quality control mechanisms through evolution,including mitochondrial protein quality control,mitochondrial dynamics,mitophagy,mitochondrial biogenesis,and intercellular mitochondrial transfer,to maintain mitochondrial homeostasis under pathological conditions.Specific interventions targeting mitochondrial quality control mechanisms have emerged as promising therapeutic strategies for subarachnoid hemorrhage.This review provides an overview of recent research advances in mitochondrial pathophysiological processes after subarachnoid hemorrhage,particularly mitochondrial quality control mechanisms.It also presents potential therapeutic strategies to target mitochondrial quality control in subarachnoid hemorrhage.

Advancements in medical treatment for pancreatic neuroendocrine tumors:A beacon of hope

This editorial highlights the remarkable advancements in medical treatment strategies for pancreatic neuroendocrine tumors(pan-NETs),emphasizing tailored approaches for specific subtypes.Cytoreductive surgery and somatostatin analogs(SSAs)play pivotal roles in managing tumors,while palliative options such as molecular targeted therapy,peptide receptor radionuclide therapy,and chemotherapy are reserved for SSA-refractory patients.Gastrinomas,insul-inomas,glucagonomas,carcinoid tumors and VIPomas necessitate distinct thera-peutic strategies.Understanding the genetic basis of pan-NETs and exploring immunotherapies could lead to promising avenues for future research.This review underscores the evolving landscape of pan-NET treatment,offering renewed hope and improved outcomes for patients facing this complex disease.

Dynamic changes of rumen microbiota and serum metabolome revealed increases in meat quality and growth performances of sheep fed bio‑fermented rice straw

Background Providing high-quality roughage is crucial for improvement of ruminant production because it is an essential component of their feed.Our previous study showed that feeding bio-fermented rice straw(BF)improved the feed intake and weight gain of sheep.However,it remains unclear why feeding BF to sheep increased their feed intake and weight gain.Therefore,the purposes of this research were to investigate how the rumen micro-biota and serum metabolome are dynamically changing after feeding BF,as well as how their changes influence the feed intake,digestibility,nutrient transport,meat quality and growth performances of sheep.Twelve growing Hu sheep were allocated into 3 groups:alfalfa hay fed group(AH:positive control),rice straw fed group(RS:negative control)and BF fed group(BF:treatment).Samples of rumen content,blood,rumen epithelium,muscle,feed offered and refusals were collected for the subsequent analysis.Results Feeding BF changed the microbial community and rumen fermentation,particularly increasing(P<0.05)relative abundance of Prevotella and propionate production,and decreasing(P<0.05)enteric methane yield.The histomorphology(height,width,area and thickness)of rumen papillae and gene expression for carbohydrate trans-port(MCT1),tight junction(claudin-1,claudin-4),and cell proliferation(CDK4,Cyclin A2,Cyclin E1)were improved(P<0.05)in sheep fed BF.Additionally,serum metabolome was also dynamically changed,which led to up-regulating(P<0.05)the primary bile acid biosynthesis and biosynthesis of unsaturated fatty acid in sheep fed BF.As a result,the higher(P<0.05)feed intake,digestibility,growth rate,feed efficiency,meat quality and mono-unsaturated fatty acid concentration in muscle,and the lower(P<0.05)feed cost per kg of live weight were achieved by feeding BF.Conclusions Feeding BF improved the growth performances and meat quality of sheep and reduced their feed cost.Therefore,bio-fermentation of rice straw could be an innovative way for improving ruminant production with mini-mizing production costs.

Genome-wide identification of the pectate lyase(PEL)gene family members in Malvaceae,and their contribution to cotton fiber quality

Pectin is a major constituent of the plant cell wall.Pectate lyase(PEL,EC 4.2.2.2)uses anti-β-elimination chemistry to cleave theα-1,4 glycosidic linkage in the homogalacturonan region of pectin.However,limited information is available on the comprehensive and evolutionary analysis of PELs in the Malvaceae.In this study,we identified 597PEL genes from 10 Malvaceae species.Phylogenetic and motif analyses revealed that these PELs are classified into six subfamilies:Clades I,II,III,IV,Va,and Vb.The two largest subfamilies,Clades I and II,contained 237 and222 PEL members,respectively.The members of Clades Va and Vb only contained four or five motifs,far fewer than the other subfamilies.Gene duplication analysis showed that segmental duplication played a crucial role in the expansion of the PEL gene family in Gossypium species.The PELs from Clades I,IV,Va,and Vb were expressed during the fiber elongation stage,but nearly all PEL genes from Clades II and III showed no expression in any of the investigated fiber developmental stages.We further performed single-gene haplotype association analysis in 2,001G.hirsutum accessions and 229 G.barbadense accessions.Interestingly,14 PELs were significantly associated with fiber length and strength traits in G.barbadense with superior fiber quality,while only eight GhPEL genes were found to be significantly associated with fiber quality traits in G.hirsutum.Our findings provide important information for further evolutionary and functional research on the PEL gene family members and their potential use for fiber quality improvement in cotton.

The impact of Internet access on household dietary quality:Evidence from rural China

Over the past few decades,the Internet has rapidly diffused across China.The spread of the Internet has had a profound economic and social impact on Chinese rural areas.Existing research shows that Internet access significantly impacts agricultural production and improves smallholder farmers’income.Beyond these,the Internet can affect other dimensions of social welfare.However,research about the impact of Internet access on dietary quality in rural China remains scarce.This study utilizes multi-period panel data from Fixed Observation Point in rural China from 2009 to 2015 to estimate the impact of Internet access on dietary quality and food consumption of rural households and conducts a causal analysis.Regression models with time and household fixed effects allow robust estimation while reducing potential issues of unobserved heterogeneity.The estimates show that Internet access has significantly increased rural household dietary quality(measured by the Chinese Diet Balance Index).Further research finds that Internet access has increased the consumption of animal products,such as aquatic and dairy products.We also examine the underlying mechanisms.Internet access improves dietary quality and food consumption mainly through increasing household income and food expenditure.These results encourage the promotion of Internet access as a valuable tool for nutritional improvements,especially in rural areas.

Exploring the relationship between ambient sulfur dioxide and semen quality parameters:A systematic review and meta-analysis

Objective:To investigate the relationship between ambient sulfur dioxide(SO2)exposure and semen quality parameters.Methods:A systematic literature search was conducted to identify relevant studies investigating the association between SO2 exposure and semen quality parameters.This search encompassed the timeframe from January 2000 to May 2023 and included electronic databases such as Web of Science,Google Scholar,PubMed,Cochrane,and Scopus.Pooled effect estimates with 95%confidence intervals(CI)were calculated using percent changes(PC).The meta-analysis included seven studies with 6711 participants and 15087 semen samples.Results:The results revealed a significant negative association between ambient SO2 exposure and certain semen quality parameters.In particular,SO2 exposure was associated with a significant decrease in progressive motility(PC=0.032;95%CI:-0.063 to-0.001;P=0.044)and sperm concentration(PC=-0.020;95%CI:-0.036 to-0.005;P=0.012).However,no statistically significant associations were observed for total sperm count(PC=-0.038;95%CI:-0.079 to 0.003;P=0.070),seminal fluid volume(PC=-0.009;95%CI:-0.048 to-0.030;P=0.662)and sperm motility(PC=-0.17;95%CI:-0.363 to 0.022;P=0.830).In addition,the results of the subgroup analysis revealed specific variables that were associated with the decrease in relevant sperm parameters.Conclusions:This systematic review and meta-analysis provides compelling evidence supporting a consistent negative association between exposure to ambient SO2 and semen quality parameters.

Effects of hormone replacement therapy on mood and sleep quality in menopausal women

BACKGROUND Hormone replacement therapy is an effective treatment strategy for the management of symptoms in naturally menopausal women.However,some patients report experiencing adverse effects.AIM To analyze the effects of hormone replacement therapy in menopausal female patients.METHODS A total of 152 menopausal female patients admitted to the Gynecology Department of the Ganzhou Maternal and Child Health Hospital between January 2021 and December 2023 were divided into the observation group(n=76,conventional treatment+hormone replacement therapy)and the control group(n=76,conventional treatment only)via random casting.The improvement observed in the following items were compared between the groups:Kupperman menopausal index(KMI),emotional state[The Positive and Negative Affect Scale(PANAS)],sleep quality[Self-Rating Scale of Sleep(SRSS)],treatment effectiveness,and treatment safety.RESULTS The modified KMI and SRSS scores of the observation group were lower than those of the control group after three rounds of treatment.The improvement in the PANAS score observed in the observation group was greater than that observed in the control group(P<0.05).The total treatment effectivity rate in the observation group was higher than that in the control group(86.84%vs 96.05%,χ2=4.121,P=0.042).The incidence rate of adverse reactions in the two groups was comparable(6.58%vs 9.21%,χ2=0.361,P=0.547).CONCLUSION Hormone replacement therapy effectively improved the clinical symptoms,actively channeled negative emotions,and improved the quality of sleep in menopausal patients,indicating its effectiveness and safety.

Curved Spine:The Shape of Spine in Taoist Body Diagrams and Its Influence on Medical Body Diagrams

From the early Taoist diagrams of the human body to the end of the Qing dynasty and the beginning of the Republic of China,Taoists exaggerated and deformed the human spine in a shape-shifting manner.It is likely that medical practitioners were influenced by this style of representation,and there are also numerous diagrams of the human body with the curved spine in the lateral-view diagrams of viscera and Ming Tang Tu(明堂图Acupuncture and Moxibustion Chart),which constantly show the human torso in an elliptical“egg shape”.No later than the Ming dynasty,medical practitioners began to depict the actual physiological spinal curve of the human body.By the Qing dynasty,the depiction of the spinal curve in medical diagrams of the human figure showed a tendency to part ways with the Taoist freehand style of the previous generation.Although the representation of the curve of the spine was very crude,later medical images of the human body at least gradually straightened the spine and no longer depicted it in a shape-shifting manner.However,the curved spine in Taoist diagrams of the human body continued to exist,and the presentation of the curved spine never changed.This way of depicting its appearance,which is very different from reality,is shaped by Taoism's special way of perceiving and viewing the body,and may also contain another form of truth.

Genetic dissection and origin of pleiotropic loci underlying multilevel fiber quality traits in upland cotton(Gossypium hirsutum L.)

Cotton fiber quality is a persistent concern that determines planting benefits and the quality of finished textile products.However,the limitations of measurement instruments have hindered the accurate evaluation of some important fiber characteristics such as fiber maturity,fineness,and neps,which in turn has impeded the genetic improvement and industrial utilization of cotton fiber.Here,12 single fiber quality traits were measured using Advanced Fiber Information System(AFIS)equipment among 383 accessions of upland cotton(Gossypium hirsutum L.).In addition,eight conventional fiber quality traits were assessed by the High Volume Instrument(HVI)System.Genome-wide association study(GWAS),linkage disequilibrium(LD)block genotyping and functional identification were conducted sequentially to uncover the associated elite loci and candidate genes of fiber quality traits.As a result,the previously reported pleiotropic locus FL_D11 regulating fiber length-related traits was identified in this study.More importantly,three novel pleiotropic loci(FM_A03,FF_A05,and FN_A07)regulating fiber maturity,fineness and neps,respectively,were detected based on AFIS traits.Numerous highly promising candidate genes were screened out by integrating RNA-seq and qRT-PCR analyses,including the reported GhKRP6 for fiber length,the newly identified GhMAP8 for maturity and GhDFR for fineness.The origin and evolutionary analysis of pleiotropic loci indicated that the selection pressure on FL_D11,FM_A03 and FF_A05 increased as the breeding period approached the present and the origins of FM_A03 and FF_A05 were traced back to cotton landraces.These findings reveal the genetic basis underlying fiber quality and provide insight into the genetic improvement and textile utilization of fiber in G.hirsutum.

Investigation of the quality of life,mental status in patients with gynecological cancer and its influencing factors

BACKGROUND Having a gynecological tumor or undergoing treatment can be a traumatic experience for women,as it affects their self-image and sexual relationships and can lead to psychological reactions.Psychological adjustment following cancer occurrence remains a key issue among the survivors.AIM To examine the current status of quality of life(QoL),anxiety,and depression in patients with gynecological cancer and to analyze the factors associated with it.METHODS Data for 160 patients with gynecological malignancies treated at Shanxi Bethune Hospital from June 2020 to June 2023 were collected and analyzed retrospectively.Patients’QoL was assessed using the European Organization for Research on Treatment of Cancer Quality of Life Questionnaire Core 30 and the Functional Assessment of Cancer Therapy-General Questionnaire.Their emotional status was evaluated using the Self-Rating Anxiety/Depression Scale.The associated factors of anxiety and depression were analyzed.RESULTS The overall QoL score of the patients 6 months after surgery was 76.39±3.63 points.This included low levels of social and emotional function and severe fatigue and pain.The scores for physiological,functional,emotional,social,and family well-being exhibited an upward trend following surgery compared with those before surgery.One month after surgery,some patients experienced anxiety and depression,with an incidence of 18.75%and 18.13%,respectively.Logistic analysis revealed that good sleep was a protective factor against anxiety and depression in patients with gynecological tumors,whereas physical pain was a risk factor.CONCLUSION Patients with gynecological malignancies often experience anxiety and depression.By analyzing the factors that affect patients’QoL,effective nursing measures can be administered.

Reservoir quality evaluation of the Narimba Formation in Bass Basin,Australia:Implications from petrophysical analysis,sedimentological features,capillary pressure and wetting fluid saturation

The evaluation of reservoir quality was accomplished on the Late Paleocene to Early Eocene Narimba Formation in Bass Basin,Australia.This study involved combination methods such as petrophysical analysis,petrography and sedimentological studies,reservoir quality and fluid flow units from derivative parameters,and capillary pressure and wetting fluid saturation relationship.Textural and diagenetic features are affecting the reservoir quality.Cementation,compaction,and presence of clay minerals such as kaolinite are found to reduce the quality while dissolution and secondary porosity are noticed to improve it.It is believed that the Narimba Formation is a potential reservoir with a wide range of porosity and permeability.Porosity ranges from 3.1%to 25.4%with a mean of 15.84%,while permeability ranges between 0.01 mD and 510 mD,with a mean of 31.05 mD.Based on the heterogenous lithology,the formation has been categorized into five groups based on permeability variations.Group I showed an excellent to good quality reservoir with coarse grains.The impacts of both textural and diagenetic features improve the reservoir and producing higher reservoir quality index(RQI)and flow zone indicators(FZI)as well as mostly mega pores.The non-wetting fluid migration has the higher possibility to flow in the formation while displacement pressure recorded as zero.Group II showed a fair quality reservoir with lower petrophysical properties in macro pores.The irreducible water saturation is increasing while the textural and digenetic properties are still enhancing the reservoir quality.Group III reflects lower quality reservoir with mostly macro pores and higher displacement pressure.It may indicate smaller grain size and increasing amount of cement and clay minerals.Group IV,and V are interpreted as a poor-quality reservoir that has lower RQI and FZI.The textural and digenetic features are negatively affecting the reservoir and are leading to smaller pore size and pore throat radii(r35)values to be within the range of macro,meso-,micro-,and nano pores.The capillary displacement pressure curves of the three groups show increases reaching the maximum value of 400 psia in group V.Agreement with the classification of permeability,r35 values,and pore type can be used in identifying the quality of reservoir.

Rock mass quality prediction on tunnel faces with incomplete multi-source dataset via tree-augmented naive Bayesian network

Rock mass quality serves as a vital index for predicting the stability and safety status of rock tunnel faces.In tunneling practice,the rock mass quality is often assessed via a combination of qualitative and quantitative parameters.However,due to the harsh on-site construction conditions,it is rather difficult to obtain some of the evaluation parameters which are essential for the rock mass quality prediction.In this study,a novel improved Swin Transformer is proposed to detect,segment,and quantify rock mass characteristic parameters such as water leakage,fractures,weak interlayers.The site experiment results demonstrate that the improved Swin Transformer achieves optimal segmentation results and achieving accuracies of 92%,81%,and 86%for water leakage,fractures,and weak interlayers,respectively.A multisource rock tunnel face characteristic(RTFC)dataset includes 11 parameters for predicting rock mass quality is established.Considering the limitations in predictive performance of incomplete evaluation parameters exist in this dataset,a novel tree-augmented naive Bayesian network(BN)is proposed to address the challenge of the incomplete dataset and achieved a prediction accuracy of 88%.In comparison with other commonly used Machine Learning models the proposed BN-based approach proved an improved performance on predicting the rock mass quality with the incomplete dataset.By utilizing the established BN,a further sensitivity analysis is conducted to quantitatively evaluate the importance of the various parameters,results indicate that the rock strength and fractures parameter exert the most significant influence on rock mass quality.

Product quality prediction based on RBF optimized by firefly algorithm

With the development of information technology,a large number of product quality data in the entire manufacturing process is accumulated,but it is not explored and used effectively.The traditional product quality prediction models have many disadvantages,such as high complexity and low accuracy.To overcome the above problems,we propose an optimized data equalization method to pre-process dataset and design a simple but effective product quality prediction model:radial basis function model optimized by the firefly algorithm with Levy flight mechanism(RBFFALM).First,the new data equalization method is introduced to pre-process the dataset,which reduces the dimension of the data,removes redundant features,and improves the data distribution.Then the RBFFALFM is used to predict product quality.Comprehensive expe riments conducted on real-world product quality datasets validate that the new model RBFFALFM combining with the new data pre-processing method outperforms other previous me thods on predicting product quality.

Effect of comprehensive nursing on the quality of life and swallowing function in individuals diagnosed with ischemic stroke

BACKGROUND Ischemic stroke(IS)is a widely recognized disease characterized by high preva-lence,mortality,morbidity,disability,and recurrence rates.It ranks prominently in terms of mortality,constituting 60%-80%of stroke cases.AIM To explore the impact of comprehensive nursing care on the quality of life and swallowing function in individuals diagnosed with IS.METHODS This study comprised 172 patients with IS admitted to our hospital between February 2018 to March 2021.The participants were divided into two groups,namely the control group(n=80)receiving routine care and the research group(n=92)receiving comprehensive care.Various assessment scales,including the standard swallowing function assessment scale(SSA),National Institutes of Health Stroke scale(NIHSS),European stroke scale(ESS),self-rating anxiety scale(SAS),self-rating depression scale(SDS),Barthel index(BI),and the motor func-tion assessment scale(MAS),were employed to evaluate the improvement in swallowing function,neurological deficits,clinical outcomes,anxiety,depression,daily living activities,and motor function before and after care.Furthermore,the study compared the occurrence of adverse reactions during the nursing period,life quality before and after the intervention,rehabilitation compliance,and nursing satisfaction between the two groups.RESULTS After the nursing intervention,the research group exhibited significantly improved SSA and NIHSS scores compared to the control group(P<0.05).Moreover,both groups demonstrated significant reductions in SAS and SDS scores(P<0.05),with the research group showing more obvious advantages(P<0.05).Compared to the control group,the research group displayed significantly better ESS,BI,and MAS scores(P<0.05),coupled with a lower incidence of adverse reactions(P<0.05).Additionally,the research group demonstrated markedly higher levels of life quality,rehabilitation compliance,and nursing satisfaction compared to the control group(P<0.05).CONCLUSION Comprehensive nursing effectively improved swallowing function,quality of life,and patient satisfaction,high-lighting its clinical significance.

Effect of lens surgery on health-related quality of life in preschool children with congenital ectopia lentis

AIM:To evaluate the effect of lens surgery on health-related quality of life(HRQoL)of preschool children with congenital ectopia lentis(CEL).METHODS:A prospective self-controlled study was conducted in Zhongshan Ophthalmic Center.Children aged from 5 to 7y whom were diagnosed with CEL and underwent phacoemulsification with scleral-fixated posterior chamber intraocular lens implantation and their parents were enrolled in this study.All of them completed the child and proxy(parental)PedsQL™4.0 before and after the surgery.Their preoperative scores were compared to their postoperative ones.Subgroup analyses were performed based on gender and preoperative bilateral presenting visual acuity of the children.RESULTS:Thirty-two children with CEL successfully underwent surgery without any complications,among whom 8 had monocular surgery and 24 had binocular surgery.Preoperative and postoperative questionnaires were completed by 32 child-parent pairs.Surgical intervention could significantly improve the vision of affected children(P<0.001).The medians of physical,psychosocial and total health scores self-reported by the children were 68.75(62.50,81.25),65.00(60.00,80.00)and 67.39(60.87,78.26)preoperatively and were 93.75(87.50,100.00),90.00(83.33,96.67)and 89.13(85.32,95.65)postoperatively.The preoperative scores of the affected children were significantly lower in all scales than age-matched healthy children(P<0.001).All the postoperative scores were significantly higher than the preoperative scores in affected children and their parents(P<0.001).In the physical functioning evaluation,the preoperative score reported by parents of girls was higher than parents of boys(P=0.041),and the postoperative score of girls was higher than that of boys(P=0.036).CONCLUSION:CEL is associated with significantly worse quality of life in preschool children.Surgical intervention can significantly improve the HRQoL in affected children from both personal and family perspective.

Analysis of factors impacting postoperative pain and quality of life in patients with mixed hemorrhoids:A retrospective study

BACKGROUND Hemorrhoids are among the most common and frequently encountered chronic anorectal diseases in anorectal surgery.They are venous clusters formed by con-gestion,expansion,and flexion of the venous plexus in the lower part of the rec-tum.Mixed hemorrhoids bleed easily and recurrently,and this can result in severe anemia.Hence,they may have a negative effect on the health of the patient and surgical treatment is required.Milligan-Morgan hemorrhoidectomy has been widely used since 1937 for the treatment of grade III and IV hemorrhoids.How-ever,most patients experience different degrees of postoperative pain that may cause anxiety.with mixed hemorrhoids post-surgery.METHODS The clinical data of patients with mixed hemorrhoids who underwent Milligan-Morgan hemorrhoidectomy were collected retrospectively.The basic character-istics of the enrolled patients with mixed hemorrhoids were recorded,and based on the Goligher clinical grading system,the hemorrhoids were classified as grades III or IV.The endpoint of this study was the disappearance of pain in all patients.Quantitative data were presented as mean±SD,such as age,pain score,and QoL score.Student’s t-test was used to compare the groups.RESULTS A total of 164 patients were enrolled.The distribution of the visual analog scale pain scores of all patients at 3,7,14 and 28 d after surgery showed that post-surgery pain was significantly reduced with the passage of time.Fourteen days after the operation,the pain had completely disappeared in some patients.Twenty-eight days after the surgery,none of the patients experienced any pain.Comparing the World Health Or-ganization Quality of Life-BREF self-reporting questionnaire scores of patients between 14 and 28 d after surgery,we observed that the quality-of-life scores of the patients post-surgery had significantly improved.There were six items that were compared at 14-and 28-d post-surgery.The mean QoL score 28 d after surgery(4.79±0.46)was higher than that at 14 d post-surgery(3.79±0.57).The mean health condition score 28 d after surgery(4.80±0.41)was also higher than that at 14 d post-surgery(4.01±0.62).The mean physical health score 28 d after surgery(32.10±2.96)was significantly higher than that at 14 d post-surgery(23.41±2.85).The mean psychological health score 28 d after surgery(27.22±1.62)was significantly higher than that at 14 d post-surgery(21.37±1.70).The mean social relations score 28 d after surgery(12.21±1.59)was significantly higher than that at 14 d post-surgery(6.32±1.66).The mean surrounding environment score 28 d after surgery(37.13±2.88)was significantly higher than that at 14 d post-surgery(28.42±2.86).The differences in quality-of-life scores at day 14 and day 28 post-surgery were ob-served to be statistically significant(P<0.001).CONCLUSION Milligan-Morgan hemorrhoidectomy can significantly improve the postoperative QoL of patients.Age,sex,and the number of surgical resections were important factors influencing Milligan-Morgan hemorrhoidectomy.