Abstract:Objective To investigate the serum levels of β-HCG,E2,D-D and AMH in pregnant women with high-risk pregnancy,and evaluate their value in diagnosing adverse pregnancy outcomes in pregnant women through logistic regression and ROC curve.Methods The observation subjects were 306 pregnant women with high-risk pregnancy,treated from March 2021 to March 2023 in the observation group.The control subjects were 300 normal pregnant women at the same time as the observation group,and the group was the control group.β-HCG,E2,D-D and AMH level were measured,use logistic regression analysis to establish regression equation,and make the ROC curve of β-HCG,E2,DD and AMH to detect adverse pregnancy outcome.Results Among 306 high-risk pregnant women,84 cases of adverse pregnancy outcomes occurred.The β-HCG,E2 and AMH levels of the observation group were lower than those of the control group,and the D-D level was higher than that of the control group(t=35.410,150.331,121.873,11.442,P<0.05).The area under the ROC curve,sensitivity,specificity,and accuracy of the combined detection of high-risk pregnancy and adverse pregnancy outcomes for the combined detection of β-HCG,E2,DD,and AMH are significantly higher than those of the four single indicators.The cut-off value of β-HCG is 5 053.32 mIU/mL,the cut-off value of E2 is 610.65 pg/mL,the critical value of D-D is 873.08 pg/L,and the critical value of AMH is 2.09 ng/mL.Conclusion The sensitivity,specificity,and accuracy of the combined detection of β-HCG,E2,D-D and AMH in predicting adverse pregnancy in high-risk pregnancy patients are significantly higher than those of the single index detection of the four.The combined detection can predict adverse pregnancy outcomes of high-risk pregnant women.

Abstract:Objective To explore the status quo and influencing factors of quality of life and its relationship with self-efficacy in stroke patients.Methods Totally 324 stroke patients in the hospital were prospectively selected from January 2023 to April 2024.Self-made basic data questionnaire,stroke-specific quality of life scale(SS-QOL)and general self-efficacy scale(GSES)were adopted to investigate the patients at 1 month after discharge.Multivariate linear regression analysis was adopted to analyze the influencing factors of quality of life of patients.The correlation between SS-QOL score and self-efficacy degree was analyzed by Point-biserial correlation.Results The SS-QOL score and self-efficacy score of 324 patients were(149.45±10.28)points and(21.68±5.31)points.The SS-QOL score was significantly different among stroke patients with different age,disease course,rehabilitation training,self-efficacy degree,marital status,frequency of onset,and National institutes of health stroke scale(NIHSS)score(P<0.05).Multiple linear regression analysis was performed on the above influencing factors,and the results showed that rehabilitation training,NIHSS score and self-efficacy degree were independent influencing factors for SS-QOL score of stroke patients(P<0.05).Point-biserial correlation analysis revealed a significant positive correlation between SS-QOL score and self-efficacy degree(r=0.534,P<0.05).Conclusion The quality of life of stroke patients is generally low after discharge.The rehabilitation training,NIHSS score and self-efficacy of the patients are independent influencing factors,and there is a certain correlation between the quality of life and self-efficacy.

Abstract:Objective To investigate the efficacy of plasma kinetic resection scope(PKRS)in patients with post-traumatic urethral stricture and to analyze the influencing factors associated with recurrence.Methods A retrospective study was conducted on 600 patients with post-traumatic urethral stricture treated with the PKRS ion electrocautery instrument from January 2019 to January 2025.Follow-up began on the day of discharge and lasted for six months(until July 2025).The statistical results showed that 45 cases of stricture recurrence were identified,forming the recurrence group.The remaining 555 patients were classified as the non-recurrence group.logistic regression was used to analyze the factors influencing postoperative recurrence,and the area under the receiver operating characteristic(receiver operating characteristic curve,ROC)curve was employed to assess the predictive power of independent risk factors for postoperative recurrence.Results Comparing demographic data between groups revealed that the recurrence group had more cases with diabetes and preoperative urinary tract infections.Postoperative maximum urinary flow rate and average urinary flow rate were significantly lower in the recurrence group compared to the non-recurrence group(P<0.05).There was no statistically significant difference in postoperative complications between the two groups(P<0.05).The results of the multivariate analysis showed that continuous traction time,surgical duration,preoperative urinary tract infection,and preoperative diabetes were independent risk factors for postoperative urethral stricture(P<0.05).The predictive power of the model was evaluated using ROC.After gradually incorporating the identified independent risk factors into the model,it was found that the predictive power ranged from 0.7 to 0.9,De-long test P<0.05,indicating good predictive reliability.The best predictive power was achieved when all factors were included,with AUC=0.806,De-long test P<0.05.Conclusion PKRS is effective in treating male urethral stricture with high surgical success rate and good therapeutic effect.It was confirmed that preoperative diabetes,urinary tract infection,continuous traction time and surgical time were independent risk factors for postoperative recurrence.Therefore,optimizing preoperative evaluation,shortening surgical time and controlling blood glucose level may be crucial for improving patient prognosis.

Abstract:Objective To investigate the effects of low glycemic index(GI)diet on glucose and lipid metabolism and body mass index(BMI)control in adult obese patients with type 2 diabetes mellitus(T2DM).Methods In this study,a prospective randomized controlled design was used to include 116 adult obese T2DM patients who were treated from January 2023 to January 2025 as subjects.The subjects were divided into observation group and control group by random number table method,58 cases each.The control group was given routine intervention and semaglutide treatment,and the observation group was given low GI diet adjuvant therapy on this basis.Both groups were treated continuously for 3 months.The glucose and lipid metabolism indexes,BMI and health survey scale(SF-36)scores before and after treatment were compared between the two groups.Results After treatment,the fasting blood glucose[(6.45±0.83)mmol/L vs.(7.63±0.96)mmol/L],glycosylated hemoglobin[(6.57±0.68)%vs.(7.38±0.82)%],2 h postprandial blood glucose[(8.23±1.61)mmol/L vs.(10.67±1.95)mmol/L],total cholesterol[(3.92±0.47)mmol/L vs.(4.83±0.54)mmol/L],triglyceride[(2.32±0.23)mmol/L vs.(2.89±0.36)mmol/L],low-density lipoprotein cholesterol[(3.47±0.65)mmol/L vs.(3.98±0.72)mmol/L],insulin resistance index[(2.12±0.33)vs.(2.75±0.39)],and BMI[(26.57±1.36)kg/m2 vs.(28.43±1.52)kg/m2]of the observation group were all lower than those of the control group(t=7.081,5.791,7.349,9.681,10.162,4.004,9.392,6.945,all P<0.05).while the high-density lipoprotein cholesterol[(1.48±0.42)mmol/L vs.(1.31±0.39)mmol/L],fasting C-peptide[(4.87±0.63)ng/mL vs.(3.26±0.58)ng/mL],and scores of all dimensions of the SF-36[mental health(83.22±6.74)points vs.(74.29±6.13)points,role-emotional(82.26±5.63)points vs.(77.68±5.34)points,vitality(86.49±6.87)points vs.(81.33±6.56)points,emotional function(79.52±5.32)points vs.(73.47±4.69)points,bodily pain(85.27±6.68)points vs.(81.95±6.27)points,social function(78.46±5.36)points vs.(71.67±4.82)points,general health(84.17±5.67)points vs.(79.42±5.31)points,physical function(80.83±5.96)points vs.(74.69±5.27)points]of the observation group were all higher than those of the control group(t=2.259,14.319,7.465,4.495,4.137,6.497,2.760,7.174,4.657,5.878,all P<0.05).Conclusion Low GI diet assisted with semaglutide in the treatment of obese T2 DM patients in adults can effectively improve their glucose and lipid metabolism,control weight and improve the quality of life.

Abstract:Objective To analyze the predictive value of prognostic nutritional index(PNI)and advanced lung cancer inflammation index(ALI)for the short-term efficacy of first-line immune checkpoint inhibitors in the treatment of advanced NSCLC patients without driver gene mutations.Methods The data of 141 NSCLC patients treated at 940 Hospital of the Joint Logistics Support Force from January 2022 to March 2024 were analyzed.Patient demographic characteristics,clinical staging,Eastern Cooperative Oncology Group score,metastasis site,etc.,were organized;PNI and ALI were calculated.Divide patients into high PNI group,low PNI group,high ALI group,and low ALI group,and compare the disease control(DCR)rates of different PNI and ALI groups.Based on the recent efficacy of the patient,conduct a multiple-factor analysis to analyze the influencing factors of DCR,and draw ROC curves to compare and analyze the predictive value of the area under the curve(AUC)for ALI and PNI.Results Among the 141 patients,there were 0 CRs,34 PRs,67 PRs,and 40 PDs,with a DCR rate of 71.63%.According to the cut-off value of the ROC curve,patients were divided into the high PNI group,the low PNI group,the high ALI group,and the low ALI group.The DCR rate of the high PNI group was 86.45%,which was higher than that of the low PNI group(42.85%)(χ2=28.306,P<0.001).The DCR rate of the high ALI group was 85.43%,which was higher than that of the low ALI group(34.21%)(χ2=35.846,P<0.001).Multivariate analysis showed that staging,number of distant metastasis sites,PNI,and ALI were independent influencing factors on the efficacy of ICIs.The Youden indices for ALI,PNI,and their combination are 0.496,0.422,and 0.571,respectively;the AUC values are 0.754,0.696,and 0.791.Conclusion The relationship between nutrition,inflammation status,and the short-term efficacy of ICIs first-line treatment in advanced NSCLC patients is closely related.The higher the PNI and ALI,the better the prognosis of patients.Compared with PNI,ALI has a higher predictive value,and the combined predictive value of the two is higher than that of single prediction.

Abstract:Objective To analyze the clinical characteristics and related factors of newly diagnosed patients with type 2 diabetes mellitus(T2DM).Methods A total of 198 newly diagnosed T2DM patients who were admitted to the Baoding Second Central Hospital from January 2021 to January 2024 were selected for the study.Clinical data were collected retrospectively.According to the tendency of newly diagnosed ketosis,the ketosis tendency group(n=63)and the non-ketosis tendency group(n=135)were included.The clinical features of newly diagnosed T2DM patients with ketosis tendency were analyzed,and the influencing factors of newly diagnosed T2DM with ketosis prone tendency were analyzed by multivariate Logistic regression.Results In this group of newly diagnosed type 2 diabetes patients,the proportion of those with a tendency towards ketosis was 31.82%.The results of multivariate Logistic analysis showed that serum level of fasting plasma glucose(FPG)>12.18 mmol/L and serum level of serum uric acid(SUA)>295.58 μmol/L were risk factors for newly diagnosed ketosis with a tendency towards T2DM.Age>46.74 years old,serum level of C-peptide(FCP)>1.90 ng/mL,and serum level of 25-hydroxyvitamin D[25-(OH)D]>51.36 nmol/L were protective factors for the tendency of newly diagnosed ketosis to T2DM(P<0.05).Conclusion Among the newly diagnosed type 2 diabetes patients in this group,31.82%had a tendency towards ketosis,there were many influencing factors,which could lay a foundation for its prevention and control.

Abstract:Objective To investigate the effect of alirocumab versus atorvastatin in improving cardiac function and blood lipid level improvement in patients with coronary artery disease.Methods A prospective study was conducted on 244 patients diagnosed with coronary heart disease at Aerospace Center Hospital from October 2023 to June 2024.The patients were divided into two groups based on their treatment regimen:a control group and an observation group,each consisting of 122 patients.The control group received oral Atorvastatin Calcium Tablets,while the observation group was treated with Alirocumab Injection.The lipid levels,including lipoprotein(a)(Lp(a)),apolipoprotein B(ApoB),apolipoprotein A1(ApoA1),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),and triglyceride(TG),were compared between the two groups.Additionally,parameters such as left ventricular posterior wall thickness(LVPWd),left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),and adverse reactions were also evaluated.Results After treatment completion,the observation group showed significantly lower levels of Lp(a),ApoB,total cholesterol(TC),triglycerides(TG),and LDL-C compared to the control group.Conversely,ApoA1 and HDL-C were significantly higher in the observation group(t=13.254,19.704,17.121,21.059,7.499,17.832,3.194,P<0.05).Additionally,LVPWd and LVEDD were significantly lower,while LVEF was significantly higher in the observation group(t=20.176,26.789,7.654,P<0.05).There was no significant difference in adverse reaction rates between the two groups(P>0.05).Conclusion Alirocumab demonstrated superior efficacy over Atorvastatin in reducing Lp(a),ApoB,TC,TG,and LDL-C levels,while increasing ApoA1 and HDL-C levels.It also improved cardiac structure and function as indicated by reduced LVPWd and LVEDD,as well as increased LVEF.Both treatments had comparable safety profiles.These findings suggest that Alirocumab may offer additional cardiovascular benefits beyond lipid-lowering effects.

Abstract:Objective To preliminarily explore the risk of chronic obstructive pulmonary disease(COPD)in population with preserved ratio impaired spirometry(PRISm).Methods From July 2024 to January 2025,289 consecutive subjects were recruited from Shanghai Jing'an District Central Hospital as study participants.According to lung function,the above 289 subjects were divided into PRISm group(n=93),healthy control group(n=116)and COPD group(n=80).The general data,lung ventilation function,bidirectional chest computed tomography(CT)and impulse oscillometry lung function were compared among the three groups.Correlation analysis between demographic characteristics,pulmonary ventilation function,bidirectional chest CT,impulse oscillometry pulmonary function and the occurrence of chronic obstructive pulmonary disease was conducted using collinearity diagnosis analysis and multivariate Logistic regression analysis model.Results There were significant differences among the three groups in terms of age,body mass index(BMI),chronic obstructive pulmonary disease screening questionnaire(COPD questionnaire),chronic obstructive pulmonary disease assessment test(CAT),proportion of smoking,smoking index,proportion of family history of respiratory diseases,proportion of second-hand smoke exposure,proportion of biofuel exposure history,among the three groups were statistically significant(F=313.458、240.856、1334.698、3213.604、489.823,χ2=37.346、9.354、35.139、23.841,P<0.05).percentage of forced expiratory volume in the first second(FEV1)to the predicted value,percentage of forced vital capacity(FVC)to the predicted value,FEV1/FVC,percentage of maximum mid-expiratory flow rate(MMEF)to the predicted value,percentage of forced expiratory flow of 50%vital capacity(FEF50%)to the predicted value,percentage of forced expiratory flow of 75%vital capacity(FEF75%)to the predicted value,percentage of total airway resistance(R5)to the predicted value,percentage of central airway resistance(R20)to the predicted value and MLDE/I(F=694.699、470.786、510.356、935.992、1533.161、1375.779、846.651,P<0.05).Through the analysis of collinearity and the multi-factor Logistic regression model analysis,age,smoking,smoking index,family history of respiratory diseases,exposure to second-hand smoke,and exposure to biofuels were positively correlated with the occurrence of chronic obstructive pulmonary disease(P<0.05);while BMI was not significantly correlated with the occurrence of chronic obstructive pulmonary disease(P>0.05).Conclusion Many indicators of pulmonary ventilation function,bidirectional chest CT,and pulse oscillation lung function in PRISm patients have significantly changed.Therefore,in clinical practice,it is necessary to pay attention to the changes in lung function of the PRISm population and take active measures based on their clinical characteristics.

Abstract:Objective To study the impact of hypothyroidism during pregnancy on pregnancy outcomes and construct a model of influencing factors.Methods From December 2019 to December 2023,a retrospective study was conducted on 118 pregnant women with hypothyroidism admitted to Yuncheng Maternal and Child Health Hospital as the case group.In the same period,125 pregnant women with normal thyroid function were selected as healthy control group.Compare the pregnancy outcomes and clinical data of two groups,and use multiple logistic regression analysis to analyze the risk factors of gestational hypothyroidism.Results Compared to the healthy control group,the observation group had a higher proportion of preterm births(χ2=10.523,P<0.05),a higher proportion of miscarriages(χ2adjusted=5.662,P<0.05),a higher proportion of stillbirths(χ2adjusted=4.576,P<0.05),and a lower proportion of vaginal deliveries(χ2=4.919,P<0.05).Compared with the healthy control group,the age of the observation group was higher(t=12.724,P<0.05),the proportion of women in the observation group with a history of spontaneous abortion was higher(χ2=4.852,P<0.05),the proportion of women in the observation group with a family history of hypothyroidism was higher(χ2=9.309,P<0.05),the proportion of women in the observation group with hypertension during pregnancy was higher(χ2=14.528,P<0.05),the proportion of women in the observation group with diabetes during pregnancy was higher(χ2=32.164,P<0.05),and the proportion of women in the observation group with low iodine intake was higher(χ2=6.671,P<0.05),The proportion of pregnant women with thyroid peroxidase antibody(TPOAb)positive in the observation group was higher(χ2=9.294,P<0.05),the serum TSH level in the observation group was higher(t=81.614,P<0.05),and the serum ghrelin level in the observation group was lower(t=127.623,P<0.05),The observation group had higher levels of serum obestatin(t=74.229,P<0.05),lower levels of serum 25 hydroxyvitamin D3[25-(OH)D3](t=43.498,P<0.05),and higher levels of serum insulin resistance(HOMA-IR)(t=42.190,P<0.05).Multivariate logistic regression analysis showed that older age,history of spontaneous abortion,family history of hypothyroidism,pregnancy complicated with hypertension,pregnancy complicated with diabetes,insufficient iodine intake,low level of serum Ghrelin,high level of serum Obestatin,low level of serum 25-(OH)D3 and positive TPOAb were all independent risk factors for hypothyroidism during pregnancy(OR=1.581,1.483,1.684,1.567,1.652,1.484,1.631,1.761,1.422,1.672,P<0.05).Conclusion The probability of adverse pregnancy outcome in hypothyroidism during pregnancy is high.In view of the specific factors affecting hypothyroidism in pregnancy,targeted intervention and treatment can reduce the occurrence of hypothyroidism in pregnancy.

Abstract:Objective To investigate the rationality of prophylactic use of antimicrobial drugs in the elderly with class I surgical incisions in clinical settings,and analyze the relationship between prophylactic use of antimicrobial drugs and surgical site infection.Methods Clinical data of 1,002 elderly patients with class I surgical incisions who were discharged from Sixian People's Hospital in 2023 were retrospectively collected.The prophylactic use rate of antimicrobial drugs,types of antimicrobial drugs,irrational drug use,and postoperative incision infection were analyzed.Univariate and multivariate logistic regression analyses were used to analyze the relationship between prophylactic use of antimicrobial drugs and surgical site infection.Results The prophylactic use rate of antimicrobial drugs in elderly patients with class I surgical incisions was 16.97%(170/1 002),and cefuroxime sodium was the main antimicrobial drug used(88.89%).The rational rate of prophylactic use of antimicrobial drugs was 17.65%(30/170),and there were 247 cases of irrational drug use,mainly including inappropriate timing of prophylactic use(38.46%)and long duration of prophylactic use(25.51%).The postoperative incision infection rate in elderly patients with class I surgical incisions was 3.59%(36/1 002).Multivariate logistic regression analysis results showed that duration of surgery,foreign body implantation,length of hospital stay,prophylactic use and rationality of antibiotics were independent risk factors for postoperative incision infection(P<0.05).Conclusion The irrational use of antimicrobial drugs in elderly patients with class I surgical incisions mainly include inappropriate timing of prophylactic use and prolonged duration of prophylactic use.Suboptimal prophylactic use of antimicrobial drugs may increase the risk of surgical site infection in elderly patients.Clinical practice should improve the rational rate of prophylactic use of antimicrobial drugs to reduce the risk of infection.

Abstract:Objective To investigate the correlation between electrocardiographic QRS duration,Tp-Te interval,PtfV1 changes,and prognosis in patients with chronic heart failure(CHF).Methods A total of 102 CHF patients admitted from January 2020 to January 2022 were selected.They were classified into NYHA functional class Ⅱ(n=38),Ⅲ(n=40),and Ⅳ(n=24)groups.A control group consisting of 40 NYHA classⅠof CHF was established.General information was collected,and electrocardiographic QRS duration,Tp-Te interval,and PtfV1 were measured.Serum NT-proBNP levels were also assessed.Follow-up was conducted for 12 months to observe heart failure hospitalization rates and mortality in each group.Results CHF patients exhibited higher QRS duration,Tp-Te interval,PtfV1,and NT-proBNP levels compared to the control group.These values increased with the worsening of heart function,showing significant differences(F=7.732、8.742、6.963、7.365、7.953,P<0.05).Multivariate logistic regression analysis revealed that QRS duration,Tp-Te interval,PtfV1,and NT-proBNP levels were independent risk factors for CHF prognosis(F=8.052,P<0.05).Using cutoff points of QRS duration≥120 ms,Tp-Te interval≥90 ms,PtfV1≥0.04 mm·ms,and NT-proBNP≥1000 pg/mL,receiver operating characteristic(ROC)curves were generated.The diagnostic value of QRS duration,Tp-Te interval,PtfV1,and NT-proBNP levels for adverse prognosis in CHF patients was high,with Tp-Te interval exhibiting the highest diagnostic accuracy(area under the curve was 0.86,sensitivity was 82.4%,specificity was 78.6%).Conclusion QRS duration,Tp-Te interval,PtfV1,and NT-proBNP levels are closely related to the prognosis of CHF patients.They serve as important indicators for evaluating the prognosis of CHF patients,with Tp-Te interval demonstrating the highest diagnostic value.

Abstract:Objective This study aims to explore the role of social activity participation in improving sarcopenia and cognitive function.Methods Based on the open-source database of the China Health and Retirement Longitudinal Study(CHARLS),6,463 individuals aged over 45 were included.Sarcopenia was assessed using the Asian Working Group for Sarcopenia(AWGS)criteria,and cognitive function was evaluated with the Mini-Mental State Examination(MMSE).The Baron and Kenny mediation model,together with Bootstrap method,were used to analyze the mediating effect of social activity participation on the relationship between sarcopenia and cognitive function.Results Baseline data showed that 827 participants had sarcopenia,with an overall prevalence of 12.8%.Correlation analysis revealed that social activity participation was negatively correlated with sarcopenia(r=-0.131,P<0.001),sarcopenia was negatively correlated with cognitive function(r=-0.232,P<0.001),and social activity participation was positively correlated with cognitive function(r=0.242,P<0.001).Mediation analysis revealed that,compared to the non-sarcopenia group,individuals with sarcopenia had a 1.041-point lower total cognitive score.Specifically,sarcopenia indirectly affected cognitive impairment by reducing social activity participation,accounting for 10.08%of the total effect(indirect effect β=-0.105,P<0.001).Conclusion Sarcopenia is significantly associated with cognitive decline,and the increased social activity participation can partially mitigate the mediating effect of sarcopenia on cognitive impairment.

Abstract:Objective To investigate the application effect of the concept"Perioperative surgical and medical co-management"in telemedicine teaching of healthcare doctors.Methods A total of 138 healthcare professionals who received telemedicine teaching on the concept of"Perioperative surgical and medical co-management"by the Second Medical Center of the Chinese PLA General Hospital from March to December 2024 were invovled.Theoretical examinations were conducted before and after the training,and the scores were compared.Meanwhile,the teaching effect was also evaluated through a questionnaire survey.Results Through the telemedicine teaching on the concept of"Perioperative surgical and medical co-management",the healthcare doctors generally believed that it had significantly improved their clinical thinking and active participation or interest during the perioperative period,as well as their communication and interaction skills with the patients.Their theoretical examination scores also significantly improved,with a statistically significant difference(73.8±5.2 vs.89.6±4.7,P<0.05).Conclusion By implementing the concept of"Perioperative surgical and medical co-management"in the telemedicine teaching of healthcare doctors,it can fully motivate their enthusiasm,enhance their professional competence and work efficiency,and enable them to better participate in the entire perioperative management process.

Abstract:Objective To investigate the relationship between preoperative sleep quality and postoperative pain,sleep,and recovery in patients undergoing general anesthesia for liver cancer surgery,and provide strong clinical evidence for optimizing perioperative management.Methods This study adopted a retrospective cohort study design to collect clinical data of patients who underwent general anesthesia for liver cancer surgery in our hospital's Department of Hepatology from October 2023 to September 2024.Based on the Pittsburgh Sleep Quality Index(PSQI)within 3 days before surgery,they were divided into a sleep disorder group(n=49)and a control group(n=113).Compare the pain,sleep quality,and recovery quality of two groups of patients at 24 hours before surgery(T0),24 hours after surgery(T1),48 hours after surgery(T2),7 days after surgery(T3),and 14 days after surgery(T4),and compare the pain relief,postoperative recovery,and adverse reactions of the two groups of patients at 48 hours after surgery.Results The visual analog scale(VAS)scores of both groups of patients within T0～T4 first increased and then decreased,reaching their peak at T1.The VAS scores of the sleep disorder group were higher than those of the control group at different time points,and the differences were statistically significant(t=2.767,2.125,3.376,2.509,P<0.05).48 hours after surgery,the number of analgesic pump presses,effective number of analgesic pump presses,and salvage analgesia rate in the sleep disorder group were all higher than those in the control group,and the differences were statistically significant(t=5.795,4.898,χ2=4.021,P<0.05).The PSQI scores of both groups of patients within T0-T4 first increased and then decreased,reaching their peak at T1,and the PSQI scores of the sleep disorder group were higher than those of the control group at different time points,with statistical significance(t=2.479,2.059,2.511,2.573,2.389,P<0.05).The 24-hour Quality of Recovery 40 questionnaire(QoR-40)scores of both groups of patients within T0-T4 first decreased and then increased,reaching the lowest value at T1.Moreover,the 24-hour QOR-40 scores of the sleep disorder group were lower than those of the control group at different time points,and the differences were statistically significant(t=2.292,2.504,2.801,2.013,2.917,P<0.05).The Post Anesthesia Care Unit(PACU)time in the sleep disorder group was longer than that in the control group,and the incidence of nausea and vomiting was higher than that in the control group,with statistical significance(t=18.658,χ2=4.022,1.176,P<0.05).Conclusion Preoperative sleep disorders in patients undergoing general anesthesia for liver cancer surgery can increase postoperative pain,affect postoperative sleep quality and recovery quality.

Abstract:Cervical cancer is the most significant malignant tumor of the reproductive system that poses a serious threat to women's health.With the continuous development of molecular biology technology,molecular detection techniques such as HPV testing and DNA methylation testing are playing an increasingly important role in screening and early diagnosis of cervical cancer.This consensus summarizes the molecular detection technologies related to cervical cancer screening and diagnosis based on the current status of cervical cancer screening and the progress of molecular detection technology.It standardizes the application of relevant molecular detection technologies in cervical cancer screening and provides strong support for the screening and early diagnosis of cervical cancer.

Abstract:Objective To analyze the prevalence characteristics and influencing factors of cognitive function in elderly people with hypertension,and to provide a scientific basis for the prevention and improvement of their cognitive impairment.Methods Using data from the(Chinese longitudinal healthy longevity survey,CLHLS)2018,a total of 15,874 adults aged 65 and above were included.After excluding non-hypertensive patients,307 elderly individuals were ultimately included as the study subjects.Basic information was collected,the mini-mental state examination(MMSE)was used to measure cognitive function.Statistical description was performed using mean±SD and proportions.Influencing factors were analyzed using t test,chi-square test,and logistic regression models.Data analysis was conducted using SPSS 25.0 software with a significance level of α=0.05.Results The average age of the 307 elderly people with hypertension was 84.31±10.14 years old,and the cognitive function score was 23.38±8.26.Among them,191 people(62.21%)had normal cognitive function,and 116 people(37.79%)had cognitive impairment.Univariate analysis showed that 14 factors such as age,gender,and marital status were related to the cognitive function of elderly people with hypertension.Multivariate Logistic regression analysis indicated that age(OR=1.15,95%CI:1.05～1.27),being female(OR=6.36,95%CI:1.61～25.17),and notdoing physical exercise(OR=4.82,95%CI:1.28～18.17)were risk factors for cognitive impairment;having a moderate(OR=0.03,95%CI:0.01～0.71)and good(OR=0.01,95%CI:0.00～0.23,95%CI:0.06～0.93)quality of life,and occasionally watching movies and TV shows(OR=0.23)were protective factors for cognitive impairment.Conclusion The cognitive function of elderly people with hypertension is affected by multiple factors.Age,gender,physical activity level,etc.are related to the risk of cognitive impairment.Improving the quality of life and appropriately watching movies and TV shows may help protect cognitive function,providing a direction for subsequent interventions.

Abstract:Objective To explore the effect of postoperative radiotherapy combined with local compression in the treatment of auricular keloids.Methods A total of 98 patients with auricular keloids were selected as the research subjects,all of whom were admitted to the hospital from January 2022 to March 2024.They were included in the radiotherapy group(n=49)and the combined group(n=49)by the random number table method.The radiotherapy group was treated with superficial X-ray irradiation,while the combined group was treated with superficial X-ray irradiation combined with local compression.The therapeutic effects,scar recovery conditions and the occurrence of adverse reactions of the three groups of patients were compared.Results The total effective rate of treatment in the combined group was 97.92%,which was higher than 79.59%in the radiotherapy group(χ2=8.098,P<0.05).At 1 and 3 months after surgery,the Vancouver Scar Scale scores of the combined group were(3.25±0.84)points and(3.42±0.88)points respectively,lower than(3.56±0.91)points and(3.99±1.05)points of the radiotherapy group,6 months,comparison between the two groups(t=2.894,P=0.005).The incidence of adverse reactions in the combined group was 12.24%,which showed no significant difference compared with 10.20%in the radiotherapy group(P>0.05).Conclusion The effect of postoperative radiotherapy combined with local compression in the treatment of auricular keloids is remarkable.It can effectively promote scar recovery and exhibits ideal safety.

Abstract:Objective To investigate the effect of combination of pelvic abdominal mechanics rehabilitation exercise and biofeedback electrical stimulation(BFES)on pelvic floor function in patients with postpartum stress urinary incontinence(SUI).Methods A total of 100 patients with postpartum SUI in the hospital were selected from January 2024 to December 2024,and were divided into combined group and control group by means of the random number table method,with 50 cases in each group.The control group received pelvic abdominal mechanics rehabilitation exercise,whereas the combined group was added with BFES on the basis of the control group.The treatment cycle was 8 weeks.The international consultation on incontinence questionnaire-short form(ICIQ-SF)score,24-hour urine pad test,pelvic floor muscle strength(Oxford score),vaginal resting pressure(VRP),vaginal contraction pressure(VCP),maximum urinary flow rate(Qmax),post-void residual(PVR),pelvic floor distress inventory-20(PFDI-20)score,patient global impression of improvement(PGI-I)score and adverse reactions were compared between groups before and after treatment.Results After 8 weeks of treatment,the ICIQ-SF score,PFDI-20 score and PGI-I score in the combined group were significantly lower than those in the control group(t=8.185,9.660,6.008,P<0.05).24-hour urine pad test revealed that the urine leakage volume in both groups was significantly reduced,and the volume was less in the combined group than that in the control group(t=7.734,P<0.05).The pelvic floor muscle function was improved in the two groups after 8 weeks of treatment,and the Oxford score,VRP and VCP in the combined group were higher than those in the control group(t=5.273、2.620、2.436、6.914、4.624,P<0.05).After 8 weeks of treatment,the Qmax in the combined group was significantly higher than that in the control group while the PVR was significantly lower(P<0.05).During treatment,there were no statistical differences in the incidence rates of adverse reactions between groups(P>0.05).Conclusion Pelvic abdominal mechanics rehabilitation exercise combined with BFES can strengthen the pelvic floor muscle strength in SUI patients,enhance the urinary control ability,improve the bladder urethral function,and reduce the urinary incontinence symptoms,and it has high clinical application value.

Abstract:Objective To investigate the risk factors of Pneumocystis jirovecii pneumonia(PJP)through a retrospective case-control study,and to provide clue for early diagnosis and treatment.Methods 31 patients with neocoronary pneumonia complicating PJP diagnosed at the Fourth Medical Center of the Chinese People's Liberation Army General Hospital from December 2022 to August 2023 were used as the study group,and cases of neocoronary pneumonia complicating PJP were matched with cases of neocoronary pneumonia uncomplicated by PJP(control group)in a ratio of 1∶2 according to a simple randomization method.Clinical data of these patients were collected,including basic information,clinical symptoms,laboratory results,cumulative hormone use,immunosuppressant application,comorbid underlying diseases,and comorbid other pathogenic bacterial infections.Results A total of 90 cases was enrolled,including 31 cases in the study group and 59 cases in the control group.In the study group,17 cases had used glucocorticoids(54.8%)and 12 cases had used immunosuppressants 38.7%).In the control group,5 cases had used glucocorticoids(8.5%)and 4 cases had used immunosuppressants(6.8%).Compared to the control group,the median absolute lymphocyte value was significantly lower in the study group,the number of days to neo-coronary nucleic acid conversion lasted longer,and cumulative glucocorticoid use was higher,Higher LDH values(P<0.05).Binary logistic regression analysis suggested that prior use of immunosuppressants(OR=9.6652,95%CI:1.491～62.441,P=0.017),and low absolute lymphocyte values(OR=5.718,95%CI:1.09～30.010,P=0.039),LDH elevation(OR=1.019,95%CI:1.005～1.034,P=0.008)were independent risk factors for the development of PJP.Conclusion Patients with SARS-CoV-2 infection need to be alerted to the combination of Pneumocystis japonicus pneumonia if they are on prior immunosuppression,have low absolute lymphocyte values,as well as longer nucleic acid conversion of neocoronavirus,higher LDH values and higher cumulative glucocorticoid doses.

Abstract:Objective Summarize the research hotspots and trends in the field of the tumor microenvironment(TME)and non-small cell lung cancer(NSCLC).Methods The studies related to the TME in NSCLC in the Web of Science Core Collection database from January 1,2014,to December 31,2024 were searched.Excel 2018 and CiteSpace 6.4.R1 software were used to perform bibliometric analysis on the included literature,including publication year,country of publication,journal of publication,authors,research institutions,keywords,and co-cited references.Results A total of 2 840 articles were included.The annual publication volume in this field exhibited an overall upward trend,with the citation frequency also increasing year after year.The country with the highest number of publications was China,followed by the United States and Italy.The institution that published the most was the French National Institute of Health and Medical Research(INSERM).The author with the highest number of publications and citation frequency was Zhou,Caicun.The journals with the highest publication volume and citation frequency were Frontiers in Immunology and Clinical Cancer Research,respectively.Keyword co-occurrence analysis reveals that the cellular components of the tumor microenvironment,spatiotemporal heterogeneity,and the regulatory mechanisms mediated by extracellular vesicles are research hotspots.Reference co-citation analysis revealed three main research directions:TME studies utilizing single-cell sequencing,bioinformatics analysis,and tumor xenograft models;basic research on TME related to KRAS and EGFR mutations,angiogenesis,and acquired resistance;and(3)clinical research on TME focusing on immune checkpoint inhibitors(e.g.,ipilimumab,pembrolizumab)and neoadjuvant chemotherapy combined with immunotherapy.Conclusion The bibliometric approach can clearly and intuitively reveal the research hotspots and trends of global non-small cell lung cancer and the tumor microenvironment.