Abstract:Objective To explore the correlation between neutrophil extracellular traps(NETs)in peripheral blood and sarcope-nia and to assess their diagnostic value for sarcopenia,aiming to provide a reference for clinical decision-making.Methods In June 2024,a comprehensive geriatric assessment was conducted in the community elderly population in Kazak Autonomous County of Mori,Xinjiang Uygur Autonomous Region,with 88 elderly individuals diagnosed with sarcopenia(age≥60)includ-ed as the sarcopenia group,and 88 age-matched,non-sarcopenic elderly individuals from the same area included as the non-sar-copenia group.The expression levels of NETs components and other inflammatory markers were compared between the two groups.Logistic regression analysis was used to analyze the independent influencing factors of sarcopenia in the elderly.Pear-son correlation analysis was conducted to explore the correlation between NETs markers,inflammatory factors,and sarcopenia phenotype.Receiver operating characteristic(ROC)curves were used to assess the diagnostic value of NETs markers and in-flammatory markers for sarcopenia in the elderly.Results Compared with the non-sarcopenia group,the sarcopenia group had smaller calf circumferences,body mass,and grip strength(P<0.05).Serum levels of the main NETs components,double-stranded DNA(dsDNA),myeloperoxidase-DNA(MPO-DNA),citrullinated histone H3(CitH3),as well as interleukin-8(IL-8),interleukin-17(IL-17),and tumor necrosis factor-alpha(TNF-α)were significantly higher in the sarcopenia group than those in the non-sarcopenia group(P<0.05).Pearson correlation analysis revealed that dsDNA was positively correlated with MPO-DNA and CitH3(r=0.194,0.205,both P<0.05).CitH3 was positively correlated with MPO-DNA,IL-17,and the time of the five-time sit-to-stand test(r=0.967,0.721,0.312,all P<0.001),and negatively correlated with grip strength and skeletal muscle index(SMI)(r=-0.312,-0.341,both P<0.001).MPO-DNA was positively correlated with IL-17 and the time of the five-time sit-to-stand test(r=0.606,0.324,both P<0.001),and negatively correlated with grip strength and SMI(r=-0.235,-0.199,P<0.05).After adjusting for confounding factors,multivariate logistic regression showed that IL-17(OR=1.198,95%CI:1.116-1.287,P<0.001),TNF-α(OR=1.081,95%CI:1.036-1.128,P<0.001),and the comprehensive NETs index(OR=6.009,95%CI:3.032-11.910,P<0.001)were independent factors in-fluencing the occurrence of sarcopenia.ROC curve analysis indicated that the predictive model combining inflammatory cyto-kines and NETs had a diagnostic performance(AUC=0.981,95%CI:0.965-0.998),significantly superior to the basic pre-diction model(AUC=0.716,95%CI:0.639-0.794).Conclusion NETs may indirectly participate in the pathogenesis of sarcopenia by upregulating inflammatory factors such as IL-17 and TNF-α.The predictive model combining inflammatory cyto-kines and NETs has good diagnostic value for sarcopenia in the elderly.

Abstract:Objective To investigate the relationship between the monocyte(Mono)to high-density lipoprotein cholesterol(HDL-C)ratio(MHR)and the occurrence of sarcopenia in elderly patients with type 2 diabetes mellitus(T2DM),with the aim of providing a clinical reference.Methods From January 2023 to February 2025,206 elderly T2DM patients treated at the First Hospital of Qinhuangdao were enrolled.Patients with sarcopenia were assigned to the sarcopenia group(n=70),and those with T2DM alone to the T2DM-only group(n=136).General clinical data were collected for both groups,and MHR was calculated.Receiver operating characteristic(ROC)curves were plotted to evaluate the predictive value of Mono,HDL-C,and MHR for sarcopenia in elderly T2DM patients.Multivariate stepwise logistic regression analysis was used to identify fac-tors influencing sarcopenia in this population.Results ROC analysis showed areas under the curve(AUCs,95%CI)for Mono,HDL-C,and MHR of 0.702(0.657-0.752),0.819(0.774-0.869),and 0.901(0.856-0.951),respectively.MHR predicted sarcopenia among elderly patients with T2DM with a specificity of 86.12%and a sensitivity of 85.47%.Pa-tients in the sarcopenia group had significantly higher triglycerides(TG)and fasting blood glucose(FBG)levels and a longer duration of diabetes than the T2DM-only group(P<0.05).Multivariate stepwise logistic regression analysis identified low body mass index(BMI)(OR=1.872,95%CI:1.022-3.430),Pittsburgh Sleep Quality Index(PSQI)score>7(OR=2.000,95%CI:1.146-3.489),longer duration of diabetes(OR=2.065,95%CI:1.223-3.484),and MHR≥0.48(OR=2.807,95%CI:1.771-4.449)as independent risk factors for sarcopenia in elderly T2DM patients(P<0.05).Con-clusion Elevated MHR is closely associated with sarcopenia in elderly T2DM patients and may serve as a biological marker for predicting sarcopenia in this population.

Abstract:Objective To explore the effectiveness of evidence-based nursing combined with humanistic concern nursing in pedi-atric patients undergoing general anesthesia surgery,providing a reference for perioperative nursing interventions in these pa-tients.Methods A total of 112 pediatric patients who underwent general anesthesia surgery at our hospital between July 2021 and December 2024 were randomly assigned to a research group and a control group,with 56 cases in each group.The control group received routine nursing interventions,while the research group received evidence-based nursing combined with humanis-tic concern nursing.The two groups were compared in terms of anxiety levels,awakening time,extubation time,incidence of complications,and physiological stress indicators.Results The preoperative modified Yale Perioperative Anxiety Scale(mYPAS)scores,pre-anesthesia mYPAS scores,and incidence of crying were all lower in the research group than in the con-trol group,with statistically significant differences(P<0.05).The awakening time and extubation time were significantly shorter in the research group than in the control group(P<0.05).There were no statistically significant differences in the pre-operative heart rate(HR),systolic blood pressure(SBP),and diastolic blood pressure(DBP)between the two groups(P>0.05).However,the postoperative HR,SBP,and DBP were all significantly lower in the research group than in the control group(P<0.05).The incidence of postoperative complications in the research group was 14.29%(8/56),while in the con-trol group it was 30.36%(17/56),with no statistically significant difference(χ2=3.296,P=0.069).The parental degree of satisfaction in the research group was 96.42%(54/56),which was higher than that in the control group,which was 83.93%(47/56),with a statistically significant difference(χ2=4.940,P=0.026).Conclusion Evidence-based nursing combined with humanistic concern nursing constructs a"physiological-psychological-social"multidimensional nursing intervention sys-tem,which can markedly reduce preoperative anxiety in pediatric patients undergoing general anesthesia,promote postopera-tive recovery,and improve nursing quality.

Abstract:Objective To describe the epidemiological features and changing trends in disease burden of fall-related deaths in Chongqing and to provide evidence for fall-prevention strategies.Methods Fall-related death cases were obtained from the Chongqing resident cause-of-death surveillance system for 2012-2024.Indicators analyzed included crude and age-standardized mortality rates,age-specific mortality rates,years of life lost(YLL)rate,and average years of life lost(AYLL).Group com-parisons by sex and region were conducted using χ2 tests.Temporal trends in rates were expressed as annual percent change(APC)and average APC(AAPC),which were estimated by Joinpoint regression.Results The crude and age-standardized mortality rates from falls in Chongqing were 10.28 and 9.16 per 100,000 in 2012,and 18.80 and 10.72 per 100,000 in 2024,with AAPCs of 3.97%and 0.13%,respectively;the changing trend in crude fall mortality was statistically significant(P<0.05).Segmented analysis indicated that the age-standardized fall mortality rose by an average of 4.38%per year from 2012 to 2018 and fell by an average of 3.94%per year from 2018 to 2024(P<0.05).Male fall mortality was significantly higher than female mortality in every year(P<0.05);male and female fall mortality increased on average by 2.68%and 6.51%per year,respectively,with significant differences in the changing trend(P<0.05).Except for 2014 and 2015(no significant differ-ence),rural fall mortality was significantly higher than urban fall mortality in all other years(P<0.05),and rural fall mortal-ity increased by an average of 5.46%per year,with significant differences in the changing trend(P<0.05).Age-specific trends showed declines in fall mortality of 7.77%,5.60%and 2.21%for the 0-4,5-14,and 15-64 age groups,respec-tively,while the≥65 age group experienced an average annual increase of 4.82%(P<0.05).The age-standardized YLL rate due to falls decreased from 305.40 per 100,000 in 2012 to 249.08 per 100,000 in 2024,with an average annual decline of 2.63%,with differences in the changing trend being statistically significant(P<0.05).AYLL and age-standardized AYLL attributable to falls declined by an average of 4.06%and 2.80%per year,respectively,with differences in the changing trend being statistically significant(P<0.05).Conclusion The overall fall-related mortality in Chongqing showed an upward trend,while the mortality-related disease burden declined.Men,rural residents,and individuals aged 65 years and older should be prioritized in fall-prevention efforts.

Abstract:Objective To investigate changes in platelet and coagulation-fibrinolysis markers in patients with preeclampsia(PE)and their relationships with pregnancy outcomes,aiming to provide a reference for clinical decision-making.Methods From April 2021 to July 2024,127 PE patients treated at a hospital in Chongqing were enrolled and classified by disease severity into a mild group(n=58)and a severe group(n=69).Fifty normal pregnant women admitted in the same period were included as a control group.PE patients were followed until delivery and grouped by pregnancy outcome into a favorable-outcome group(n=94)and an adverse-outcome group(n=33).Platelet and coagulation-fibrinolysis markers were compared among groups.Logistic regression analysis was used to analyze risk factors for adverse pregnancy outcomes in PE patients,and the predictive value of platelet and coagulation-fibrinolysis markers for adverse outcomes was evaluated.Results Across the control,mild,and severe PE groups,platelet count(PLT),prothrombin time(PT),and activated partial thromboplastin time(APTT)pro-gressively decreased,while fibrinogen(FIB)and D-dimer(D-D)progressively increased;these differences were statistically significant(P<0.05).Compared with the favorable-outcome group,the adverse-outcome group had significantly lower PLT,PT,and APTT and higher FIB and D-D(P<0.05);patients in the adverse-outcome group aged 35 or adove accounted for a higher proportion and their 24-h urinary protein levels were higher than those in the favorable-outcome group,with differences being statistically significant(P<0.05).Logistic regression analysis identified elevated D-D and increased 24-h urinary protein as independent risk factors for adverse pregnancy outcomes in PE patients(P<0.05).The area under the curve(AUC)for D-D and 24-h urinary protein in predicting adverse outcomes were 0.738(95%CI:0.642-0.833)and 0.775(95%CI:0.666-0.883),respectively;the combined predictor yielded an AUC of 0.889(95%CI:0.813-0.965),which was significantly higher than either single marker alone(Z=3.022,2.234,P<0.05).Conclusion Patients with PE frequently show abnor-malities in platelet and coagulation-fibrinolysis markers.Combined assessment of D-dimer and 24-h urinary protein has high predictive value for adverse pregnancy outcomes in PE.

Abstract:Objective To investigate the effect of gestational subclinical hypothyroidism(SCH)combined with thyroid peroxi-dase antibody(TPOAb)positivity on the risk of preeclampsia,so as to provide a reference for clinical practice.Methods Pregnant women who received prenatal care and delivered at Urumqi Maternal and Child Health Hospital were grouped as fol-lows:155 women with normal thyroid function and negative TPOAb were enrolled as the normal control group;155 women with normal thyroid function but positive TPOAb were enrolled as the isolated TPOAb-positive group;155 women diagnosed with SCH were enrolled as the SCH group,which was further divided by TPOAb status into SCH+TPOAb-positive(n=69)and SCH+TPOAb-negative(n=86).The incidence of preeclampsia,adverse pregnancy outcomes,and adverse neonatal out-comes were compared among the four groups.Results The incidence of preeclampsia in the SCH+TPOAb-positive group was 27.54%,which was significantly higher than that in the SCH+TPOAb-negative group(12.79%),the isolated TPOAb-posi-tive group(9.68%),and the normal control group(4.52%;P<0.05).The SCH+TPOAb-negative group also had a signifi-cantly higher incidence of preeclampsia than the normal control group(P<0.05),while the difference in incidence of pre-eclampsia between the isolated TPOAb-positive group and the normal control group was not statistically significant(P>0.05).The SCH+TPOAb-positive group had significantly higher rates of preterm birth,placental abruption,and fetal intrau-terine distress than both the isolated TPOAb-positive group and the normal control group(P<0.05).The incidence of low-birth-weight infants in the SCH+TPOAb-positive group was 15.94%,which was significantly higher than 4.52%in the isola-ted TPOAb-positive group and 3.23%in the normal control group(P<0.05).Conclusion Gestational SCH combined with TPOAb positivity significantly increases the risk of preeclampsia and the incidence of adverse pregnancy outcomes.Clinical practice should strengthen combined screening of thyroid function and TPOAb in pregnant women,and provide early interven-tion and close monitoring for high-risk individuals to improve maternal and neonatal outcomes.

Abstract:Objective To investigate the current status of nutritional literacy in patients with gastroesophageal reflux disease(GERD)and analyze its influencing factors,thereby providing a reference for clinical decision-making.Methods Using a multi-stage sampling method,160 GERD patients treated at a hospital in Sichuan from January 2021 to January 2025 were en-rolled.General Information Questionnaire,the Adult Nutrition Literacy Measurement Scale,the Perceived Social Support Scale(PSSS),and the Chronic Disease Self-Efficacy Scale(CDSES)were employed.Multiple linear regression analysis was used to explore factors influencing nutritional literacy in GERD patients.Results The total score on the Adult Nutrition Liter-acy Measurement Scale was 166.86±10.26,the total PSSS score was 55.24±1.42,and the total CDSES score was 38.45±1.28.Pearson correlation analysis showed that nutritional literacy was positively correlated with social support and self-efficacy(r=0.644 and r=0.236,respectively;all P<0.05).Significant differences in nutrition literacy total scores were observed across subgroups defined by age,education level,personal monthly income,place of residence,course of the disease,weekly symptom fre-quency,malnutrition status,dietary management,social support level,and self-efficacy level among these patients(P<0.05).Multi-ple linear regression analysis indicated that age,education level,personal monthly income,place of residence,dietary management,to-tal PSSS score,and total CDSES score were all significant predictors of the Adult Nutrition Literacy Measurement Scale total score(P<0.05),together explaining 66.90%of the total variance.Conclusion Nutritional literacy among GERD patients remains subop-timal and is affected by multiple factors.Clinical staff should pay attention to patients'nutritional literacy and provide targeted interven-tions based on the identified influencing factors to strengthen nutritional literacy.

Abstract:Objective To analyze the relationships between serum Toll-like receptor 4(TLR4),macrophage inflammatory pro-tein-1α(MIP-1α),and T-cell immunoglobulin,and mucin domain-containing protein 4(TIM-4)and the occurrence and prog-nosis of pulmonary infection in patients with severe traumatic brain injury(sTBI),and to evaluate the predictive value of these serum markers for pulmonary infection and prognosis in sTBI patients,aiming to provide a reference for clinical decision-mak-ing.Methods A total of 182 patients with sTBI admitted to our hospital from January 2022 to January 2025 were enrolled.According to whether pulmonary infection occurred,patients were assigned to an infection group(n=75)and a non-infection group(n=107).Patients with pulmonary infection were further classified by outcome into a good-prognosis group(n=43)and a poor-prognosis group(n=32).Serum TLR4,MIP-1α,and TIM-4 levels were measured on admission.Logistic regres-sion analysis was used to analyze the associations of serum TLR4,MIP-1α,and TIM-4 with pulmonary infection and progno-sis;receiver operating characteristic(ROC)curves were used to evaluate the predictive performance of these markers.Results Compared with the non-infection group,patients in the infection group had significantly higher TLR4,MIP-1α,and TIM-4 levels(P<0.05).Among patients with pulmonary infection,those with poor prognosis had significantly higher TLR4,MIP-1α,and TIM-4 levels than those with good prognosis(P<0.05).Logistic regression analysis showed that elevated TLR4(OR=1.497,95%CI:1.265-1.772),MIP-1α(OR=1.080,95%CI:1.027-1.136)and TIM-4(OR=1.073,95%CI:1.041-1.106)were independent risk factors for pulmonary infection in sTBI patients;likewise,increased TLR4(OR=2.191,95%CI:1.336-3.594),MIP-1α(OR=1.324,95%CI:1.122-1.562)and TIM-4(OR=1.112,95%CI:1.029-1.201)were independent risk factors for poor prognosis among sTBI patients with pulmonary infection.ROC analysis demon-strated that the combined prediction model using TLR4,MIP-1α,and TIM-4 yielded an AUC of 0.843(95%CI:0.782-0.892)for predicting pulmonary infection,with a sensitivity of 73.33%and specificity of 87.85%;the combined model out-performed each marker alone(P<0.05).For predicting prognosis among infected patients,the combined markers produced an AUC of 0.880(95%CI:0.784-0.944),with a sensitivity of 84.37%and specificity of 83.72%,again superior to indi-vidual markers,with significant differences(P<0.05).Conclusion TLR4,MIP-1α,and TIM-4 levels are closely correlated with both the occurrence of pulmonary infection and clinical outcomes in patients with sTBI.Joint measurement of these mark-ers improves the prediction of pulmonary infection and prognosis and may provide useful guidance for clinical management.

Abstract:Objective To analyze the risk factors for macular edema(ME)in patients with type 2 diabetes(T2DM)and con-struct a nomogram model to provide a reference for clinical decision-making.Methods A total of 208 T2DM patients admitted to our hospital from March 2023 to February 2025 were selected as study participants.Based on the presence or absence of ME,they were assigned to the ME group(n=76)and the non-ME group(n=132).The risk factors for ME in T2DM pa-tients were analyzed using the multivariate logistic stepwise regression analysis.A nomogram model was constructed to predict the risk of ME in T2DM patients,and the prediction value was evaluated using receiver operating characteristic(ROC)curves.Results In the ME group,patients were older,had a higher proportion with a history of hypertension,a T2DM duration of≥10 years,and a higher proportion using insulin compared to the non-ME group,with statistically significant differences(P<0.05).Additionally,fasting blood glucose,hemoglobin A1c(HbA1c),total cholesterol,low-density lipoprotein cholesterol(LDL-C),and blood uric acid levels were higher,and estimated glomerular filtration rate(eGFR)was lower in the ME group compared to the non-ME group,with statistically significant differences(P<0.05).Multivariate analysis showed that a histo-ry of hypertension(OR=2.243,95%CI:1.552-3.243),duration of T2DM≥10 years(OR=2.593,95%CI:1.708-3.937),high HbA1c(OR=3.025,95%CI:1.943-4.711),high LDL-C levels(OR=2.370,95%CI:1.611-3.487),and relatively high eGFR(OR=0.475,95%CI:0.333-0.679)were influence factors for the development of ME in T2DM pa-tients(P<0.05).The concordance index(C-index)of the nomogram model was 0.895(95%CI:0.844-0.946),with the o-riginal curve close to the ideal curve.Decision curve analysis showed that when the threshold probability>0.05,the net bene-fit rate of the model for predicting ME in T2DM patients was>0.The area under the curve(AUC)of the nomogram model for predicting ME in T2DM patients was 0.901(95%CI:0.850-0.952),with a specificity of 68.96%and a sensitivity of 92.55%.Conclusion The influence factors for ME in T2DM patients include a history of hypertension,duration of T2DM,HbA1c,LDL-C,and eGFR.The nomogram model constructed based on these factors has good predictive performance and can serve as an important tool to guide clinical treatment.

Abstract:Objective To investigate the incidence of malnutrition in stroke patients with dysphagia and to construct a risk prediction model.Methods Convenience sampling was used to select 200 stroke patients with dysphagia treated at the First Affiliated Hospital with Nanjing Medical University from February 2021 to March 2024.The incidence of malnutrition was recorded,and the patients were assigned to a training set(n=140)and a validation set(n=60)in a 7∶3 ratio.In the train-ing set,univariate and multivariate logistic regression analyses were used to identify risk factors for malnutrition in stroke patients with dysphagia,and a nomogram model was constructed based on these factors.The model's discrimination and calibration were assessed using receiver operating characteristic(ROC)curves and the Hosmer-Lemeshow test.The model was further validated using data from the validation set.Results In this study,the incidence of malnutrition among the 200 patients was 41.00％(82/200).In the training set,the malnutrition group had a higher proportion of patients aged＞60 years,with a body mass index(BMI)＜18.5 kg/m2 at admission,lung infections,severe dependence in daily life,and a Grade Ⅴ result in the water swallow test.They also had lower serum albumin(Alb)levels compared to the well-nourished group,with all differences being statistically significant(P＜0.05).Multivariate logistic regression analysis indicated that age＞60 years(OR=3.312,95％CI:1.317-8.326),severe dependence in daily life(OR=12.110,95％CI:1.343-109.206),Grade V in the water swallow test(OR=4.610,95％CI:1.298-16.379),BMI＜18.5 kg/m2 at admission(OR=3.458,95％CI:1.054-11.347),and decreased Alb levels(OR=0.629,95％CI:0.522-0.757)were independ-ent predictors of malnutrition after stroke.Based on these five variables,a risk prediction model for malnutrition in stroke patients with dysphagia was developed.The logistic regression equation was:Logit(P)=1.198 × Age(＞60 years)+2.494 × Barthel Index(severe dependence)+1.528 × Water Drinking Test Grade(Ⅴ)—0.464 × Alb+1.241 × BMI at ad-mission(＜18.5 kg/m2)+14.959.The area under the curve(AUG)for the model in the training set was 0.865(95％CI:0.796-0.923),with a sensitivity of 74.39％and specificity of 86.21％.The Hosmer-Lemeshow goodness-of-fit test for the training set model was x2=10.535,P=0.229.In the validation set,AUC was 0.830(95％CI:0.724-0.936),with a sensitivity of 61.11％and specificity of 87.50％,and the Hosmer-Lemeshow goodness-of-fit test was x2=11.280,P=0.186.Conclusion The incidence of malnutrition in stroke patients with dysphagia remains high.Age＞60 years,se-vere dependence in daily life,Grade V in the water swallow test,BMI＜18.5 kg/m2 at admission,and decreased Alb levels are independent risk factors for malnutrition.The risk prediction model based on these indicators has good discrimination and calibration,and can be used for early screening of dysphagia in stroke patients in clinical practice.

Abstract:Objective To investigate the prevalence of prenatal and postpartum depression in both pregnant and postpartum women and their husbands in Ma'anshan,and to explore the influencing factors of perinatal depression.Methods This study used a cross-sectional design and included couples who received prenatal care,postpartum 42-day checkups,and"4-2-1"child health checkups at the Perinatal Health Care Center and Child Healthcare Department of Ma'anshan Women and Children's Hospital from November 2023 to June 2024(examination time points included seven time points:the early preg-nancy,middle pregnancy,late pregnancy,42 days postpartum,3 months postpartum,6 months postpartum,and 1 year postpartum).Depression screening was conducted using the Edinburgh Postnatal Depression Scale(EPDS)through the"Mom's Good Mood(MGM)"platform.Logistic regression analysis was used to examine the factors influencing depression in pregnant and postpartum women and their husbands during the prenatal and postpartum periods.Results A total of 1,350 valid questionnaires were collected.The depression detection rates for pregnant and postpartum women during the early,middle,and late pregnancy stages,42 days postpartum,3 months postpartum,6 months postpartum,and 1 year postpartum were 19.6％,14.0％,19.3％,18.0％,24.9％,25.3％,and 23.0％,respectively.For their husbands,the depression detection rates at the same seven time points were 15.2％,18.5％,15.8％,14.1％,12.7％,13.7％,and 26.2％,respectively.Multivariate analysis showed that pregnant and postpartum women with poor sleep quality(OR=2.09,95％CI:1.25-3.48),moderate pregnancy symptoms(OR=1.98,95％CI:1.22-3.21),severe pregnancy symptoms(OR=2.11,95％CI:1.21-3.70),and moderate relationship distress with their husbands(OR=2.77,95％CI:1.45-5.29)were more likely to experience prenatal depression(P＜0.05).Pregnant and postpartum women with poor sleep quality(OR=1.79,95％CI:1.13-2.84),unplanned pregnancies(OR=1.67,95％CI:1.07-2.61),moderate rela-tionship distress(OR=2.96,95％CI:1.61-5.43)and severe relationship distress(OR=2.33,95％CI:1.23-4.41)with their husbands,and low family care and support(OR=2.52,95％CI:1.39-4.57)were more likely to develop postpartum de-pression(P＜0.05).Pregnant and postpartum women who actively sought support when distressed(OR=0.31,95％CI:0.16-0.62)were less likely to develop postpartum depression(P＜0.05).Husbands with poor sleep quality(OR=3.03,95％CI:1.81-5.07),moderate relationship distress(OR=3.76,95％CI:2.13-6.65)and severe relationship distress(OR=2.01,95％CI:1.00-4.04),and frequent alcohol consumption(OR=2.47,95％CI:1.20-5.11)were more likely to experience prenatal depression(P＜0.05).Husbands with moderate relationship distress(OR=3.33,95％CI:1.93-5.73)and severe relationship distress(OR=4.33,95％CI:2.19-8.57),and frequent alcohol consumption(OR=2.29,95％CI:1.09-4.82)were more likely to experience postpartum depression(P＜0.05).Conclusion The prevalence of prenatal and postpartum depression in both pregnant and postpartum women and their husbands in Ma'anshan remains high,and several factors contribute to it.Improving both partners' sleep quality,reducing screen time,optimizing marital rela-tionships,and enhancing psychological support services are essential for promoting the mental health of couples during the perinatal period.

Abstract:Objective To explore the effect of an operating-room risk nursing protocol in patients undergoing laparoscopic surgery,with the aim of providing a reference for clinical practice.Methods Laparoscopic surgery patients admitted to the Second Affiliated Hospital of Air Force Medical University from March 2023 to February 2024 were enrolled as the control group(n=113)and received routine operating-room nursing.Patients admitted from March 2024 to February 2025 were enrolled as the experimental group(n=113)and received the operating-room risk nursing protocol in addition to routine nursing.Surgical parameters,intraoperative risk events,and degree of satisfaction with nursing were compared between the two groups.Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),and 36-Item Short-Form Health Survey(SF-36)scores were compared before nursing and after nursing(at discharge).Results Body temperature at 30 minutes in-to surgery was higher in the experimental group than in the control group;surgery duration,anesthesia awakening time,time to recovery of gastrointestinal peristalsis,and length of hospital stay were all shorter in the experimental group than in the control group;postoperative pain as measured by the Visual Analogue Scale(VAS)was lower in the experimental group than in the control group;all these differences were statistically significant(P＜0.05).There were no significant between-group differences in SAS and SDS scores before nursing(P＞0.05).After nursing,SAS and SDS scores decreased in both groups,and the decreases were significantly greater in the experimental group than in the control group(P＜0.05).The in-cidence of intraoperative risk events in the experimental group was significantly lower than that in the control group(12.39％vs.31.86％;P＜0.05).There were no significant pre-nursing differences between groups across the eight di-mensions(physical functioning,role physical,social functioning,bodily pain,role emotional,mental health,vitality,gen-eral health)of SF-36(P＞0.05).After nursing,scores on all eight dimensions of SF-36 increased in both groups compared with before nursing,and were significantly higher in the experimental group than in the control group(P＜0.05).The o-verall degree of satisfaction with nursing was significantly higher in the experimental group than in the control group(P＜0.05).Conclusion Application of an operating-room risk nursing protocol in patients undergoing laparoscopic surgery can effectively improve surgical efficiency and promote postoperative recovery,reduce negative emotions,decrease the incidence of risk events,and raise quality of life and degree of satisfaction with nursing,warranting clinical promotion and application.

Abstract:Objective To evaluate the effects of WeChat check-in supervision on psychological resilience and self-efficacy in patients performing home pulmonary rehabilitation after lung cancer surgery,providing a reference for clinical practice.Methods A total of 145 patients discharged for postoperative rehabilitation after lung cancer surgery at Shanghai Chest Hospital from June 2022 to August 2023 were enrolled and assigned to an observation group(n=73)and a control group(n=72)using a random number table.The control group received routine home pulmonary rehabilitation care;the observa-tion group received routine care plus WeChat check-in supervision.Outcomes compared at discharge and at 6 months after discharge included the Psychological Resilience Scale,the Pulmonary Rehabilitation Training Self-Efficacy Scale,the Chinese version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30(EORTC QLQ-C30),and pulmonary function indices(forced expiratory volume in 1 second[FEV1],maximal voluntary ventilation[MVV],forced vital capacity[FVC],and FEV1/FVC).Results At discharge,there were no significant between-group differences in subscales(tenacity,self-strength,optimism)or total scores of Psychological Resilience Scale(P＞0.05).At 6 months after discharge,subscale and total scores were higher than at discharge in both groups and were significantly high-er in the observation group than in the control group(P＜0.05).There were no significant between-group differences at discharge in subscale of the Pulmonary Rehabilitation Training Self-Efficacy Scale such as acquisition and application of reha-bilitation information,or in the total score(P＞0.05);at 6 months,the subscale and the total scores were higher than at discharge in both groups and were significantly higher in the observation group than in the control group(P＜0.05).Pul-monary function indices(FVC,FEV1,MVV,FEV1/FVC)did not differ between groups at discharge(P＞0.05);at 6 months,FVC,FEV1,MVV,and FEV1/FVC increased in both groups compared with discharge and were significantly higher in the observation group than in the control group(P＜0.05).There were no significant pre-discharge differences be-tween groups in subscale(physical functioning,role functioning,cognitive functioning,emotional functioning,and social functioning)or in total score(P＞0.05);at 6 months,scores on these dimensions and the total score improved in both groups and were significantly better in the observation group than in the control group(P＜0.05).Conclusion WeChat check-in supervision applied to home pulmonary rehabilitation after lung cancer surgery can rebuild psychological resilience,promote self-efficacy,strengthen impaired pulmonary function,and raise quality of life,which merits wider clinical promo-tion and application.

Abstract:Objective To observe the therapeutic efficacy of exogenous pulmonary surfactant(PS)combined with different respiratory support modes for neonatal respiratory distress syndrome(NRDS),providing a reference for clinical decision-making.Methods Ninety-two NRDS pediatric patients treated at a hospital in Guangdong from January 2021 to December 2024 were enrolled and as-signed,using a random number table,to a reference group treated with PS plus nasal continuous positive airway pressure(NCPAP,n=45)and a study group treated with PS plus synchronized nasal intermittent positive pressure ventilation(SNIPPV,n=47).Clinical efficacy,blood gas parameters,therapeutic efficacy,inflammatory factor levels,and complications were compared between the two groups.Results The overall response rate in the study group was significantly higher than that in the reference group(95.74％[45/47]vs.73.33％[33/45];P＜0.05).At different time points,repeated-measures analysis showed statis-tically significant effects of time,group,and their interaction for arterial oxygen tension(PaO2)(F=249.70,126.00,13.03;all P＜0.05),arterial carbon dioxide tension(PaCO2)(F=109.20,54.31,4.78;allP＜0.05),and oxygenation index(OI)(F=395.80,84.74,5.62;all P＜0.05).Pairwise comparisons indicated that both groups had increased PaO2 and decreased PaCO2 and OI after treatment(P＜0.05).At 12,24,and 48 hours after treatment,the study group had significantly higher PaO2 and lower PaCO2 and OI than the reference group(P＜0.05).The study group also had significantly shorter durations of oxygen therapy,du-ration of noninvasive ventilation,time to establish feeding,and length of hospital stay than the reference group(P＜0.05).After treatment,white blood cell count(WBC),C-reactive protein(CRP),and procalcitonin(PCT)decreased in both groups and were significantly lower in the study group than in the reference group(P＜0.05).The complication rate in the study group was 6.39％,versus 8.88％in the reference group,a difference that was not statistically significant(P＞0.05).Conclusion PS combined with SNIPPV produces superior therapeutic efficacy in NRDS,effectively improving blood gas and oxygenation indices,shortening durations of oxygen therapy and noninvasive ventilation as well as time to feeding and length of hospital stay,justifying clinical promotion and application.

Abstract:Objective To investigate the incidence of postoperative pneumonia in patients with lung cancer and to develop a risk prediction model based on logistic regression analysis to inform clinical decision-making.Methods A total of 300 pa-tients who underwent radical surgery for lung cancer in the Department of Thoracic Surgery at the First Affiliated Hospital with Nanjing Medical University from March 2022 to June 2024 were enrolled and randomly assigned in a 7∶3 ratio to a modeling group(n=210)and a validation group(n=90).In the modeling group,patients were classified into pneumonia and non-pneumonia subgroups according to whether postoperative pneumonia occurred.Clinical data were collected and lo-gistic regression analysis was used to identify independent risk factors for postoperative pneumonia;a risk prediction model was then constructed based on these factors.Model performance was evaluated by receiver operating characteristic(ROC)curve,calibration curve,and decision curve analysis.Results The overall incidence of postoperative pneumonia in this cohort was 27.67％.Multivariate logistic regression analysis identified older age(OR=1.235,95％CI:1.146-1.332),longer operative time(OR=1.028,95％CI:1.005-1.050),open thoracotomy(OR=8.677,95％CI:2.359-31.912),and postoperative invasive pro-cedures(OR=2.796,95％CI:1.057-7.395)as independent risk factors for postoperative pneumonia,while use of dexmedetomidine was a protective factor(OR=0.229,95％CI:0.079-0.666;P＜0.05).The derived risk prediction model was:P=1[1+e-19.593+0.211×(age)+2.161×(surgical approach)-1.475×(use of dexmedetomidine)+0.027×(operative time)+1.028×(postoperative invasive procedures)],and a nomogram was plotted ac-cordingly.ROC analysis showed an area under curve(AUC)of 0.897(95％CI:0.849-0.945)for the model;calibration curve analy-sis indicated good calibration,and clinical decision curve analysis demonstrated favorable clinical net benefit.Conclusion Age,opera-tive time,surgical approach,dexmedetomidine use,and postoperative invasive procedures are independent factors influen-cing postoperative pneumonia in patients with lung cancer.The validated risk prediction model based on these factors can ef-fectively predict the risk of postoperative pneumonia.

Abstract:Objective To explore the relationship between C-reactive protein-triglyceride glucose index(CTI)and lower limb atherosclerosis in perimenopausal women with type 2 diabetes(T2DM),aiming to provide a reference for clinical decision-making.Methods A total of 218 perimenopausal women with T2DM diagnosed between August 2021 and December 2024 at our hospital were selected as the study group.Additionally,100 perimenopausal healthy women who underwent physical examinations at the hospital during the same period were selected as the control group.Levels of C-reactive protein(CRP),fasting plasma glucose(FPG),triglycerides(TG),and other indices were measured,and triglyceride glucose(TyG)index and CTI were calculated.The study group underwent lower limb color Doppler ultrasound,and based on the presence or ab-sence of lower limb atherosclerosis,they were assigned to the atherosclerosis group(n=96)and non-atherosclerosis group(n=122).The predictive value of CTI for lower limb atherosclerosis in perimenopausal T2DM women was analyzed using the receiver operating characteristic(ROC)curve,and multivariate logistic stepwise regression analysis was conducted to i-dentify the influencing factors for lower limb atherosclerosis in these women.Results CRP,TyG index,and CTI in the study group were significantly higher than those in the control group(P＜0.05).In the atherosclerosis group,CRP,TyG index,and CTI were significantly higher than those in the non-atherosclerosis group(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)for CTI in predicting lower limb atherosclerosis in perimenopausal T2DM women was 0.905,significantly higher than the AUCs of CRP(0.746)and TyG index(0.872)alone(Z=10.729,9.481,P＜0.001).Univariate analysis showed no statistically significant differences between the atherosclerosis and non-athero-sclerosis groups in age,body mass index(BMI),diastolic blood pressure,systolic blood pressure,neutrophil count(NE),alanine aminotransferase(ALT),aspartate aminotransferase(AST),total cholesterol(TC),high-density lipoprotein cho-lesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),and the proportion of patients with a smoking or drinking history(P＞0.05).The atherosclerosis group had a longer duration of T2DM,higher waist-to-hip ratio,higher glycated hemoglobin(HbA1c),higher white blood cell count(WBC),and higher TG compared to the non-atherosclerosis group,with all differences being statistically significant(P＜0.05).Multivariate logistic stepwise regression analysis showed that high waist-to-hip ratio(OR=2.617,95％CI:1.491-4.593),high HbA1c(OR=2.291,95％CI:1.374-3.821),and CTI ≥ 9.77(OR=2.983,95％CI:1.740-5.114)were independent risk factors for lower limb atherosclerosis in perim-enopausal women with T2DM(P＜0.05).Conclusion Elevated CTI is associated with the occurrence of lower limb athero-sclerosis in perimenopausal women with T2DM and is an independent influencing factor for lower limb atherosclerosis in these women.Moreover,CTI has high predictive value for the occurrence of lower limb atherosclerosis in perimenopausal women with T2DM.

Abstract:Chlorogenic acid(CGA),a phenolic compound widely distributed in herbal plants,serves as a primary component in many traditional Chinese medicine formulations.Recent studies have revealed its diverse pharmacological activities,inclu-ding regulation of glucose and lipid metabolism,anti-inflammatory effects,antioxidant properties,anticancer potential,and immunomodulatory functions.Concurrently,its renal protective effects have garnered significant attention.This article sys-tematically reviews the applications of CGA in preventing and treating various kidney diseases,and further summarizes its underlying renal protective mechanisms,aiming to provide a theoretical basis for CGA as a natural medicine in the preven-tion and treatment of renal diseases.

Abstract:Objective To establish an efficient high-performance liquid chromatography-tandem mass spectrometry(HPLC-MS/MS)method for the simultaneous determination of six aconitine-type alkaloids(benzoylhypacoitine,benzoylmesaco-nine,benzoylaconine,hypaconitine,mesaconitine,aconitine)and rhodojaponin Ⅱ in Weikang Gel.Methods Chromato-graphic separation was performed on an Agilent InfinityLab Poroshell 120 EC-C18 column(4.6 mm × 150 mm,4 μm)using acetonitrile-0.1％formic acid in water as the mobile phase with gradient elution;column temperature was 30 ℃ and flow rate 0.45 mL/min.Detection was carried out by electrospray ionization in positive ion mode using multiple reaction monito-ring.Results The reference solution was prepared with a blank matrix,and the linear relationship between the six aconitine alkaloids and rhodojaponin Ⅱ was good in their respective ranges(r≥ 0.999 0).Precision,stability,and repeatability met method validation requirements.Mean spiked recoveries ranged from 81.56％to 107.08％,with relative standard deviations(RSDs)of 1.75％-4.78％.Conclusion The developed HPLC-MS/MS method overcomes matrix effects,offers high sen-sitivity and specificity,and can provide an experimental basis for quality control strategies aimed at balancing efficacy and toxicity of Weikang Gel.

Abstract:Objective To investigate the maternal and infant health literacy level and the awareness of related knowledge a-mong pregnant women in Chongqing's two wings region(northeastern and southeastern regions),and to analyze the influen-cing factors,providing a basis for formulating targeted health promotion strategies.Methods From September to December 2023,a cluster random sampling method was used to conduct a questionnaire survey among 446 pregnant women.The ques-tionnaire covered basic information,pregnancy-related information,and maternal and infant health literacy.Data were pro-cessed using the chi-square test,t-test or non-parametric test(as appropriate),and logistic regression analysis.Results The overall maternal and infant health literacy level in Chongqing's two wings region was 10.76％,with the northeastern region of Chongqing(15.49％)significantly higher than the southeastern region(1.34％)(P＜0.05).The overall health literacy score was(45.61±22.05)points,and the overall awareness rate was 47.35％.The northeastern region had significantly higher scores and awareness rates than the southeastern region(P＜0.05).Among all items,25 had an awareness rate lower than 60％,with the lowest awareness rate for"the benefits of breastfeeding",which was only 7.17％.Multivariate stepwise logistic regres-sion analysis showed that region,education level,concerns about work impact,number of times attending antenatal classes,and sleep status were the main factors influencing pregnant women's maternal and infant health literacy levels(P＜0.05).Conclusion Maternal and infant health literacy among pregnant women in Chongqing's two wings region is at a relatively low level,with the southeastern region being particularly prominent.It is recommended that future maternal and infant health education focus on the southeastern region,pregnant women with lower educational levels,and those who have not participated in antenatal classes,in order to comprehensively raise maternal and infant health literacy in the region.

Abstract:Objective To explore the predictive value of arterial blood gas analysis combined with procalcitonin(PCT)and N-terminal pro-brain natriuretic peptide(NT-proBNP)levels for respiratory failure in emergency trauma patients with multiple injuries.Meth-ods A total of 204 critically ill trauma patients who were treated at the Emergency Department of Baoding No.1 Central Hospital from January 2022 to January 2025 were selected for the study.Patients were grouped according to whether they developed respira-tory failure within one week of treatment.A total of 72 patients with combined respiratory failure were included in Group A,and 132 patients without combined respiratory failure were included in Group B.Clinical data,including PCT,NT-proBNP,partial pressure of carbon dioxide(PaCO2),partial pressure of oxygen(PaO2),and oxygen saturation(SaO2)levels,were collected.Re-ceiver operating characteristic(ROC)curves were plotted to analyze the predictive value of arterial blood gas analysis indicators com-bined with PCT and NT-proBNP for respiratory failure in emergency trauma patients.Results The Injury Severity Score(ISS)of Group A was significantly higher than that of Group B(P＜0.05).PaCO2 levels in Group A were higher than in Group B,while PaO2 and SaO2 levels in Group A were lower than those in Group B,with statistically significant differences(P＜0.05).PCT and NT-proBNP levels in Group A were significantly higher than those in Group B(P＜0.05).ROC curve analysis showed that the ar-ea under the curve(AUC)for PaCO2,PaO2,SaO2,PCT,and NT-proBNP in predicting respiratory failure in emergency trauma patients were 0.839,0.683,0.724,0.760,and 0.662,respectively.The AUC for combined prediction of these indicators was 0.939.Conclusion Arterial blood gas indicators,PCT,and NT-proBNP all have certain value in predicting respiratory failure in e-mergency trauma patients with multiple injuries.The combined prediction of these indicators offers the highest predictive value.