Abstract:Objective To analyze the risk factors for early spontaneous abortion in patients with recurrent miscarriage(RSA)and construct a predictive model.Methods A retrospective analysis was conducted on the clinical data of 129 patients with RSA in Changzhou Hospital Affiliated to Nanjing University of Chinese Medicine from October 2023 to October 2024.They were divided into an early abortion group(103 cases)and a continued pregnancy group(26 cases)based on whether spontaneous abortion occurred before 12 weeks.The clinical data of the two groups of patients were compared.Univariate and multivariate Logistic regression analyses were used to analyze the risk factors of early spontaneous abortion in RSA patients and a predictive model was constructed.Results Univariate analysis showed that comparisons of positive rates of embryonic chromosomes,thyroid stimulating hormone(TSH),free triiodothyronine(FT3),maximum aggregation rate of adenosine diphosphate(ADP),protein C(PC),fibrinogen(FIB),and antinuclear antibody(ANA)between the early miscarriage group and the continued pregnancy group.The differences were all statistically significant(P<0.05).Multivariate Logistic regression analysis showed that TSH(OR=0.60,95%CI:0.37-0.96,P=0.03),ADP(OR=0.96,95%CI:0.93-0.99,P=0.01),PC(OR=1.03,95%CI:1.00-1.05,P=0.03),FIB(OR=1.68,95%CI:1.03-2.76,P=0.04)and ANA(OR=0.23,95%CI:0.07-0.74,P=0.01)are risk factors for early spontaneous abortion in RSA patients;Based on this,the area under the receiver operating characteristic(ROC)curve(AUC)of the nomogram model constructed was 0.758,the sensitivity was 0.806,and the specificity was 0.750.Conclusion TSH,ADP,PC,FIB,and ANA are risk factors for early spontaneous abortion in RSA patients.The nomogram model constructed based on these factors has certain predictive value for early spontaneous abortion in RSA and is helpful for timely intervention by medical staff.

Abstract:Objective To explore the relationship between triglyceride-glucose index(TyG)and metabolic associated fatty liver disease(MAFLD).Methods This study was a secondary analysis of relevant data from the National Health and Nutrition Examination Survey(NHANES)database in the United States.Data of subjects over 18 years old from the NHANES database in 2017 to 2018 were collected.Weighted generalized linear regression,generalized additive regression,and curve fitting were used to comprehensively evaluate the correlation between TyG and MAFLD after adjusting for multiple covariates.Results A total of 4992 subjects with complete physical examination data,questionnaires,and laboratory test information for diagnosing MAFLD were included in the 2017 to 2018 NHANES database,among whom 2806 met the diagnostic criteria for MAFLD,with a weighted prevalence rate of 54.09%.The weighted generalized linear regression showed that in the fully adjusted model,for every 1-unit increase in TyG,the weighted risk of MAFLD increased by 147%(weighted OR=2.47,95%CI=1.24-4.91,P=0.0111).Further analysis revealed that the correlation between TyG and the weighted risk of MAFLD was most significant in the TyG T3 group(weighted OR=2.55,95%CI=1.29-5.03,P=0.001).Generalized linear models and smooth curve fitting indicated that the risk of MAFLD increased linearly with the increase in TyG overall(OR=3.27,95%CI=2.58-4.14,P<0.001).However,in the T3 group,the relationship between TyG and MAFLD tended to be curvilinear,and when TyG exceeded 9.2 in the T3 group,the risk of MAFLD increased by 597%(OR=6.97,95%CI=2.10-23.09,P=0.0015).Conclusion The TyG index is significantly correlated with the risk of MAFLD,especially when TyG exceeds 9.2,and the risk of MAFLD should be particularly vigilant.

Abstract:Objective To review and analyze the current research status of type 2 diabetes mellitus(T2DM)combined with metabolic associated fatty liver disease(MAFLD),explore research hotspots and trends,and provide references for future research.Methods Relevant literatures on the treatment of T2DM combined with MAFLD with traditional Chinese medicine from 2010 to 2024 retrieved from the databases of China National knowledge infrastructure(CNKI),Weipu(VIP),and Wanfang patent data base(WFPD).Visual analysis was conducted on the authors,institutions,and keywords in this field.Results A total of 179 articles were included;The number of published articles generally showed a fluctuating upward trend,reaching the first peak in 2019;A total of 238 scholars and 145 institutions were involved in the research in this field,among which Yu Rong was the most productive researcher,and Anhui University of Chinese Medicine had the highest number of published articles.A total of 248 keywords were included in the map,with 31 high centrality keywords,and 11 keyword cluster labels were generated.Conclusion There is a lack of core authors and institutional collaboration groups in this field,and there is less in-depth cross-regional communication.Research hotspots are concentrated in the combination of traditional Chinese and Western medicine,immune mechanisms,and pharmacological research.There is still considerable research space and value in the future.

Abstract:Objective To explore the mechanism of action of Baihe Gujin Decoction on lung adenocarcinoma(LUAD)using network pharmacology and molecular docking techniques.Methods The active components of Baihe Gujin Decoction were screened through the traditional Chinese medicine systems pharmacology database and analysis platform(TCMSP),and the target proteins of these active components were predicted using the TCMSP database.The information of target proteins was standardized through the Uniprot protein database.The disease-related therapeutic targets of LUAD were retrieved from databases such as GeneCards and OMIM.The intersection of the active component targets of traditional Chinese medicine and the disease targets was obtained using the online tool VENNY,and a"Chinese medicine-active component-target"network was constructed using Cytoscape 3.7.1 software.The protein-protein interaction(PPI)network was constructed using the STRING database,and the core target proteins in the network were screened using Cytoscape 3.7.2 software.The potential targets were subjected to Kyoto encyclopedia of genes and genomes(KEGG)signaling pathway enrichment analysis and gene ontology(GO)functional enrichment analysis using the Metascape database.Finally,molecular docking was performed using AutoDockTools and PyMOL software to verify the key active components and core target proteins.Results A total of 145 active ingredients of Baihe Gujin Decoction were obtained through the TCMSP database search.Molecular docking identified 5813 LUAD-related disease targets,and 287 potential targets for the treatment of LUAD by Baihe Gujin Decoction.The core targets of Baihe Gujin Decoction in the treatment of LUAD identified by network pharmacology were glyceraldehyde-3-phosphate dehydrogenase(GAPDH),AKT serine/threonine kinase 1(AKT1),and tumor protein P53(TP53).Conclusion This study explored the molecular mechanism of action of Baihe Gujin Decoction in regulating LUAD through network pharmacology and molecular docking techniques,interpreted its scientific connotation,and provided certain assistance and promotion for subsequent research on the material basis of its efficacy and molecular mechanism experiments.

Abstract:Objective To investigate the impact of epidermal growth factor receptor(EGFR)gene mutation detection results in non-small cell lung cancer on the selection of clinical targeted therapy.Methods A retrospective selection was made of 110 patients diagnosed with non-small cell lung cancer in Xuchang People's Hospital from January 2023 to January 2024 as the research subjects.According to the results of EGFR gene mutation detection,they were divided into a detected group(51 cases)and a non-detected group(59 cases).The clinical characteristics of the two groups of patients were compared.Meanwhile,100 patients with non-small cell lung cancer admitted to Xuchang People's Hospital during the same period were selected.According to the EGFR gene mutation detection results and treatment plans,they were divided into a wild group(wild type+surgery+chemotherapy,49 cases),a mutant group(mutant type+surgery+chemotherapy,26 cases),and a targeted group(mutant type+surgery+chemotherapy+tyrosine kinase inhibitor treatment,25 cases).The clinical characteristics,toxic and side effects of chemotherapy drugs,and disease-free survival(DFS)of the three groups of patients were compared.Results Among 110 patients with non-small cell lung cancer,the mutation rate of the EGFR gene was 46.36%.The proportions of female patients,adenocarcinoma patients and well-differentiated patients in the detection group were all higher than those in the non-detection group,and the differences were statistically significant(P<0.05).There were no statistically significant differences in the composition ratios of different ages,lymph node metastasis conditions and pathological tumor-lymph node metastasis(pTNM)stages between the two groups(P>0.05).There were statistically significant differences in the composition ratio of pathological types and the DFS survival rates at 6,12,and 18 months among different patients in the targeted group,wild group,and mutation group(P<0.05).Among them,the proportion of adenocarcinoma in the targeted group was higher than that in the wild group(χ2=12.404,P<0.001).There were no statistically significant differences in the constituent ratios of different genders,ages,T stages,N stages,degrees of differentiation,pTNM stages,as well as the constituent ratios of different degrees of allergic reactions,liver and kidney damage,neurotoxins,bone marrow suppression,and gastrointestinal reactions among the three groups(P>0.05).Conclusion Females,adenocarcinoma,and an increased proportion of highly differentiated components can increase the EGFR gene mutation rate in patients with non-small cell lung cancer.For EGFR mutation-positive patients,the combination of tyrosine kinase inhibitor targeted therapy on the basis of conventional surgery+chemotherapy can significantly prolong their DFS.

Abstract:Objective To explore the application value of goal-directed feedback mechanism(GDF)in clinical internship teaching of otorhinolaryngology.Methods Forty clinical interns from the department of otorhinolaryngology head and neck surgery of The First Affiliated Hospital of Shenzhen University from June 2024 to March 2025 were selected and randomly divided into a control group and an observation group,with 20 cases in each group.The control group was taught with conventional methods,while the observation group was taught with the addition of the goal-directed feedback mechanism.The final examination scores,clinical practice abilities,satisfaction of interns with teaching,and satisfaction of teachers with students were compared between the two groups.Correlation analysis was conducted between satisfaction and scores.Results The theoretical examination scores and clinical skills assessment scores of the observation group were higher than those of the control group,with statistically significant differences(P<0.05).The scores of the observation group in all dimensions of the Mini-CEX(interview skills,physical examination skills,humanistic care,clinical judgment,communication skills,organizational effectiveness,and overall clinical competence)were higher than those of the control group,with statistically significant differences(P<0.05).The satisfaction of interns with clinical internship teaching in the observation group was higher than that in the control group,and the satisfaction of teachers with the clinical internship of interns in the observation group was also higher than that in the control group,with statistically significant differences(P<0.05).Spearman correlation analysis showed that the satisfaction of teachers was positively correlated with the clinical skills assessment scores and overall clinical competence of interns(r=0.921,0.428,both P<0.01),and the satisfaction of students was positively correlated with theoretical examination scores and clinical skills assessment scores(r=0.760,P<0.01;r=0.313,P<0.05).Conclusion The goal-directed feedback mechanism can improve the theoretical knowledge and skills of clinical interns,enhance their comprehensive abilities,and effectively improve the quality of clinical internship teaching.

Abstract:Objective To analyze the distribution characteristics and laboratory test results of blood donors of different age groups in Dongguan City,and to provide a basis for formulating scientific and reasonable voluntary blood donation recruitment strategies and improving blood quality.Methods Data and blood test results of 492 580 blood donors of different age groups in Dongguan City from January 1,2020 to December 31,2024 were selected for statistical analysis.Results The average age of blood donors in Dongguan City increased from 38.72 to 40.67 years from 2020 to 2024,showing a trend towards middle-aged and elderly donors.There were statistically significant differences in age,donation frequency,gender,blood type,occupation,and donation volume among blood donors of different age groups(P<0.001).Among them,the proportion of donors aged 35-44 years was the highest(32.42%-38.04%),and the proportion of donors under 35 years old was mainly first-time donors.Multiple linear regression showed that female gender was positively correlated with donation age(β=0.680,P<0.001),while first-time donors,medical staff,and 200 mL donation volume were negatively correlated with donation age(β=-0.914,-0.443,-0.337,all P<0.001).Blood test results showed that the total unqualified rate was the highest in the 45-54 age group(1.61%),and alanine aminotransferase(ALT)was the top unqualified item in four age groups except for the 45-54 age group,with the highest ALT unqualified rate(0.85%)in the 25-34 age group.The unqualified rate of hepatitis B virus(HBV)in the 45-54 age group(0.69%)was significantly higher than that in other groups,with a statistically significant difference(P<0.001).Conclusion Blood donors in Dongguan City are showing a trend towards middle-aged and elderly donors,with the 35-44 age group being the main force of blood donation.Special attention should be paid to the high-risk group of ALT/HBV in the 45-54 age group,and precise health education and age-specific recruitment strategies should be implemented to ensure the sufficiency and safety of clinical blood supply.

Abstract:Objective To explore the detection rate of adenoma during Pentax colonoscopy and the risk factors for postoperative polyp recurrence.Methods The general information and endoscopic test results of 900 subjects who underwent Pentax colonoscopy at the General Hospital of Hebi Coal Industry Group Co.,Ltd.from January 2022 to December 2024 were collected.The detection rate was calculated and they were divided into a detection group(109 cases)and a non-detection group(791 cases)based on whether adenomas were detected.The general information of the subjects in the two groups was compared.Analyze its independent influencing factors.The follow-up data of 109 patients who were first diagnosed with adenoma and underwent endoscopic resection after colonoscopy and histological examination in the same period were collected.According to the colonoscopy examination results during the follow-up,the patients were divided into a recurrence group(73 cases)and a non-recurrence group(36 cases).The general data of the two groups of patients were compared,and the risk factors and protective factors of postoperative polyp recurrence were analyzed.Results The detection rate of adenoma was 12.11%(109/900);The proportions of male subjects,those aged≥45 years,those with diabetes,chronic constipation,and intestinal preparation scores ranging from 7 to 9 in the detection group were higher than those in the non-detection group,while the proportion of anesthesia was lower than that in the non-detection group.The differences were statistically significant(P<0.05).The results of multivariate Logistic regression analysis showed that male gender,age≥45 years old,and intestinal preparation score of 7-9 were all independent influencing factors for the detection of adenoma during colonoscopy(P<0.05).The proportions of male patients,chronic constipation,and adenoma≥10 mm in the recurrence group were all higher than those in the non-recurrence group,and the proportions after a bowel preparation score of 7-9 was lower than that in the recurrence group,with statistically significant differences(P<0.05).The results of multivariate Logistic regression analysis showed that male gender and chronic constipation were risk factors for postoperative polyp recurrence(P<0.05),and a bowel preparation score of 7 to 9 was a protective factor for postoperative polyp recurrence(P<0.05).Conclusion Male gender,age≥45 years old,and a bowel preparation score of 7-9 will increase the detection rate of adenoma.Male gender and chronic constipation will increase the risk of postoperative polyp recurrence,while a bowel preparation score of 7-9 will reduce the risk of postoperative polyp recurrence.

Abstract:Objective To explore the impact of embedding mind mapping(MM)into the BOPPPS framework on the quality of standardized training for anesthesiology residents.Methods Sixty residents rotating in the department of anesthesiology of the First Affiliated Hospital of Guangdong Pharmaceutical University from October 2022 to December 2024 were selected as the research subjects and randomly divided into a N group(new teaching model group)and a T group(traditional teaching model group),with 30 residents in each group.The N group residents were taught using the"MM+BOPPPS"six-step integrated teaching method(pre-class mind map design → situational introduction → objectives → pre-assessment → participatory learning → post-assessment+summary),while the T group residents were taught using traditional lectures and case interactions.The operational skills and comprehensive clinical diagnosis and treatment abilities of the residents in both groups before entering the department and after teaching were compared.Results After teaching,the scores of the N group residents in terms of understanding of indications,relevant anatomy,and operation techniques,pre-operation preparation,pain relief and sedation,technical ability,communication skills,and overall performance were all higher than those of the T group residents,and the differences were statistically significant(P<0.05).After teaching,the scores of the N group residents in medical interviews,physical examinations,clinical judgment,organizational efficiency,and overall performance were all higher than those of the T group,and the differences were statistically significant(P<0.05).Conclusion The MM-BOPPPS integration strategy can simultaneously enhance the operational precision and clinical decision-making ability of anesthesiology residents.

Abstract:Objective To explore the causal association between 20 dietary habits and non-alcoholic fatty liver disease(NAFLD)using two-sample Mendelian randomization(MR)analysis.Methods Based on the summary data of genome-wide association studies(GWAS)in a large-scale European population,the inverse variance weighted(IVW)method was used as the main analysis method,and MR Egger regression,weighted median method,weighted mode method,and simple model method were used for verification.Sensitivity analysis and statistical correction were conducted for heterogeneity and pleiotropy.Results IVW analysis showed that the frequency of alcohol consumption(OR=1.3960,95%CI:1.1422-1.7062,P=0.0011)was positively associated with the risk of NAFLD onset,while the intake of dried fruits(OR=0.5184,95%CI:0.3188-0.8432,P=0.0081)and cheese(OR=0.7171,95%CI:0.5349-0.9615,P=0.0262)were negatively associated with the risk of NAFLD onset.Sensitivity analysis did not find significant pleiotropy or outliers,and the results were robust.Conclusion This study suggests that in the European population,an increase in the frequency of alcohol consumption predicted by genes is a risk factor for NAFLD,while a higher intake of dried fruits and cheese indicates potential protective effects.The results can provide genetic evidence for dietary intervention in high-risk populations of NAFLD.

Abstract:Objective To explore the influencing factors of non-culprit vessel lesion progression in patients with acute ST-segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Methods The clinical data of 80 patients with acute STEMI who underwent PCI treatment in Gushi County People's Hospital from October 2022 to December 2024 were retrospectively collected.The patients were divided into a progression group and a non-progression group based on the results of coronary angiography 6 months after the operation.General data of the two groups were compared,and the influencing factors of non-culprit vessel lesion progression in patients with acute STEMI after PCI were analyzed.Results Among the 80 patients with acute STEMI who underwent PCI,39 patients had non-culprit vessel lesion progression,while 41 patients did not have non-culprit vessel lesion progression.The age,proportion of diabetes,fasting blood glucose,fibrinogen(FIB),and low-density lipoprotein of the progression group were significantly higher than those of the non-progression group,with statistically significant differences(P<0.05).There were no statistically significant differences in other general data and laboratory indicators between the two groups(P>0.05).Multivariate Logistic regression analysis showed that age,history of diabetes,fasting blood glucose,FIB,and low-density lipoprotein were the influencing factors of non-culprit vessel lesion progression in patients with acute STEMI after PCI(P<0.05).Conclusion Age,history of diabetes,fasting blood glucose,FIB,and low-density lipoprotein are the influencing factors of non-culprit vessel lesion progression in patients with acute STEMI after PCI.

Abstract:Objective To analyze the latent profiles of fear of cancer progression(FCP)in patients with cervical cancer and explore the influencing factors,providing a basis for targeted nursing interventions in clinical practice.Methods A cross-sectional survey design was adopted.A total of 236 patients with cervical cancer who were hospitalized in the gynecological oncology department of Xuchang Central Hospital from August 2024 to May 2025 were selected as the research subjects.Data were collected using the fear of cancer progression short form,the chinese version of the impact of event scale-revised,and the Chinese version of the painful disclosure index scale.Latent profile analysis was used to identify the latent classes of FCP.Logistic regression analysis was conducted to screen the factors influencing the FCP classes.Results Through latent profile analysis,three latent profiles of FCP in patients with cervical cancer were identified,namely,the low fear group(70 cases,29.66%),the moderate fear group(94 cases,39.83%),and the high fear group(72 cases,30.51%).Univariate analysis showed that age,educational level,per capita monthly family income,pathological stage,comorbidities,disease understanding,negative cognitive processing,and painful disclosure were all influencing factors of FCP classes(P<0.05).Multivariate Logistic regression analysis indicated that pathological stage,comorbidities,disease understanding,negative cognitive processing,and painful disclosure were independent influencing factors of FCP classes(P<0.05).Conclusion Patients with cervical cancer have different latent profiles of FCP,which are related to multiple factors.In clinical nursing practice,individual differences among patients should be emphasized.Particularly for those with advanced pathological stages,multiple comorbidities,insufficient disease understanding,severe negative cognitive processing,and weak painful disclosure ability,personalized psychological support and nursing interventions should be provided to improve their mental health and quality of life.

Abstract:Objective To explore the risk factors for cognitive dysfunction in patients with acute ischemic stroke(AIS)complicated with leukoaraiosis(LA).Methods The clinical data of 191 patients with AIS complicated with LA admitted to Puyang People's Hospital from January 2024 to June 2024 were retrospectively analyzed.The patients were divided into a cognitive impairment group(58 cases,with a Montreal cognitive assessment(MoCA)score<26)and a cognitive normal group(133 cases,with a MoCA score≥26)based on whether they had cognitive dysfunction.The baseline and clinical data of the two groups were compared,and multivariate Logistic regression analysis was used to explore the risk factors for cognitive dysfunction in patients with AIS complicated with LA.Results The age of the cognitive impairment group was higher than that of the cognitive normal group,and the National Institutes of Health stroke scale(NIHSS)score,serum homocysteine(Hcy)level,the proportions of history of stroke,history of diabetes,and history of coronary heart disease in the cognitive impairment group were higher than those in the cognitive normal group,while the MoCA score in the cognitive impairment group was lower than that in the cognitive normal group,the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that history of stroke,history of diabetes,NIHSS score,MoCA score,and Hcy were independent risk factors for cognitive dysfunction in patients with AIS complicated with LA(P<0.05).Conclusion History of stroke,history of diabetes,NIHSS score,MoCA score,and Hcy are independent risk factors for cognitive dysfunction in patients with AIS complicated with LA,and should be given due attention in clinical practice.

Abstract:Objective To explore the effect of the pre-prescription review system combined with prescription and medical order evaluation on the rational use of traditional Chinese medicine(TCM)injections.Methods A retrospective analysis was conducted on 748 TCM injection medical orders managed by conventional medication management from January 2023 to December 2023 and 1,629 TCM injection medical orders managed by the pre-prescription review system combined with prescription and medical order evaluation from January 2024 to December 2024 in the information system of Zhengzhou Jinshui District General Hospital.The usage of TCM injections,the rate of irrational use,the distribution of irrational use types,and the departmental distribution were compared between the two periods.Results The usage rate of TCM injections in 2024 was higher than that in 2023,the rate of irrational use of TCM injections was lower than that in 2023,and the rate of TCM injections with adverse interactions or contraindications was lower than that in 2023.However,the rate of inappropriate drug selection in 2024 was higher than that in 2023,and the differences were statistically significant(P<0.05).The departments with the highest proportion of irrational use of TCM injections in 2023 and 2024 were Geriatrics and Neurology 2,respectively,with proportions of 36.67%(11/30)and 21.05%(8/38).Conclusion The pre-prescription review system combined with prescription and medical order evaluation can reduce the rate of irrational use of TCM injections in clinical practice.

Abstract:Objective To explore the current situation of cognitive impairment in stroke patients in a community rehabilitation institution in Shenzhen and analyze the influencing factors,as well as to investigate the relationship between cognitive status,swallowing function,and nutritional status in these patients.Methods A total of 228 stroke patients who were hospitalized in the neurorehabilitation department of a community rehabilitation hospital in Shenzhen from May 2022 to October 2023 were selected as the research subjects.They were divided into a PSCI group(120 cases)and a non-PSCI group(108 cases)based on whether they had post-stroke cognitive impairment(PSCI).The clinical data and nutritional status of the two groups were compared.Binary Logistic regression was used to analyze the influencing factors of cognitive impairment in community stroke patients;Pearson correlation test was used to explore the correlation between cognitive impairment and nutritional status and swallowing function.Results A total of 228 stroke patients were included in this study,with a PSCI incidence rate of 52.6%.The results of univariate analysis showed that there were statistically significant differences in the proportions of different ages,stroke frequencies,exercise frequencies,whether tube feeding was used,whether dysphagia was used,and whether nutritional status was used between the two groups of patients(P<0.05).Multivariate logistic regression analysis revealed that malnutrition(β=1.216,OR=3.373,95%CI:1.015-11.211)and dysphagia(β=1.669,OR=5.307,95%CI:2.320-12.148)were independent risk factors affecting the cognitive function of stroke patients,while enteral feeding during hospitalization(β=-1.768,OR=0.171,95%CI:0.053-0.547)was a protective factor;Pearson correlation analysis showed that there was a significant positive correlation between cognitive function and dysphagia as well as nutritional status,and there was also a significant positive correlation between dysphagia and nutritional status(all r>0,P<0.001).Conclusion The incidence of PSCI in community stroke patients is relatively high,and there is a correlation among PSCI,dysphagia,and nutritional status.Therefore,multi-dimensional intervention strategies should be adopted for the treatment and rehabilitation of stroke patients to improve their overall health.

Abstract:Objective To explore the correlation between adiponectin(APN),interleukin-6(IL-6)and postoperative atrial fibrillation(AF)in patients with aortic stenosis after valve replacement.Methods The clinical data of 66 patients with aortic stenosis who underwent valve replacement in the department of cardiac surgery of Zhengzhou Central Hospital from March 2020 to February 2025 were retrospectively analyzed.The patients were divided into an occurrence group(45 cases)and a non-occurrence group(21 cases)based on whether they developed AF within 72 hours after surgery.The general data,preoperative serum APN and IL-6 levels of the two groups were compared,and the correlation between APN,IL-6 and postoperative AF in patients with aortic stenosis after valve replacement was analyzed.Results The left ventricular ejection fraction(LVEF)of the occurrence group was lower than that of the non-occurrence group,and the left atrial diameter(LAD)and left ventricular end-diastolic diameter(LVEDD)were longer than those of the non-occurrence group,with statistically significant differences(P<0.05).The level of serum APN of the occurrence group was lower than that of the non-occurrence group,and the level of serum IL-6 was higher than that of the non-occurrence group,with statistically significant differences(P<0.05).Logistic regression analysis showed that high levels of serum APN and high LVEF are protective factors for postoperative AF in patients(OR=0.370,0.697,P=0.035,0.049),while high levels of serum IL-6 are risk factors for postoperative atrial fibrillation in patients(OR=1.187,P=0.039).Conclusion APN and IL-6 are related to postoperative AF in patients with aortic stenosis after valve replacement.When serum APN is expressed at a low level and IL-6 is expressed at a high level,the risk of postoperative AF in patients increases significantly.

Abstract:Objective To explore the potential categories of health behavior autonomy in patients with cervical cancer and their influencing factors,and to provide targeted nursing implications for clinical practice to promote the development of health behavior autonomy and improve the quality of life of patients.Methods A cross-sectional survey was conducted among 230 patients with cervical cancer in the oncology department of Xuchang Central Hospital from August 2024 to May 2025.Data were collected using a general information questionnaire,the family support scale,the Fried frailty Phenotype,and the autonomy function index scale.Latent profile analysis was used to classify the health behavior autonomy of the patients,and multivariate logistic regression analysis was employed to explore the factors influencing the categories of health behavior autonomy.Results The health behavior autonomy of patients with cervical cancer could be classified into three potential categories:low health behavior autonomy group(29.57%),moderate health behavior autonomy group(40.00%),and high health behavior autonomy group(30.43%).Univariate analysis showed that age,educational level,per capita monthly family income,comorbidities,disease understanding,family support,and frailty were all influencing factors of health behavior autonomy categories in patients with cervical cancer,with statistically significant differences(P<0.05).Multivariate analysis indicated that educational level,comorbidities,disease understanding,family support,and frailty were all influencing factors of health behavior autonomy categories in patients with cervical cancer(P<0.05).Conclusion There are significant individual differences in health behavior autonomy among patients with cervical cancer.Clinical nurses should provide personalized nursing interventions based on these factors to enhance the health behavior autonomy of patients,improve their quality of life,and promote recovery.

Abstract:Objective To explore the predictive value of basal luteinizing hormone(LH),insulin-like growth factor-1(IGF-1),anti-Müllerian hormone(AMH),adiponectin(ADPN),and their combined detection for central precocious puberty(CPP)in girls.Methods A total of 120 girls with precocious puberty admitted to the First Affiliated Hospital of Henan University of Chinese Medicine from January 2022 to December 2024 were selected as the research subjects and divided into a CPP group(48 cases)and a peripheral precocious puberty(PPP)group(72 cases)based on the type of precocious puberty.The levels of serum AMH,ADPN,IGF-1,and basal LH were compared between the two groups.The correlation between basal serum LH,IGF-1,AMH,ADPN levels and CPP was analyzed by Spearman correlation analysis,and the predictive efficacy of each index and their combination was evaluated by receiver operating characteristic(ROC)curve.Results The levels of basal LH,IGF-1,and AMH in the CPP group were all higher than those in the PPP group,while the level of ADPN was lower,and the differences were statistically significant(P<0.05).Spearman correlation analysis showed that basal LH,IGF-1,and AMH levels were positively correlated with CPP(r>0,P<0.05),while ADPN level was negatively correlated with CPP(r<0,P<0.05).ROC curve analysis showed that the area under the curve(AUC)for the prediction of CPP using basal LH,IGF-1,AMH and ADPN was all greater than 0.7,among which the combined detection had the highest AUC(0.942).Conclusion Elevated basal serum LH,IGF-1,and AMH levels and decreased ADPN level are associated with CPP.Combined detection of basal LH,IGF-1,AMH,and ADPN has a high predictive value for CPP in girls.

Abstract:Objective To explore the expression of RSPO2,p53 and Ki-67 in esophageal squamous intraepithelial neoplasia(ESIN)and their clinical significance.Methods This study compared the immunohistochemical(IHC)expression of the new marker RSPO2 with p53 and Ki-67 in different types of esophageal squamous lesions and evaluated the correlation of their expression levels in these lesions.Results RSPO2 and Ki-67 had high sensitivity and specificity for the diagnosis of ESIN.The sensitivity of RSPO2 in differentiating high-grade intraepithelial neoplasia(HGESIN)from low-grade intraepithelial neoplasia(LGESIN)was as high as 97.92%,but the specificity was only 72.00%.Strong staining of RSPO2 had a specificity of 100.00%in differentiating HGESIN from LGESIN,but the sensitivity was as low as 29.17%.High expression of Ki-67 and p53 had a specificity of 96.00%in differentiating HGESIN from LGESIN,but the sensitivity decreased to 56.25%and 62.50%,respectively.Conclusion This study indicates that both RSPO2 and Ki-67 can be used for the differential diagnosis of ESIN.

Abstract:Objective By summarizing and analyzing the clinical characteristics of new adverse drug reactions(ADRs),to explore the nursing intervention measures for preventing new ADRs,and provide references for rational drug use and reducing the occurrence of ADRs in clinical practice.Methods A retrospective analysis was conducted on the data of 91 new ADR reports submitted by the zhengzhou Second People's Hospital to the National Adverse Drug Reaction Monitoring System from January 1,2023 to December 31,2024.The data included patients'age,gender,combined medication use,time of ADR occurrence,involved drugs,and patients'outcomes.Results Among the 91 new ADRs,56 were female(61.54%),and 35 were male(38.46%).The incidence was higher in those under 10 years old and those aged 30 to 59.There were 15 cases of combined medication use,including 11 cases of dual medication,3 cases of triple medication,and 1 case of quadruple medication.73.63%(67/91)of the ADRs occurred within 24 hours after administration.Doxycycline hydrochloride for injection had the highest number of new ADRs,with 7 cases(7.69%).Among the new ADRs,there were 13 cases of serious adverse drug reactions(SADRs),including 3 cases of central retinal artery occlusion caused by triamcinolone acetonide acetate injection.Among the new ADRs,28 cases had recovered,60 cases had improved,2 cases had not improved,and 1 case was unknown.Conclusion New ADRs are unpredictable and may lead to serious clinical consequences.Effective nursing interventions can effectively reduce the incidence of new ADRs and ensure medication safety.