Objective To investigate the clinical efficacy and safety between laparoscopic and transabdomi -nal hysterectomy ,reduce the occurrence of complications measures .Methods On 154 cases of hysterectomy indica-tions were nonrandomly divided into two groups ,one group for the observation group of 79 cases of laparoscopic opera-tion,another group was control group of 75 patients with transabdominal operation;two groups had no significant differ-ence in age and disease .The clinical effect ,postoperative complications and safety between the two groups during and after operations were observed .Results The operation time of the laparoscopic group (72.0 ±13.2) min was signifi-cantly shorter than that of the control group (98.0 ±20.7)min (t=3.396,P=0.021);The bleeding quantity of the laparoscopic group(96.0 ±75.4)mL was significantly shorter than that of the control group (159.4 ±98.0)mL(t=9.680,P=0.014);The aerofluxus time of the laparoscopic group (17.2 ±4.2) h was significantly shorter than that of the control group(28.6 ±6.1)h(t=9.760,P=0.013).The average postoperative hospital stay time was significantly shorter in laparoscopic group(5.2 ±1.9)d than those in abdominal group(9.5 ±3.2)d (t=-5.025,P=0.018). The analgesic used in the laparoscopic group (3/89)was significantly shorter than that in the control group (48/78) (t=-8.820,P=0.000).Conclusion Laparoscopic hysterectomy is safe and effective .It is worth to promote in clinical,while improving the operation skills is the key to reduce the complications .

Objective To explore the value of laparoscopy in the treatment of ovarian cyst.Methods The clinical datas of 48 cases with laparoscopic surgery were retrospectively analyzed,its safety and possibility were explored.Results Forty-eight patients with ovarian cyst underwent laparoscopic oophorocystectomy.The average blood loss during operation was 80ml,the mean operation was 55 minutes,the mean hospitalization was 4 days.No one converted to open prodecure,no visceral injured,no chemical peritonitis occurred.Conclusion If the indications are well selected,laparoscopic operation is feasible and safe in treating most ovarian cysts.It may be a kind of ideal type of treatment for the clinic to choose.

Objective To predict the biological process and signaling pathways in which hsa-miR-1908 might be in-volved by a series of bioinformatics analysis, so as to lay foundations and provide theoretical basis for the further studies of hsa-miR-1908 biological function in human preadipocytes. Methods The sequence of hsa-miR-1908 was acquired from miR-Base database, and target genes of hsa-miR-1908 were predicted by miRanda, and then the intersection of the results and the results of gene-chip as gene set were further analyzed by gene ontology and pathway enrichment. Results The hsa-miR-1908 had some conserved property among different species. The functions of the target genes were enriched in Wnt receptor signal-ing pathway through beta-catenin, cell cycle, cell apeptosis and other biological processes. The GnRH signaling, MAPK sig-naling, insulin signaling, cell cycle signal transduction pathways and signaling pathway in pancreatic cancer were signiifcantly enriched. Conclusions The target genes set of hsa-miR-1908 were enriched in multiple biological process which are related with the obesity. This study provides guidance for the further study in human preadipocytes.

Objective:To investigate the pain level of lumbar puncture and family anxiety of hospitalized children, and analyze the influencing factors of family anxiety.Methods:A multi-center cross-sectional survey was used to enroll 190 children and their families who underwent lumbar puncture in 4 hospitals of Jiangsu Province from July 2018 to December 2019. The FLACC scale and face pain scale (WONG-BAKER scale) were adopted. The visual analogue scale (VAS) was used to investigate the pain level, and the anxiety state-trait questionnaire (STAI) was used to investigate the anxiety level.Results:The pain level scores before and after lumbar puncture were (2.86 ± 1.08) and (6.24 ± 1.59) scores respectively, and the difference was statistically significant ( t = 24.241, P<0.001). The total anxiety level of the children′s family members was (73.78 ± 4.67) scores, which was affected by factors such as the pain score, the age of the child, the number of lumbar punctures, the success rate of a lumbar puncture, the level of the hospital, the family status, and the education level of the family (adjusted R2 = 0.574, F = 29.784, P = 0.001). Conclusions:The pain in children is at a high level, and the anxiety level of their family members is also at a high level and is affected by many factors. Clinical medical staff can stratify the children and their families, and adopt targeted methods to relieve the pain of the children and the anxiety of the family members and promote the smooth development of the lumbar puncture.

Objective: To investigate the epidemiological characteristics of varicella outbreaks in primary and middle schools, and to establish a risk predictive model, so as to provide scientific guidance for the prevention of varicella outbreaks in schools. Methods: Based on a nested case-control study, primary and middle schools in 4 districts of Shanghai (Yangpu District and Jingan District) and Hangzhou (Xiaoshan District and Linping District) from January to December 2023 were selected to observe the status of varicella outbreaks. Associated factors of varicella outbreaks were investigated and used for establishing the predictive model, which was evaluated by the Hosmer-Lemeshow(H-L) goodness of fit test, receiver operating characteristic (ROC) curve, Calibration curve, decision curve analysis (DCA). Results: A total of 98 varicella outbreaks were included, with 195 schools without varicella outbreaks during the same period as controls. Eight factors, including the availability of warm water in restroom, availability of hand soap in restroom, average class size, duration of student attendance at school per day, presence of a fulltime school doctor, hesitancy of the school principal towards varicella vaccination, and rates of first and second doses of varicella vaccination, were identified as potential factors for school varicella outbreaks, with statistically significant differences (χ2/Z=10.01, 20.49, 17.43, 9.74, 32.17, 6.60, 2.20, 3.39, P<0.05). The 8 variables above were employed to construct a risk predictive model, and Hosmer-Lemeshow goodness of fit test yielded a χ2 value of 5.863 (P>0.05); the area under the ROC curve (AUC) was 0.846 (95%CI=0.799-0.893); Calibration curve analysis indicated good consistency between predicted and actual values of the model. DCA demonstrated favorable predictive performance of the model over a wide range. Conclusions The predictive model for school varicella outbreaks demonstrates satisfactory accuracy and efficacy. It suggested to make good use of this prediction model and take relevant measures to reduce the risk of varicella transmission in schools.

Background Sleep disturbances in children and adolescents have become a global public health concern,with pronounced issues in the Western China.Despite this,research on the prevalence of insomnia and its influencing factors among children and adolescents in Chongqing is still lacking.Objective To understand the prevalence of insomnia and analyze its influencing factors among children and adolescents in Chongqing,so as to provide references for clinical interventions and preventive strategies of insomnia.Methods A stratified random sampling method was used to select 9 969 children and adolescents in Chongqing from November to December 2021.Insomnia Severity Index(ISI)and a self-designed questionnaire on awareness of core mental health knowledge were administered.Binary Logistic regression analysis was used to identify the influencing factors of insomnia in this population.Results A total of 3 578 children and adolescents(35.89％)were found to have insomnia symptoms.There were statistically significant differences in the detection of insomnia symptoms among gender,ethnicity,education level,domicile,only-child status,parental education level,introversion/extroversion,parental relationship,average monthly per capita income,family history of mental illness,medical insurance coverage,living situation and understanding of mental health knowledge(P<0.05 or 0.01).Binary Logistic regression analysis identified several risk factors for insomnia,including female gender(OR=1.301,95％CI:1.192～1.419),ethnic minority status(OR=1.163,95％CI:1.015～1.333),junior high school for education level(OR=1.985,95％CI:1.774～2.220),senior high school for education level(OR=3.085,95％CI:2.749～3.462),non-only-child status(OR=1.127,95％CI:1.013～1.253),degree of harmony between parents is not high or not harmonious[(OR=1.846,95％CI:1.669～2.041 for relatively harmonious;OR=2.524,95％CI:2.214～2.877 for generally harmonious;OR=2.452,95％CI:1.999～3.007 for not very harmonious;OR=2.926,95％CI:2.307～3.710 for very discordant)]and incomplete medical insurance coverage(OR=1.218,95％CI:1.093～1.358).Protective factors included an extroverted personality(OR=0.838,95％CI:0.766～0.917),absence of family history of mental illness(OR=0.719,95％CI:0.549～0.941),junior high school for mother's education level(OR=0.822,95％CI:0.734～0.920),senior high school or secondary specialized school for mother's education level(OR=0.862,95％CI:0.752～0.988),college and above for mother's education level(OR=0.748,95％CI:0.633～0.884)and knowledge of mental health(OR=0.854,95％CI:0.778～0.937).Conclusion The problem of insomnia among children and adolescents in Chongqing is quite serious.Risk factors for insomnia include female gender,ethnic minority status,higher education levels,being a non-only child,poor family relationships and incomplete medical insurance.Conversely,an extroverted personality,absence of family history of mental illness,higher maternal education and knowledge of mental health serve as protective factors against insomnia.

To investigate the knowledge regarding clinical research among children at 8-18 years of age. The survey results will form the basis for developing public education program for this population. Methods The survey was conducted among children at 8-18 years of age using WeChat and spot investigation between January 2016 and January 2017. According to different developmental stages, the survey population was divided into four groups: age 8-10, 11-13, 14-15 and 16-18 years. The level of knowledge regarding clinical research was analyzed. Results Totally 1 329 questionnaires were issued and 1 233 effective questionnaires were returned with a recovery rate of 92.8%. The overall awareness rate regarding clinical research was 32.8% (405/1 233). It revealed that 282 (22.9%) individuals thought that clinical research was to treat people like experimental rats. When asked"who have the final decision on research participation", the percentages of those who chose oneself, parents or guardian and doctor were 44.6% (550/1 233), 74.2% (915/1 233) and 36.8% (454/1 233) respectively. When asked "If you want to participate a study, but your parents or guardian do not agree, what would you do?", 33.9% (418/1 233) of individuals will "give up". As to "If you do not want to participate a study, but your parents or guardian think you should, what would you do? ", 51.3% (632/1 233) chose"listen to parents" and 28.8% (355/1 233) chose"refuse the suggestions of parents or guardian". As to "what are your greatest concerns of participating an investigation?", 68.1% (840/1 233) chose"worry about added pain or discomfort". But 58.0%(715/1 233) thought if"doctors and nurses take good care of me"their "concerns will reduce" or "feel better to participate in the research? ". 55.6% (686/1 233) and 49.3% (608/1 233) individuals responded that they will"participate in an research? "when they"know that other people also participate the research" and when they"know the details regarding what will happen after the enrollment". Conclusions The knowledge level of clinical research among children aged 8-18 years were not high. It is very necessary to promote the public education of clinical research for this population and also very necessary to address their concern regarding the research.

To assess the positive predictive value (PPV) of extended noninvasive prenatal testing (NIPT-plus) for fetal chromosomal abnormalities. This retrospective research enrolled 511 cases of pregnant women with positive NIPT-plus results at the Obstetrics and Gynecology Hospital of Fudan University from May 2017 to January 2021. Karyotype analysis and chromosome microarray analysis (CMA) techniques was applied for verification. All cases were followed to determine their pregnancy outcome. The Chi-square test was used in PPV. 63 out of 511 refused prenatal diagnosis after counseling, 448 pregnant women with prenatal diagnosis showed that the PPVs of NIPT-plus test for fetal trisomy 21, 18 and 13 (T21, T18, T13), sex chromosome aneuploidy (SCAs) and chromosome microdeletion/microduplication syndrome (MMS) were 86.0% (92/107), 79.5% (35/44), 54.5% (12/22), 39.5% (75/190), and 41.7% (30/72), respectively. The results revealed that the PPV was higher among older pregnant women compared to young pregnant women (77.8% vs. 51.9%, P<0.01). With increasing maternal age, the PPV of NIPT-plus presented increasing trends for T21, T13, and composite PPV except for T18 or SCAs. In addition, the termination rates for confirmed SCAs fetal karyotypes 45, X; 47, XXX; 47, XXY and 47, XYY were 11/11, 3/15, 91.7% (22/24) and 1/14, respectively. NIPT-plus can safely and effectively detect fetal chromosomal abnormalities and can be extended to MMS screening, significantly reducing the proportion of interventional prenatal diagnoses, and those with positive screening still require further confirmation.

To assess the positive predictive value (PPV) of extended noninvasive prenatal testing (NIPT-plus) for fetal chromosomal abnormalities. This retrospective research enrolled 511 cases of pregnant women with positive NIPT-plus results at the Obstetrics and Gynecology Hospital of Fudan University from May 2017 to January 2021. Karyotype analysis and chromosome microarray analysis (CMA) techniques was applied for verification. All cases were followed to determine their pregnancy outcome. The Chi-square test was used in PPV. 63 out of 511 refused prenatal diagnosis after counseling, 448 pregnant women with prenatal diagnosis showed that the PPVs of NIPT-plus test for fetal trisomy 21, 18 and 13 (T21, T18, T13), sex chromosome aneuploidy (SCAs) and chromosome microdeletion/microduplication syndrome (MMS) were 86.0% (92/107), 79.5% (35/44), 54.5% (12/22), 39.5% (75/190), and 41.7% (30/72), respectively. The results revealed that the PPV was higher among older pregnant women compared to young pregnant women (77.8% vs. 51.9%, P<0.01). With increasing maternal age, the PPV of NIPT-plus presented increasing trends for T21, T13, and composite PPV except for T18 or SCAs. In addition, the termination rates for confirmed SCAs fetal karyotypes 45, X; 47, XXX; 47, XXY and 47, XYY were 11/11, 3/15, 91.7% (22/24) and 1/14, respectively. NIPT-plus can safely and effectively detect fetal chromosomal abnormalities and can be extended to MMS screening, significantly reducing the proportion of interventional prenatal diagnoses, and those with positive screening still require further confirmation.

Objective To explore the effects of rural family nursing intervention on psychological status of patients with cerebral apoplexy hemiplegia.Methods This community area was randomly divided into the intervention group and the control group, and 42 stroke patients with hemiplegia were randomly selected in each group. Patients in the intervention group were given family rehabilitation nursing intervention for 12 months by community nurses who received training and evaluation, while patients in the control group received original care mode, regular blood pressure measure, and routine follow up. Patients' psychological status before and after intervention were investigated.Results After 12 months' family rehabilitation nursing intervention, the psychological status of patients in the intervention group was significantly improved, and the differences between two groups were statistically significant (P<0.01).Conclusions Rural family rehabilitation nursing intervention can significantly improve the psychological status of patients with stroke, promote patients' recovery, and improve the quality of life of patients.