Objective To investigate the MR findings of fetal cleft lip (CL) and evaluate the advantages and limitations of MRI in the diagnosis. Methods Twelve pregnant women suspicious of fetal CL/cleft palate(CP) on ultrasonography were enrolled in the study. The findings of ultrasonography, MRI and following-up were compared. Results MRI and ultrasonography detected 12 fetuses with CL/CP. The following-up results showed 1 case with incomplete cleft lip and the other 11 cases with complete cleft lips and cleft palates. MRI and unltrasonography were consistent with the follow-up in CL detection, showing completed or uncompleted soft tissue interruption of the fetal lips with amniotic fluid filling which is high signal on T_2WI. On MRI, CP showed discontinuous of the soft tissue which were interrupted by long T_2 signal and communicating with oral cavity and nasal cavity. MRI missed 1 case and excluded 1 case of CP. Ultrasonography predicted 5 case of CL, excluded 1 CP but missed 6 cases. The accuracy, sensitivity and specificity in detection CL/CP was 91.7% (11/12), 90.9% (10/11), 100% (1/1) for MRI and 50.0% (6/12),45.5% (5/11), 100% (1/1) for ultrasonography, respectively. Conclusion MR imaging had advantage over ultrasonography in detecting CP, MRI is an essential when CP is suspicious on ultrasonography.

Objective:To explore the effect of transitional nursing on medicine-taking compliance and insight of first hospitalized female schizophrenic patients.Methods:Seventy female cases who met ICD-10 diagnostic criteria that were discharged after stable treatment were randomly divided into intervention group and control group, 35 cases for each group.The medicine-taking compliance of the two groups was evaluated by the Morisky medication adherence scale, and the treatment effect was evaluated by the Insight and Treatment Attitude Questionnaire (ITAQ).The follow-up period was two months after discharge with four assessment points.Results:The Morisky scores in intervention group at the end of 1 week[ (4.7±1.2) vs. (4.0±0.8) ], 2 weeks[ (5.1±1.2) vs. (3.8±1.1) ], 1 month[ (5.1±1.5) vs. (3.5±1.2) ]and 2 months[ (5.8±1.2) vs. (3.3±1.0) ]were higher than those in control group (F=52.74, P＜0.001).The ITAQ scores in intervention group at the end of 1 week[ (3.4±2.1) vs. (2.9±1.4) ], 2 weeks[ (5.5±3.2) vs. (3.7±2.5) ], 1 month[ (4.6±2.7) vs. (4.5±2.7) ]and 2 months[ (6.9±3.4) vs. (3.9±2.6) ]were also higher than those in control group (F=7.12, P=0.010).Conclusion:Transitional nursing can improve the medicine-taking compliance and rehabilitation effect of first hospitalized female schizophrenic patients.

The concept and significance of readiness for hospital discharge, measuring tools, application status, shortcomings and prospects of readiness for hospital discharge among patients with chronic diseases were reviewed in this article, with attempts to draw more attention to the readiness for hospital discharge among patients with chronic diseases in clinical practice and provide theoretical basis for forming the intervention plan suitable for China.

Objective To understand the hospital discharge readiness and discharge instruction quality in chronic disease patients and to analyze the correlation between them. Methods Totals of 602 chronic disease patients of related departments from 7 ClassⅢGrade A hospitals in Shanghai were selected by convenience sampling. All of them were investigated with the general information questionnaire, Readiness for Hospital Discharge Scale (RHDS) and Quality of Discharge Teaching Scale (QDTS), and their data were analyzed. Results Among those patients, the scores of hospital discharge readiness and discharge instruction quality were (8.01±1.41) and (8.65±1.29) out of 10 respectively. The score of hospital discharge readiness had a positive correlation with the score of discharge instruction quality with a statistical difference (r=0.507, P＜ 0.01). Conclusions Hospital discharge readiness and discharge instruction quality of chronic disease patients are all in high levels and with a positive correlation. Nurses should enrich the content of discharge instruction to improve the quality of discharge instruction by appropriate instruction skills and to improve the hospital discharge readiness.

Objective:To observe the effects and safety of dienogest on the volume and symptoms of ovarian endometrioma (OMA).Methods:The clinical data of 75 patients with OMA who underwent treatment with dienogest (2 mg/day) at the First Affiliated Hospital of Nanjing Medical University from July 1st 2020 to March 31st 2024 were retrospectively analysed, mainly comparing the changes in the volume of OMA and the visual analogue scale (VAS) scores of endometriosis-related pain before and after the treatment, as well as observing the changes in the blood biological indicators, liver and kidney function, coagulation function and changes in breast.Results:The median cyst volumes of the OMA patients at 3, 6 and 12 months of dienogest treatment were 13.21 cm 3 (volume reduction rate: 36.00%), 8.33 cm 3 (volume reduction rate: 56.00%) and 4.10 cm 3 (volume reduction rate: 77.62%), respectively, which were all significantly decreased from the pre-treatment period (all P<0.05). The VAS scores of pain of the OMA patients at 3, 6 and 12 months of dienogest treatment all were 0 mm. Blood cancer antigen 125 (CA 125) and cancer antigen 19-9 (CA 19-9) levels decreased progressively during treatment (all P<0.05). There were no statistical differences in the coagulation indexes, liver and kidney function indexes of the patients during dienogest treatment compared with those before treatment (all P>0.05). During the follow-up period, there were a few patients with changes in the growth sites or lesion category of the breast nodules, but there were no occurrence of breast cancer or precancerous lesions. Conclusion:Dienogest is effective in reducing OMA volume and alleviating endometriosis-related pain with few adverse effects.

Mentalizing is the vital cognitive basis of understanding of action intention.However,there are few studies on the complex relationship of them.The present study,firstly,discusses the concepts and the brain mechanisms of empathy and understanding of action intention,indicating the temporal dynamic features of mentalizing as well as understanding of action intention.Secondly,based on Intention Processing Network,the process of mentalizing in understanding of action intention is in hierarchy and division.During which,ventral medial prefrontal lobe plays a vital role on integrating and transforming the cognitive and affective information.Empathy and mentalizing transform into each other through ventral medial prefrontal lobe.So empathy probably mediates the relationship of mentalizing and understanding of action intention.Empathy,mentalizing and understanding of action intention can be integrated under the framework of hybrid models.Future studies should examine the relationship between empathy and understanding of action intention by empirical researches.

Objective:To analyse the clinical significance of selective single embryo transfer by time-lapse mo-nitoring(TLM)or conventional morphology assessment(CMA)in vitro fertilization/intracytoplasmic sperm in-jection and embryo transfer(IVF/ICSI-ET),and to initially explore the predictive value of Raman spectral analy-sis of embryo culture medium for clinical pregnancy rate.Methods:The study is a prospective randomized con-trolled clinical trial.We assigned 139 patients treated with IVF/ICSI-ET in Reproductive and Genetics Center of Suzhou Municipal Hospital from April 2019 to July 2020,which were randomly assigned to either the CMA or the TLM group.We performed selective single-embryo transfer(fresh cycle and FET)after selecting the optimal em-bryos with TLM or CMA respectively.If the patient's first embryo transfer was unsuccessful,a second one would be performed to compare the differences in the cumulative live birth rate of embryo transfer and other pregnancy outcomes between the two groups.Meanwhile,we collected 15 μl of embryo culture medium at day 3 after IVF/ISCI fertilization for Raman spectroscopy analysis.Results:There were no differences in cumulative live birth,cu-mulative clinical pregnancy,cumulative premature birth,cumulative early spontaneous abortion,cumulative ectopic pregnancy and LGA or SGA between TLM and CMA groups(P＞0.05).The Neonatal sex ratio in the TLM group was lower than that in the CMA group,but the difference was not significant(P＞0.05).Raman spectros-copy analysis of embryo culture medium predicted the clinical pregnancy rate with 67.21％accuracy.Conclu-sions:In young women with a good ovarian reserve,the advantage of using TLM to evaluate embryos is not obvi-ous,so we should remain vigilant that embryo selection based on morphokinetic parameters may affect the sex ratio.Raman spectroscopic analysis of embryo culture medium is not yet able to effectively predict the planting ability of embryos.

Objective To investigate the clinical effect of transcatheter arterial chemoembolization (TACE) combined with microwave ablation (MWA) (TACE-MWA) versus repeat resection (RR) in the treatment of recurrent hepatocellular carcinoma (RHCC). Methods A total of 178 patients with RHCC who were admitted to The Second People's Hospital of Neijiang from June 2015 to September 2020 were enrolled, and according to the treatment modality, they were divided into RR group with 64 patients and TACE-MWA group with 114 patients. Baseline demographic data, liver function, and tumor conditions before treatment were recorded, and the patients were followed up to October 2021 to compare postoperative overall survival (OS) time and recurrence-free survival (RFS) time between the two groups. Subgroup analysis based on recurrence pattern (recurrence time and tumor size) was performed, and the influencing factors for prognosis were analyzed. The independent samples t -test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data; the Kaplan-Meier method was used for postoperative survival rate, the Log-rank test was used for survival difference analysis, and a multivariate Cox regression analysis was used to investigate independent risk factors for survival. Results The multivariate analysis showed that tumor diameter, alpha-fetoprotein (AFP) level, alanine aminotransferase, albumin, and time to recurrence were independent prognostic factors for OS (all P < 0.05), and AFP level and time to recurrence were independent prognostic factors for RFS (both P < 0.05). For RHCC with late recurrence (> 2 years), there were significant differences between the two groups in median OS (54.0 months vs 36.0 months, χ 2 =6.171, P =0.013) and median RFS (28.0 months vs 21.0 months, χ 2 = 5.211, P =0.022). For RHCC with a tumor diameter of ≤5 cm, there was a significant difference in median OS between the two groups (33.0 months vs 27.0 months, χ 2 =6.447, P =0.011). Conclusion RR has a similar clinical effect to TACE-MWA in RHCC with early recurrence or a tumor diameter of > 5 cm, but RR should be the first choice for RHCC with late recurrence or a tumor diameter of ≤5 cm.

Immunoglobulin (IgG) glycosylation affects the effector functions of IgG in a myriad of biological processes and has been closely associated with numerous autoimmune diseases, including systemic lupus erythematosus (SLE), thus underlining the pathogenic role of glycosylation aberration in autoimmunity. This study aims to explore the relationship between IgG sialylation patterns and lupus pregnancy. Relative to that in serum samples from the control cohort, IgG sialylation level was aberrantly downregulated in serum samples from the SLE cohort at four stages (from preconception to the third trimester of pregnancy) and was significantly associated with lupus activity and fetal loss during lupus pregnancy. The type I interferon signature of pregnant patients with SLE was negatively correlated with the level of IgG sialylation. The lack of sialylation dampened the ability of IgG to suppress the functions of plasmacytoid dendritic cells (pDCs). RNA-seq analysis further revealed that the expression of genes associated with the spleen tyrosine kinase (SYK) signaling pathway significantly differed between IgG- and deSia-IgG-treated pDCs. This finding was confirmed by the attenuation of the ability to phosphorylate SYK and BLNK in deSia-IgG. Finally, the coculture of pDCs isolated from pregnant patients with SLE with IgG/deSia-IgG demonstrated the sialylation-dependent anti-inflammatory function of IgG. Our findings suggested that IgG influences lupus activity through regulating pDCs function via the modulation of the SYK pathway in a sialic acid-dependent manner.
Humans ; Pregnancy ; Female ; Lupus Erythematosus, Systemic/pathology* ; Signal Transduction ; N-Acetylneuraminic Acid/metabolism* ; Immunoglobulin G ; Dendritic Cells/pathology*

We conducted a prospective study to assess the non-inferiority of adjuvant chemotherapy alone versus adjuvant concurrent chemoradiotherapy (CCRT) as an alternative strategy for patients with early-stage (FIGO 2009 stage IB-IIA) cervical cancer having risk factors after surgery. The condition was assessed in terms of prognosis, adverse effects, and quality of life. This randomized trial involved nine centers across China. Eligible patients were randomized to receive adjuvant chemotherapy or CCRT after surgery. The primary end-point was progression-free survival (PFS). From December 2012 to December 2014, 337 patients were subjected to randomization. Final analysis included 329 patients, including 165 in the adjuvant chemotherapy group and 164 in the adjuvant CCRT group. The median follow-up was 72.1 months. The three-year PFS rates were both 91.9%, and the five-year OS was 90.6% versus 90.0% in adjuvant chemotherapy and CCRT groups, respectively. No significant differences were observed in the PFS or OS between groups. The adjusted HR for PFS was 0.854 (95% confidence interval 0.415-1.757; P = 0.667) favoring adjuvant chemotherapy, excluding the predefined non-inferiority boundary of 1.9. The chemotherapy group showed a tendency toward good quality of life. In comparison with post-operative adjuvant CCRT, adjuvant chemotherapy treatment showed non-inferior efficacy in patients with early-stage cervical cancer having pathological risk factors. Adjuvant chemotherapy alone is a favorable alternative post-operative treatment.
Female ; Humans ; Uterine Cervical Neoplasms/drug therapy* ; Prospective Studies ; Quality of Life ; Neoplasm Staging ; Chemoradiotherapy ; Chemotherapy, Adjuvant/adverse effects* ; Adjuvants, Immunologic ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Retrospective Studies