rse effect when compared with tibolone.

Objective To explore the microsurgery methods in patients with early intracranial aneurysm rupture. Methods Sixty-seven patients with early intracranial aneurysm rupture received the emergency microsurgery after releasing cerebrospinal fluid from improved Paine point via pterion craniotomy. Thirty-nine patients received surgery within 1 d after intracranial aneurysm rupture, and the other 28 patients were within 1-3 d. Results The therapeutic effect was evaluated by Glasgow outcome score (GOS) at discharge. Among the 45 patients with Hunt-Hess Ⅰ-Ⅲ grade, cure was in 41 cases, improved in 4 cases. Among the 22 patients with Hunt-HessⅣ-Ⅴgrade, cure was in 6 cases, improved in 6 cases, moderate disability in 4 cases, severe disability in 1 case, and death was in 5 cases. Conclusions The microsurgery of clipping aneurysm directly via pterion approach is still by far the most reliable treatment. And releasing cerebrospinal fluid from improved Paine points can effectively reduce the acute brain swelling of early operation, which will make it an effective adjuvant therapy to emergency microsurgery of clipping aneurysm.

Objective:To compare the clinical efficacy of drug coated balloon (DCB) vs. plain old balloon (POB) on in-stent restenosis (ISR) of femoropopliteal artery occlusive disease of the lower limb. Methods:The clinical data of 91 ISR patients admitted at Shanxi Bethune Hospital from Jul 2016 to Dec 2017 were retrospectively analyzed. The primary patency rates were compared.Results:There were 43 patients treated with drug coated balloons and 48 patients treated with plain old balloons. The surgical procedure was successful in all cases, and the symptoms of lower limb ischemia were significantly improved after surgical procedure. The primary patency rate of patients who were treated by drug coated balloons was significantly higher than by plain old balloons at 12 months after surgery (83.7% vs. 62.5%, P<0.05). Conclusion:The use of drug coated balloons could acquire more satisfactory short-term clinical efficacy for ISR patients of femoropopliteal artery occlusive disease.

Objective:The aim of this study was to explore the relationship between nurses ′ work environment and menopausal symptoms. Methods:A multicenter, cross-sectional study was performed in Beijing, China, distributed to 2 194 registered nurses at 37 hospitals. Using a self-designed questionnaire included individual personal details, and the hospital working environment. Menopausal symptoms were evaluated using a modified Kupperman index (KMI) scoring system.Results:The average natural age at menopause stag was 47.64 years with 63.91% (1 328/2 078) nurses without menopausal symptoms. Logistic analysis showed that menopausal symptoms were co-dependently influenced by the following: to frequently contact with patient bodily fluids during your work ( P=0.037); be intimidated in your work ( P<0.01); to often or occasionally face death at work ( P=0.013 and P=0.002). Nurses suffered more stressful environment with high prevalence of menopausal symptoms. Conclusions:The mid-age nurses with menopausal symptoms were related with work environment. Managers should pay more attention to this problem.

Objective To assess effectiveness of ketogenic diet on improving polycystic ovary syndrome (PCOS) patients accompanying with overweight and obesity. Methods A total of 72 PCOS patients planned to recruit in our study from December 29, 2018 to June 2019 were selected, and were randomly divided into experimental group and control group. The control group was given routine treatment and suggestions of life style, while the experimental group carried out ketogenic diet intervention alone for three months. All patients were followed up every day and rechecked monthly. The safety and effectiveness indexes of the two groups were observed. Results A total of fifty patients had been recruited until March 30, 2019, but one patient was lost in the follow-up. As a result, there were totally twenty-five patients in the experimental group with one patient lost in follow-up. In the remaining twenty-four patients, 75％ of these patients had recovered spontaneous menstruation in good condition. Ten patients who have been intervened over one month accepted the first re-examination. The results showed that the patient's weight, the body fat rate and the level of androgen detected in venous blood were all reduced after ketogenic diet after the intervention (P ＜ 0. 01), which revealed that the effect of ketogenic diet's intervention for PCOS was significant in the short term. Conclusion Ketogenic diet intervene in PCOS effectively restore spontaneous menstruation in patients for one month, the state of hyperandrogenism is significantly improved. Other hormones show improvement trends, but no significant difference compared with baseline. The mid-term and final reports of KIDs-001 are worthy of the wait.

Objective To assess effectiveness of ketogenic diet on improving polycystic ovary syndrome (PCOS) patients accompanying with overweight and obesity. Methods A total of 72 PCOS patients planned to recruit in our study from December 29, 2018 to June 2019 were selected, and were randomly divided into experimental group and control group. The control group was given routine treatment and suggestions of life style, while the experimental group carried out ketogenic diet intervention alone for three months. All patients were followed up every day and rechecked monthly. The safety and effectiveness indexes of the two groups were observed. Results A total of fifty patients had been recruited until March 30, 2019, but one patient was lost in the follow-up. As a result, there were totally twenty-five patients in the experimental group with one patient lost in follow-up. In the remaining twenty-four patients, 75％ of these patients had recovered spontaneous menstruation in good condition. Ten patients who have been intervened over one month accepted the first re-examination. The results showed that the patient's weight, the body fat rate and the level of androgen detected in venous blood were all reduced after ketogenic diet after the intervention (P ＜ 0. 01), which revealed that the effect of ketogenic diet's intervention for PCOS was significant in the short term. Conclusion Ketogenic diet intervene in PCOS effectively restore spontaneous menstruation in patients for one month, the state of hyperandrogenism is significantly improved. Other hormones show improvement trends, but no significant difference compared with baseline. The mid-term and final reports of KIDs-001 are worthy of the wait.

Objective:To explore the application effect of the milestone evaluation system based on ACGME core competencies in the standardized training of residents in the department of rheumatology and immunology.Methods:A modified Milestone Evaluation Scale was developed for the department of rheumatology and immunology. Self evaluation and mentor evaluation were conducted on 150 residents who received standardized training in grades 1-3 before May 2023. The results were collected and statistically analyzed. One-way analysis of variance and t-test were performed using SPSS 27.0. Results:The self-evaluation and mentor evaluation scores of all residents increased with the training years. Self-evaluation scores were significantly higher than mentor evaluation scores ( P<0.05) for the medical knowledge ( t=2.95, P=0.006), diagnosis and treatment ability ( t=2.57, P=0.015), and learning ability ( t=2.67, P=0.015) of grade 2 residents and the learning ability ( t=2.87, P=0.007) of grade 3 residents. There were no significant differences in the baseline score and ability improvement of residents from different institutions ( P>0.05). Conclusions:The milestone evaluation system is an effective tool for training, assessing, and providing feedback to residents in rheumatology and immunology, and provides essential feedback to resident training bases regarding the training effectiveness. The method is worth promoting.

Objective:To understand the spatial distribution of mushroom poisoning in Hunan Province and its influential factors,and to provide the evidence for control of the mushroom poisoning.Methods:The surveillance data for mushroom poisoning cases from 122 counties in Hunan Province in 2015 were collected.Based on geographical information system database,spatial autocorrelation analysis and spatial regression analysis (via OpenGeoDa) was conducted.Results:The incidence of mushroom poisoning in Hunan Province in 2015 was 2.94/100 000.Global Moran's I values was 0.315 (P＜0.05).Local spatial autocorrelation analysis indicated that Ningxiang,Xiangtan,Shaoyang,Lingling,Jiahe,and Linwu districts et al were "positive hotspot" regions.Guzhang,Hecheng,Dingcheng,Yueyang districts et al were "negative hotspot" regions.Spatial regression analysis revealed that the reported incidence of mushroom poisoning was positively correlated with the annual average temperate (Z=2.145,P=0.032),the number of health care institutions per capita (Z=2.352,P=0.019),and the number of students enrollment in secondary schools (Z=4.309,P＜0.001).It was negatively associated with the number of school staff and workers of secondary schools (Z=-2.626,P=0.009).Conclusion:The spatial distribution of mushroom poisoning cases in Hunan Province in 2015 is highly clustered.Mushroom poisoning cases are more prevalent in the middle and southern regions and less prevalent in the northern areas of the province.The annual average temperate and the number of students enrollment in secondary schools demonstrate a certain positive influence on the distribution of mushroom poisoning in Hunan.

Objective:To evaluate the impact of self-crosslinked hyaluronic acid (SCH) gel on endometrium recovery after artificial abortion.Methods:A multicenter, prospective randomized controlled trial was conducted across 18 hospitals from December 2021 to February 2023, involving 382 women who underwent artificial abortion. Participants were randomly allocated to receive either treatment with SCH gel (SCH group) or no treatment (control group) in a 1∶1 ratio. The primary outcome was endometrium thickness in 14 to 18 days after the first postoperative menstruation. Secondary outcomes included changes in menstrual volume during the first postoperative menstruation, menstruation resumption within 6 postoperative weeks, time to menstruation resumption, duration of the first postoperative menstruation, and incidence of dysmenorrhea.Results:Baseline characteristics of participants were comparable between the two groups (all P>0.05), with 95.3% (182/191) in SCH group and 92.7% (177/191) in the control group completed the study. The postoperative endometrial thickness in SCH group was significantly greater than that in the control group [(9.78±3.15) vs (8.95±2.32) mm; P=0.005]. SCH group also had significantly fewer participants with reduced menstrual volume [23 cases (12.6%, 23/182) vs 31 cases (17.5%, 31/177); P=0.038]. Although SCH group experienced less dysmenorrhea during the first postoperative menstrual period, this difference was not statistically significant [28.5% (51/179) vs 37.1% (65/175); P=0.083]. Outcomes were similar between SCH group and the control group regarding the proportion of participants who resumed menstruation within 6 weeks postoperatively, time to menstruation resumption, and duration of the first postoperative menstruation ( P=0.792, 0.485, and 0.254, respectively). No serious adverse events were observed during the study period, and no adverse events were attributed to SCH gel treatment. Conclusion:The application of SCH gel after artificial abortion is safe and might aid in the recovery of the endometrium.

Objective To investigate the mechanism and protective effect of Humanin(HN)on rotenone(Rot)-induced toxic damage for dopamine neurons.Methods The Rot-poisened PC12 cell model was constructed,and the control group,the Rot poisening group,the HN pretreated Rot poisening group,and the HN treatment group were set up.ELISA was used to detect the content of HN inside and outside of Rot-infected cells,CCK-8 assay was used to detect cell viability,and ATP detection kit was used to detect the intracellular ATP content.Dichloro-dihydro-fluorescein diacetate(DCFH-DA)assay was used to detect the level of reactive oxygen species(ROS)in cells.Western blotting was performed to detect the expression level of mitochondrial autophagy regulatory proteins Pink1,Parkin,p62,LC3,mitochondrial biogenesis regulatory protein PGC1α,division/fusion regulatory proteins OPA1,MFN2,DRP1,p-DRP1 and antioxidant stress regulatory proteins Keap1 and Nrf2.HBAD-mcherry-EGFP-LC3 adenovirus transfected cells was used to observed the number of autophagosomes and autophagolysosomes.Results The results showed that the intracellular concentration of HN in PC12 in the Rot poisening group was significantly higher than that in the control group(P＜0.05);Compared with the control group,the Rot poisening group had significantly decreased activity of PC12 cells,decreased ATP content and increased production of ROS.After the poisen of Rot in PC12 cells,the expression of Pink1 and p-Parkin,the ratio of LC3Ⅱ/LC3Ⅰ and the expression of p-DRP1 in mitochondrial fusion protein was increased,while the expression of p62,the expression of mitochondrial biogenesis protein PGC1 α,mitochondrial fusion proteins MFN2 and OPA1,and antioxidant stress proteins Keap1 and Nrf2 were decreased(all P＜0.05).The number of autophagosomes and autophagolysosomes in PC12 cells in the Rot poisening group was higher than that in the control group(P＜0.05),and HN pretreatment(20 μmol/L)could significantly improve the changes mentioned above caused by Rot poisening(P＜0.05).Conclusion HN ameliorates Rot-induced toxic damage for dopamine neurons by inhibiting mitophagy and mitochondrial division and promoting mitochondrial biogenesis and fusion,and anti-oxidative stress.