Objective To investigate the relationship between serum nesfatin-1(NSF-1)and soluble tumor necrosis factor receptor-Ⅰ(sTNFR-Ⅰ)with premature rupture of membrane(PROM)in patients with severe preeclampsia(SPE),and their effects on pregnancy outcomes.Methods A total of 84 patients diagnosed with SPE in the Obstetrics Department of The First Affiliated Hospital of Nanyang Medical College from April 2023 to April 2024 were selected and grouped into the PROM and non-PROM groups based on whether they had PROM.The pregnant women were separated into good and poor pregnancy groups based on their pregnancy outcomes.Logistic regres-sion analysis was performed to assess the factors influencing PROM in patients with SPE and adverse pregnancy outcomes in patients with PROM.Receiver operating characteristic(ROC)curves were plotted to analyze the value of serum NSF-1 and sTNFR-Ⅰ in the evaluation and prediction of PROM in patients with SPE,as well as adverse pregnancy outcomes in patients with PROM.Results Serum levels of NSF-1 and sTNFR-Ⅰ were significantly higher in the study group than in the control group(P＜0.05).In addition,serum levels of NSF-1 and sTNFR-Ⅰ were significantly higher in the PROM group than in the non-PROM group(P＜0.05).Logistic regression analysis showed that NSF-1 and sTNFR-Ⅰ were risk factors for PROM in patients with SPE(P＜0.05).Based on the ROC curve,the area under the ROC curve(AUC)of serum NSF-1 and sTNFR-Ⅰ levels combined to assess PROM in patients with SPE was 0.887,and the combination of the two was superior to their respective individual predictions(Z=2.601,Z=2.585,both P＜0.05).Serum levels of NSF-1 and sTNFR-Ⅰ in the poor pregnancy group were significantly higher than those in the good pregnancy group(P＜0.05).Logistic regression analysis showed that NSF-1 and sTNFR-Ⅰ levels were risk factors for adverse pregnancy outcomes in patients with PROM(P＜0.05).Based on the ROC curve,the AUC of the combination of serum NSF-1 and sTNFR-Ⅰ for predicting adverse pregnancy outcomes in patients with PROM was 0.908,and the combination of the two was better than their respective individual predictions(Z=2.534,Z=2.556,both P＜0.05).Conclusion Serum levels of NSF-1 and sTNFR-Ⅰ were significantly increased in patients with SPE,and both were related to PROM.Elevated levels of both proteins can increase the risk of adverse pregnancy outcomes.

Objective To investigate the relationship between serum nesfatin-1(NSF-1)and soluble tumor necrosis factor receptor-Ⅰ(sTNFR-Ⅰ)with premature rupture of membrane(PROM)in patients with severe preeclampsia(SPE),and their effects on pregnancy outcomes.Methods A total of 84 patients diagnosed with SPE in the Obstetrics Department of The First Affiliated Hospital of Nanyang Medical College from April 2023 to April 2024 were selected and grouped into the PROM and non-PROM groups based on whether they had PROM.The pregnant women were separated into good and poor pregnancy groups based on their pregnancy outcomes.Logistic regres-sion analysis was performed to assess the factors influencing PROM in patients with SPE and adverse pregnancy outcomes in patients with PROM.Receiver operating characteristic(ROC)curves were plotted to analyze the value of serum NSF-1 and sTNFR-Ⅰ in the evaluation and prediction of PROM in patients with SPE,as well as adverse pregnancy outcomes in patients with PROM.Results Serum levels of NSF-1 and sTNFR-Ⅰ were significantly higher in the study group than in the control group(P＜0.05).In addition,serum levels of NSF-1 and sTNFR-Ⅰ were significantly higher in the PROM group than in the non-PROM group(P＜0.05).Logistic regression analysis showed that NSF-1 and sTNFR-Ⅰ were risk factors for PROM in patients with SPE(P＜0.05).Based on the ROC curve,the area under the ROC curve(AUC)of serum NSF-1 and sTNFR-Ⅰ levels combined to assess PROM in patients with SPE was 0.887,and the combination of the two was superior to their respective individual predictions(Z=2.601,Z=2.585,both P＜0.05).Serum levels of NSF-1 and sTNFR-Ⅰ in the poor pregnancy group were significantly higher than those in the good pregnancy group(P＜0.05).Logistic regression analysis showed that NSF-1 and sTNFR-Ⅰ levels were risk factors for adverse pregnancy outcomes in patients with PROM(P＜0.05).Based on the ROC curve,the AUC of the combination of serum NSF-1 and sTNFR-Ⅰ for predicting adverse pregnancy outcomes in patients with PROM was 0.908,and the combination of the two was better than their respective individual predictions(Z=2.534,Z=2.556,both P＜0.05).Conclusion Serum levels of NSF-1 and sTNFR-Ⅰ were significantly increased in patients with SPE,and both were related to PROM.Elevated levels of both proteins can increase the risk of adverse pregnancy outcomes.

The minor purchasing process and mode of some hospital were introduced,and the implementation of the hospital's minor purchasing projects in the past year was analyzed.The causes for high failure rate of purchasing were pointed out including long interval between project creation and procurement,unreasonable demand presentation,insufficient demand demonstration and lack of active participation of suppliers.Some suggestions were put forward such as timely adjustment of demands,strengthening of demand demonstration,improvement of supplier motivation and enhancement of procurement process management,which were of great significance for increasing the success rate of minor purchasing of the hospital.[Chinese Medical Equipment Journal,2025,46(8):91-95]

Background: s/Aims: Non-invasive models stratifying clinically significant portal hypertension (CSPH) are limited. Herein, we developed a new non-invasive model for predicting CSPH in patients with compensated cirrhosis and investigated whether carvedilol can prevent hepatic decompensation in patients with high-risk CSPH stratified using the new model. Methods: Non-invasive risk factors of CSPH were identified via systematic review and meta-analysis of studies involving patients with hepatic venous pressure gradient (HVPG). A new non-invasive model was validated for various performance aspects in three cohorts, i.e., a multicenter HVPG cohort, a follow-up cohort, and a carvediloltreating cohort. Results: In the meta-analysis with six studies (n=819), liver stiffness measurement and platelet count were identified as independent risk factors for CSPH and were used to develop the new “CSPH risk” model. In the HVPG cohort (n=151), the new model accurately predicted CSPH with cutoff values of 0 and –0.68 for ruling in and out CSPH, respectively. In the follow-up cohort (n=1,102), the cumulative incidences of decompensation events significantly differed using the cutoff values of <–0.68 (low-risk), –0.68 to 0 (medium-risk), and >0 (high-risk). In the carvediloltreated cohort, patients with high-risk CSPH treated with carvedilol (n=81) had lower rates of decompensation events than non-selective beta-blockers untreated patients with high-risk CSPH (n=613 before propensity score matching [PSM], n=162 after PSM). Conclusions Treatment with carvedilol significantly reduces the risk of hepatic decompensation in patients with high-risk CSPH stratified by the new model.

Background: Delivering a poor prognosis to patients and their families is critically challenging in pediatric populations. The application of palliative care (PC) provides a bridge between accepting the occurrence of mortality and offering lifelong support.However, little is known about the specifics of PC. This study aims to explore the unmet need for PC in pediatric populations. Methods: We retrospectively reviewed the medical records of mortality cases in the Department of Pediatric Hematology and Oncology at Chang Gung Memorial Hospital. Statistical tests, including Chi-square and Student’s t-tests, were applied to determine the differences between early and late intervention groups in terms of the timing of PC introduction. Results: During the study period, 41 patients were included. Their median age was 11.8 years (IQR, 7.6-15.9). The majority of the disease statuses were refractory or relapsing (R/R). The incidence of memento application was significantly higher in the early intervention group (47.6% vs. 10%, P=0.0081). Vital signs variations tended to be end-of-life (EoL) indicators in this study. Conclusion The early introduction of PC encourages families to accompany their beloved child. EoL signs in the pediatric population include vital sign variations. With the presence of relevant EoL signs, clinical physicians can apply PC earlier to meet the needs.

Background: Delivering a poor prognosis to patients and their families is critically challenging in pediatric populations. The application of palliative care (PC) provides a bridge between accepting the occurrence of mortality and offering lifelong support.However, little is known about the specifics of PC. This study aims to explore the unmet need for PC in pediatric populations. Methods: We retrospectively reviewed the medical records of mortality cases in the Department of Pediatric Hematology and Oncology at Chang Gung Memorial Hospital. Statistical tests, including Chi-square and Student’s t-tests, were applied to determine the differences between early and late intervention groups in terms of the timing of PC introduction. Results: During the study period, 41 patients were included. Their median age was 11.8 years (IQR, 7.6-15.9). The majority of the disease statuses were refractory or relapsing (R/R). The incidence of memento application was significantly higher in the early intervention group (47.6% vs. 10%, P=0.0081). Vital signs variations tended to be end-of-life (EoL) indicators in this study. Conclusion The early introduction of PC encourages families to accompany their beloved child. EoL signs in the pediatric population include vital sign variations. With the presence of relevant EoL signs, clinical physicians can apply PC earlier to meet the needs.

Background: Delivering a poor prognosis to patients and their families is critically challenging in pediatric populations. The application of palliative care (PC) provides a bridge between accepting the occurrence of mortality and offering lifelong support.However, little is known about the specifics of PC. This study aims to explore the unmet need for PC in pediatric populations. Methods: We retrospectively reviewed the medical records of mortality cases in the Department of Pediatric Hematology and Oncology at Chang Gung Memorial Hospital. Statistical tests, including Chi-square and Student’s t-tests, were applied to determine the differences between early and late intervention groups in terms of the timing of PC introduction. Results: During the study period, 41 patients were included. Their median age was 11.8 years (IQR, 7.6-15.9). The majority of the disease statuses were refractory or relapsing (R/R). The incidence of memento application was significantly higher in the early intervention group (47.6% vs. 10%, P=0.0081). Vital signs variations tended to be end-of-life (EoL) indicators in this study. Conclusion The early introduction of PC encourages families to accompany their beloved child. EoL signs in the pediatric population include vital sign variations. With the presence of relevant EoL signs, clinical physicians can apply PC earlier to meet the needs.

Background: s/Aims: Non-invasive models stratifying clinically significant portal hypertension (CSPH) are limited. Herein, we developed a new non-invasive model for predicting CSPH in patients with compensated cirrhosis and investigated whether carvedilol can prevent hepatic decompensation in patients with high-risk CSPH stratified using the new model. Methods: Non-invasive risk factors of CSPH were identified via systematic review and meta-analysis of studies involving patients with hepatic venous pressure gradient (HVPG). A new non-invasive model was validated for various performance aspects in three cohorts, i.e., a multicenter HVPG cohort, a follow-up cohort, and a carvediloltreating cohort. Results: In the meta-analysis with six studies (n=819), liver stiffness measurement and platelet count were identified as independent risk factors for CSPH and were used to develop the new “CSPH risk” model. In the HVPG cohort (n=151), the new model accurately predicted CSPH with cutoff values of 0 and –0.68 for ruling in and out CSPH, respectively. In the follow-up cohort (n=1,102), the cumulative incidences of decompensation events significantly differed using the cutoff values of <–0.68 (low-risk), –0.68 to 0 (medium-risk), and >0 (high-risk). In the carvediloltreated cohort, patients with high-risk CSPH treated with carvedilol (n=81) had lower rates of decompensation events than non-selective beta-blockers untreated patients with high-risk CSPH (n=613 before propensity score matching [PSM], n=162 after PSM). Conclusions Treatment with carvedilol significantly reduces the risk of hepatic decompensation in patients with high-risk CSPH stratified by the new model.

Background: s/Aims: Non-invasive models stratifying clinically significant portal hypertension (CSPH) are limited. Herein, we developed a new non-invasive model for predicting CSPH in patients with compensated cirrhosis and investigated whether carvedilol can prevent hepatic decompensation in patients with high-risk CSPH stratified using the new model. Methods: Non-invasive risk factors of CSPH were identified via systematic review and meta-analysis of studies involving patients with hepatic venous pressure gradient (HVPG). A new non-invasive model was validated for various performance aspects in three cohorts, i.e., a multicenter HVPG cohort, a follow-up cohort, and a carvediloltreating cohort. Results: In the meta-analysis with six studies (n=819), liver stiffness measurement and platelet count were identified as independent risk factors for CSPH and were used to develop the new “CSPH risk” model. In the HVPG cohort (n=151), the new model accurately predicted CSPH with cutoff values of 0 and –0.68 for ruling in and out CSPH, respectively. In the follow-up cohort (n=1,102), the cumulative incidences of decompensation events significantly differed using the cutoff values of <–0.68 (low-risk), –0.68 to 0 (medium-risk), and >0 (high-risk). In the carvediloltreated cohort, patients with high-risk CSPH treated with carvedilol (n=81) had lower rates of decompensation events than non-selective beta-blockers untreated patients with high-risk CSPH (n=613 before propensity score matching [PSM], n=162 after PSM). Conclusions Treatment with carvedilol significantly reduces the risk of hepatic decompensation in patients with high-risk CSPH stratified by the new model.

Background: Delivering a poor prognosis to patients and their families is critically challenging in pediatric populations. The application of palliative care (PC) provides a bridge between accepting the occurrence of mortality and offering lifelong support.However, little is known about the specifics of PC. This study aims to explore the unmet need for PC in pediatric populations. Methods: We retrospectively reviewed the medical records of mortality cases in the Department of Pediatric Hematology and Oncology at Chang Gung Memorial Hospital. Statistical tests, including Chi-square and Student’s t-tests, were applied to determine the differences between early and late intervention groups in terms of the timing of PC introduction. Results: During the study period, 41 patients were included. Their median age was 11.8 years (IQR, 7.6-15.9). The majority of the disease statuses were refractory or relapsing (R/R). The incidence of memento application was significantly higher in the early intervention group (47.6% vs. 10%, P=0.0081). Vital signs variations tended to be end-of-life (EoL) indicators in this study. Conclusion The early introduction of PC encourages families to accompany their beloved child. EoL signs in the pediatric population include vital sign variations. With the presence of relevant EoL signs, clinical physicians can apply PC earlier to meet the needs.