Objective:To explore the effects of Yiqi Yangyin Tongluo Decoction combined with TCM syndrome differentiation diet on renal function, inflammatory factors, and nutritional status of DN patients with qi-yin deficiency and blood stasis syndrome based on propensity score matching method.Methods:Retrospective clinical studies were carried out. A total of 152 DN patients with qi-yin deficiency and blood stasis syndrome in Dongfang Hospital, Beijing University of Chinese Medicine from January 2022 to January 2024 were selected and divided into an observation group of 83 cases and a control group of 69 cases according to the treatment method. Propensity score matching (PSM) was further adopted to balance the confounding factors before treatment at a ratio of 1:1. Finally, 46 patients in each group were successfully matched. The control group received conventional Western medicine therapy intervention, while the observation group received a combination of Yiqi Yangyin Tongluo Decoction and TCM syndrome differentiation diet treatment on the basis of the control group. Both groups were treated for 3 months. TCM syndrome scores were performed before and after treatment, and t-test was used to detect the levels of SCr, BUN, and β2-MG. ELISA was used to detect the levels of IL-1β, TGF-β1, and TNF-α. Body composition analyzer was used to measure the triceps circumference (AMC) and triceps skinfold thickness (TSF) of the upper arm; the Mini Nutritional Assessment (MNA) was used to assess the risk or status of malnutrition. Adverse reactions were recorded and clinical efficacy was evaluated.Results:The total effective rate of the observation group was 91.3% (42/46), while that of the control group was 69.7% (32/46). There was a statistical significance in the total effective rate between the two groups ( χ2=4.84, P=0.028). After treatment, the observation group had lower scores of soreness and weakness in the waist and knees, fatigue and weakness, restlessness and heat in the five hearts, and a decrease in the depth of the tongue and dark veins compared to the control group ( t values of 4.23, 3.86, 3.68, 4.62, respectively, P<0.001); serum SCr [(221.53±23.40) mmol/L vs. (261.92±25.48) mmol/L, t=7.92], BUN [(21.74 ± 4.13) mmol/L vs. (25.12 ± 4.50) mmol/L, t=3.75], β2-MG [(2.88 ± 0.71) mg/L vs. (4.54 ± 0.93) mg/L, t=9.62] levels, as well as IL-1β [(47.21 ± 5.48) μg/L vs. (51.92 ± 5.63) μg/L, t=4.07], TGF-β [(67.84 ± 8.03) μg/L vs. (73.29 ± 8.88) μg/L, t=4.75], TNF-α [(29.74 ± 4.13) μg/L vs. (33.12 ± 4.98) μg/L, t=3.54] were lower than those in the control group ( P<0.001); the MNA score (24.89 ± 4.48 vs. 21.02 ± 4.16, t=4.29), AMC [(24.34±2.83) mm vs. (22.19 ± 2.88) mm, t=3.61], TSF [(8.34 ± 2.13) mm vs. (7.12 ± 1.98) mm, t=2.85] were higher than those in the control group ( P<0.001 or P<0.05). During the treatment period, the incidence of adverse reactions in the observation group was 13.0% (6/46), while in the control group it was 8.7% (4/46). There was no statistical significance between the two groups ( χ2=0.45, P=0.503). Conclusion:The combination of Yiqi Yangyin Tongluo Decoction and TCM syndrome differentiation diet can effectively alleviate the clinical symptoms of DN patients, improve their kidney function, enhance their nutritional and health status, and inhibit inflammatory response levels, with good treatment safety.

Objective:To analyze the validity of an enhanced nutrition management model for all pregnant women in reducing the incidence of macrosomia.Methods:This retrospective cohort study utilized data from the Beijing Birth Cohort database established by Beijing Obstetrics and Gynecology Hospital, Capital Medical University. A total of 73 193 pregnant women who underwent regular prenatal examinations and delivered at the hospital between January 2018 and December 2023 were consecutively included. From 2018 to 2020, all participants received nutrition education, and high-risk pregnancies predisposed to macrosomia were referred to nutrition clinics for further follow-up. From 2021 to 2023, obstetricians participated in nutritional assessments and gestational weight gain guidance, with repeated nutrition evaluations and education provided during early, mid, and late pregnancy. A multidisciplinary team (obstetrics and nutrition departments) collaborated to implement an enhanced nutrition management model for all pregnant women. General data, parity, gestational age at delivery, neonatal birth weight, and clinical information were collected. Annual incidences of macrosomia and low birth weight were calculated. Chi-square tests and variance analysis were used to analyzed yearly changes in macrosomia rates and evaluate the impact of the two-phase management strategies on macrosomia incidence, thereby to explore the validity of an enhanced nutrition management model for all pregnant women in reducing the incidence of macrosomia.Results:The number of deliveries included annually from 2018 to 2023 was 14 578, 15 413, 11 496, 11 146, 10 396, and 10 164, respectively. Maternal pre-pregnancy body mass indices in 2022 to 2023 were higher than those in 2018 to 2021 [(22.26±3.50) and (22.23±3.65) vs (21.87±3.27), (21.82±3.31), (21.86±3.34) and (21.94±3.39) kg/m2, respectively (all P<0.05)]. Neonatal birth weights in 2021 to 2022 were lower than those in 2018 to 2020 [(3 271±514) and (3 270±513) vs (3 323±504), (3 314±500), and (3 315±510) g], and the birth weight in 2023 was further reduced compared to that in 2018 to 2022 [(3 236±506) vs (3 323±504), (3 314±500), (3 315±510), (3 271±514) and (3 270±513) g] (all P<0.05). The incidence of macrosomia in 2021 to 2022 was lower than those in 2018 to 2020 (5.55%, 5.75% vs 6.97%, 6.68%, 6.67%), and the incidence in 2023 further decreased compared to those in 2018 to 2022 (4.16% vs 6.97%, 6.68%, 6.67%, 5.55%, 5.75%) (all P<0.05). Conclusion:The enhanced nutrition management model for all pregnant women effectively reduces the incidence of macrosomia, demonstrating significant clinical value for widespread implementation.

Objective:To analyze the validity of an enhanced nutrition management model for all pregnant women in reducing the incidence of macrosomia.Methods:This retrospective cohort study utilized data from the Beijing Birth Cohort database established by Beijing Obstetrics and Gynecology Hospital, Capital Medical University. A total of 73 193 pregnant women who underwent regular prenatal examinations and delivered at the hospital between January 2018 and December 2023 were consecutively included. From 2018 to 2020, all participants received nutrition education, and high-risk pregnancies predisposed to macrosomia were referred to nutrition clinics for further follow-up. From 2021 to 2023, obstetricians participated in nutritional assessments and gestational weight gain guidance, with repeated nutrition evaluations and education provided during early, mid, and late pregnancy. A multidisciplinary team (obstetrics and nutrition departments) collaborated to implement an enhanced nutrition management model for all pregnant women. General data, parity, gestational age at delivery, neonatal birth weight, and clinical information were collected. Annual incidences of macrosomia and low birth weight were calculated. Chi-square tests and variance analysis were used to analyzed yearly changes in macrosomia rates and evaluate the impact of the two-phase management strategies on macrosomia incidence, thereby to explore the validity of an enhanced nutrition management model for all pregnant women in reducing the incidence of macrosomia.Results:The number of deliveries included annually from 2018 to 2023 was 14 578, 15 413, 11 496, 11 146, 10 396, and 10 164, respectively. Maternal pre-pregnancy body mass indices in 2022 to 2023 were higher than those in 2018 to 2021 [(22.26±3.50) and (22.23±3.65) vs (21.87±3.27), (21.82±3.31), (21.86±3.34) and (21.94±3.39) kg/m2, respectively (all P<0.05)]. Neonatal birth weights in 2021 to 2022 were lower than those in 2018 to 2020 [(3 271±514) and (3 270±513) vs (3 323±504), (3 314±500), and (3 315±510) g], and the birth weight in 2023 was further reduced compared to that in 2018 to 2022 [(3 236±506) vs (3 323±504), (3 314±500), (3 315±510), (3 271±514) and (3 270±513) g] (all P<0.05). The incidence of macrosomia in 2021 to 2022 was lower than those in 2018 to 2020 (5.55%, 5.75% vs 6.97%, 6.68%, 6.67%), and the incidence in 2023 further decreased compared to those in 2018 to 2022 (4.16% vs 6.97%, 6.68%, 6.67%, 5.55%, 5.75%) (all P<0.05). Conclusion:The enhanced nutrition management model for all pregnant women effectively reduces the incidence of macrosomia, demonstrating significant clinical value for widespread implementation.

Objective To investigate the best evidence application of exercise prescription in patients with chronic heart failure in clinical practice and evaluate its effectiveness.Methods The best evidence of exercise prescription for patients with chronic heart failure was summarized,and the evidence-based practice plan was developed,and it was implemented in the cardiology department of a tertiary hospital in Zhejiang Province from August to October,2022.Nurses'exercise prescription knowledge-attitude-practice level,implementation rate of review indicators,the length of hospital stay,exercise endurance,daily living ability and grip strength of both groups before and after the intervention were compared.Results After the application of the best evidence,the score of knowledge dimension was(9.34±0.98)points;the score of attitude dimension was(63.29±1.37)points;the score of practice dimension was(25.49±1.51)points,which were statistically significant compared with the scores before the application of evidence(P<0.05).After the application of the best evidence,the implementation rate of 16 review indicators was higher than that before the application of evidence(P<0.001).The length of hospital stay in the evidence application group was shorter than that in the baseline examination group(Z=-2.610,P<0.001).After intervention,the exercise endurance,daily living ability and grip strength of patients in the evidence application group were improved compared with the baseline review group,and the difference was statistically significant(P<0.05).Conclusion After the application of the best evidence of exercise prescription in patients with chronic heart failure,it can improve the level of knowledge,attitude and practice of nurses on exercise prescription,standardize the compliance of nurses'exercise prescription,reduce the number of days in the hospital,and improve patients'exercise endurance,daily living ability and grip strength.

OBJECTIVE To explore the impact and mechanism of curcumin on endometriosis （EMS） model rats based on Notch1 signaling pathway. METHODS Female SD rats with synchronized estrous cycles were implanted with autologous endometrium on the abdominal wall to construct EMS model. EMS rats were randomly divided into model group， low-， medium- and high-dose groups of curcumin （60， 120， 240 mg/kg）， and Notch 1 inhibitor DAPT group （7 mg/kg）. The sham surgery group was also established， with 10 rats in each group. Rats in each group received intragastric administration or injection via caudal veins with the corresponding drugs for 4 weeks. Endometriotic lesions were observed and measured using ultrasound and visual inspection， and their volumes were calculated. Histopathological morphology of the lesion tissues was observed. The levels of interleukin-1β （IL-1β）， IL-6， and tumor necrosis factor-α （TNF-α） in the abdominal cavity fluid， as well as the mRNA and protein expression levels of Notch1， matrix metalloproteinase-9 （MMP-9）， and vascular endothelial growth factor （VEGF） in the endometriotic lesions were measured. RESULTS Compared with the model group， the volume of endometriotic lesions in the low- ， medium- and high-dose groups of curcumin and the DAPT group was significantly decreased （P＜0.05）； atrophy or disappearance of columnar epithelium， cyst disappearance； the levels of IL-1β， IL-6， and TNF- α （except for the low-dose curcumin group） in the abdominal cavity fluid， as well as the mRNA （except for MMP-9 and VEGF in the low-dose curcumin group） and protein （except for MMP-9 in the low-dose curcumin group） expression levels of Notch1， MMP-9， and VEGF in the endometriotic lesions were significantly decreased （P＜0.05）. The curcumin high-dose group and DAPT group showed superior results in most indicators compared to the curcumin low- and medium-dose groups. CONCLUSIONS Curcumin has an improving effect on EMS， and its mechanism may be related to inhibiting Notch1 signaling pathway， reducting local inflammatory responses， and inhibiting ectopic endometrial invasion and angiogenesis.

Objective:To explore the characteristics of weekly gestational weight gain (GWG) in women with obesity and its correlation with the risk of macrosomia.Methods:Clinical data of women with singleton pregnancy and pre-pregnancy body mass index (PPBMI) ≥28 kg/m 2 were retrospectively analyzed, from January 2014 to December 2019, in Beijing Obstetrics and Gynecology Hospital, Capital Medical University (Beijing Maternal and Child Health Care Hospital). The participants were divided into three groups based on their PPBMI: group A (28-<30 kg/m 2), group B (30-<32 kg/m 2), and group C (≥32 kg/m 2). The study compared the characteristics of GWG among the three groups, explored the correlation between the weekly weight gain during each gestational stage and the risk of macrosomia, and discussed the impacts of the GWG pattern in women with different PPBMI on the risk of macrosomia. Chi-square (or Fisher's exact), Kruskal-Wallis, and Mann-Whitney U tests were performed for statistical analysis. Multivariate logistic regression was used to analyze the impact of weekly weight gain in specific gestational stages on macrosomia. Results:(1) A total of 2 046 participants were included in the study, with 982 in group A, 588 in group B, and 476 in group C. For all of the 2 046 cases, the median PPBMI was 30.1 kg/m 2 (29.0-31.9 kg/m 2), GWG was 10.5 kg (7.3-14.0 kg), and neonatal birth weight was 3 520 g (3 215-3 816 g) with 60 (2.9%) ≥4 500 g, and the biggest baby weighed 5 580 g. Out of the births analyzed, macrosomia occurred in 318 cases (15.5%). (2) Among the three groups (A, B and C), the differences in maternal age [32.0 years (29.0-35.0 years), 32.0 years (29.0-35.0 years) and 32.0 years (29.0-34.0 years), H=6.58] and women with a history of type 2 diabetes mellitus [0.9% (9/982), 0.3% (2/588) and 1.9% (9/476), χ2=6.61] were statistically significant (all P<0.05). (3) The weekly weight gain in each group exhibited a gradual upward trend before 20-24 weeks, reached a plateau at 24-32 weeks, peaked at 32-36 weeks, and subsequently declined. The weekly weight gain of group A in the pre-pregnancy to 14 weeks [0.14 kg/week (0.00-0.25 kg/week)], 14 to 20 weeks [0.25 kg/week (0.17-0.42 kg/week)], and 20 to 24 weeks [0.38 kg/week (0.25-0.63 kg/week)] were higher than those of group B [0.07 kg/week (－0.03-0.21 kg/week), 0.25 kg/week (0.10-0.42 kg/week), and 0.38 kg/week (0.22-0.60 kg/week)], respectively ( Z value was－3.73,－2.16, and－2.01, all P<0.05). Likewise, the weekly weight gain of group B in the above three stages were all higher than those of group C [0.07 kg/week (－0.10-0.21 kg/week), 0.17 kg/week (0.05-0.33 kg/week), and 0.25 kg/week (0.08-0.50 kg/week)], respectively ( Z value was－2.55,－3.28, and－3.25, all P<0.05). (4) The risk of macrosomia increased with the weekly weight gain in specific gestational stages in different PPBMI groups. In group A, the stages correlated with increased risk were 14-20 weeks [adjusted odd ratio ( aOR)=2.669, 95% CI: 1.378-5.169] and 20-24 weeks ( aOR=1.764, 95% CI: 1.143-2.723), while the stages were 20-24 weeks ( aOR=2.149, 95% CI: 1.156-3.996) and 36 weeks until delivery ( aOR=1.888, 95% CI: 1.268-2.810) in group B, and pre-pregnancy to 14 weeks ( aOR=3.515, 95% CI: 1.158-10.665) and 14-20 weeks ( aOR=3.021, 95% CI: 1.058-8.628) in group C (all P<0.05). The risk of macrosomia increased when the weekly weight gain of both risk-related stages in group A ( aOR=2.255, 95% CI: 1.029-4.940) ≥50th percentile, and group B ( aOR=4.399, 95% CI: 1.017-19.023) ≥75th percentile, and for group C ( aOR=3.404, 95% CI: 1.004-11.543) when the weekly weight gain above 25th percentile (all P<0.05). Conclusions:Weekly GWG demonstrates an observable gradual acceleration pattern in women with obesity. Therefore, clinical attention should be directed towards monitoring fluctuations in the weekly weight gain in this population, as excessive weekly weight gain before 24 gestational weeks is associated with an elevated risk of macrosomia.

Objective:To analyze the maternal gestational weight gain (GWG) in women with pre-pregnancy obesity and its relationships with adverse pregnancy outcomes.Methods:This retrospective cohort study recruited 513 obese women (pre-pregnancy body mass index ≥30 kg/m 2) with singleton pregnancy in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 2014 to December 2016. All participants were divided into three groups according to GWG: inadequate (GWG<5 kg, n=83), adequate (5 kg≤GWG≤9 kg, n=154), and excessive (GWG>9 kg, n=276) groups. Chi-square test, Fisher's exact test, Kruskal-Wallis test, and Mann-Whitney U test were used to compare the clinical data among the three groups, including GWG, pregnancy and neonatal outcomes, and labor process. Multivariate logistic regression was performed to analyze the association between maternal GWG and main pregnancy complications associated with obesity. Results:(1) Among 238 participants who gained more than 2.0 kg in the first trimester, 75.6% (180/238) were in the excessive group, while the rate was 34.9%(96/275) among the participants who gained less than 2.0 kg. (2) Postpartum body mass index retention (body mass index at six weeks postpartum minus pre-pregnancy body mass index) was the highest in the excessive group, followed by the adequate group and the inadequate group [0.8 kg/m 2 (0.0-2.2 kg/m 2) vs -0.7 kg/m 2 (-1.6 to 0.0 kg/m 2) vs -2.5 kg/m 2 (-3.2 to -1.5 kg/m 2), all P<0.05]. (3) The rates of primary cesarean section in the inadequate and adequate groups were 29.9% (20/67) and 32.6% (42/129), which were lower than that in the excessive group [43.3% (104/240), χ2=3.955 and 4.047, both P<0.05]. There were no statistically significant differences in the incidence of gestational hypertension, small/large for gestational age, or other major adverse pregnancy outcomes among the three groups (all P>0.05). The weight gain in the first trimester and before the oral glucose tolerance test were not correlated with gestational diabetes mellitus (GDM) ( aOR=1.038, 95% CI: 0.986-1.094, P=0.157; aOR=1.055, 95% CI: 1.000-1.113, P=0.051). The maternal weight gain of women with GDM during the 2nd, the 3rd, and the whole trimesters were lower than women without GDM respectively [3.0 kg (1.3-4.0 kg) vs 3.0 kg (2.0-5.0 kg), 4.0 kg (2.0-6.0 kg) vs 6.0 kg (4.0-8.0 kg), 9.0 kg (5.0-12.0 kg) vs 10.7 kg (7.5-15.0 kg); Z =-2.938, -6.352 and-4.104, all P<0.01]. Conclusions:In women with pre-pregnancy obesity, the first trimester is the critical window to control maternal GWG. GWG guidelines recommended by the Institute of Medicine could help to reduce the weight retention at six weeks postpartum, but couldn't reduce the risk of GDM, gestational hypertension, small/large for gestational age, or other major adverse pregnancy outcomes.

Objective:To investigate auricular lobule index difference in healthy young female of different height or weight, and to provide an additional reference for otoplasty of auricular lobule.Methods:Subjects were made up of 266 healthy young females of Henan residents. Their height, weight, physiognomic ear breadth, morphological ear breadth, physiognomic ear length, morphological ear length, auricular lobule length, auricular lobule breadth were measured and calculated. All the data were analyzed by SPSS 15.0 software.Results:We obtained the means, standard deviation of each items, and data were treated statistically. In the 266 subjects, average height was (162.9±4.1) cm, weight (55.3±6.5) kg, morphological ear breadth (4.9±0.6) cm, morphological ear length (2.9±0.3) cm, physiognomic ear breadth (6.2±0.4) cm, physiognomic ear length (3.3±0.3) cm, auricular lobule breadth (1.6±0.3) cm, auricular lobule length (1.8±0.2) cm, lobule physiognomic ear breadth index (25.6±4.9)%, lobule-physiognomic ear length index (53.69±7.69)%, and auricular lobule index (91.4±19.3)%. The differences among the indices mentioned above were of statistical significance ( P<0.05); the indices of subjects of different height were significantly different ( P<0.05); the indices of subjects of different weight were of no statistical difference. ( P>0.05). Conclusions:The subjects of different height or weight have no different morphological ear breadth, morphological ear length, physiognomic ear breadth, physiognomic ear length, auricular lobule length, lobule-physiognomic ear length index and auricular lobule index; hence, the indices are no related to body height and weight. However, the subjects of different height have different auricular lobule breadth and lobule-physiognomic ear breadth index.

Objective To investigate the relationship between the facial morphology and the nasal shape for young women of Han nationality in Henan.Methods Aiming at the female conscripts in Henan province in 2016,210 healthy young females were enrolled in this study,and their anthropometric features were measured including height,weight,total head height,physiognomic facial height,morphological facial height,upper lip height,lip height,facial width,mandibular width,mouth breadth,nasal height,nasal length,nasal depth,and width of nose.The nasal indexes were divided into 5 groups according to different facial types.And their mean and standard deviation were calculated.The differences were analyzed by SPSS version 21.0.Results Among the indexes measured,there were significant differences in height,face height,shape face height,upper lip height,face width,mandibular width,head height/face width,face height/face width,shape face height/face width and nose index;P values were significant.The classification of facial types was based on the ratio of morphological surface index to area width,and the main types of the groups were mid-facial and narrow-facial types.The differences among different facial types were statistically significant (F =12.75,P＜0.05).The scatter plot showed that there was a linear correlation between nasal index and facial shape.Linear regression analysis showed that the linear equation Y=135.84-75.5X (X is the ratio of morphological index to facial width,Y is the nasal index).Conclusions Nasal type is related to the face type.The linear fitting equation between morphological facial height/facial width and nasal index is Y=135.84-75.5x.These findings may enrich the external nasal database,provide reference for the correction of nasal deformity and nasal reconstruction,and direct the clinical therapy.

Objective To investigate auricle index difference in Henan residents,and to provide an additional reference for otoplasty.Methods Subjects were made up 266 healthy young of Henan residents.Their height,weight,total head height,maximum head length,maximum head breadth,vertex to tragion height,physiognomic ear breadth,morphological ear breadth,physiognomic ear length and morphological ear length were measured and calculated.All the data were analyzed by SPSS 15.0 software.Results We obtained the means,standard deviation of each items,and data were treated statistically.Height (162.9±4.1) cm,weight (55.3±6.5) kg,total head height (18.6±1.0) cm,maximum head length (17.0±0.7) cm,maximum head breadth (14.1±0.8) cm,vertex to tragion height (11.9±0.7) cm,physiognomic ear length (6.2±0.4) cm,morphological ear breadth (4.9±0.6) cm,physiognomic ear breadth (3.3±0.3) cm and morphological ear length (2.9±0.3) cm were determined.The differences among the indices mentioned above were of statistical significance (P＜0.05);the indices of female subjects of different height were significantly different (P＜0.05);the indices of female subjects of different weight were also statistically different (P＜0.05).The auricle index subjects of different height and weight were of no stistical difference.(P＞0.05).Conclusions Subjects of different height and weight have different total head height;hence,the indices are related to body height and weight.Subjects of different height have different vertex to tragion height,length-height index of the head and breadth-height index of the head.This study has certain reference values on analyzing the characteristics of the human and auricle cosmetology of henan young females.