Objective:To explore the diagnostic value of ultrasound for retained products of conceptions com-plicated with uterine arteriovenous fistula(UAVF)after early pregnancy miscarriage and the predictive value for massive bleeding by constructing a risk model for bleeding.Methods:A total of 90 patients who were diagnosed by ultrasound in West China Second Hospital of Sichuan University as having retained products of conceptions complicated with UAVF after early pregnancy miscarriage from July 2013 to September 2021 were selected,among which 37 cases underwent digital subtraction angiography(DSA).Clinical and ultrasound data were collected and statistical analysis was conducted on the ultrasound parameters of whether DSA examination was accompanied by UAVF and whether there was major bleeding(spontaneous and intraoperative).We performed multivariate Lo-gistic regression analysis on parameters with statistical differences,plotted receiver operating characteristic(ROC)curve for predicting major bleeding(spontaneous and intraoperative),and calculated the area under the curve(AUC).Results:① After DSA examination,14 out of 37 patients(37.8%)were diagnosed with UAVF based on ultrasound diagnosis of pregnancy residue combined with UAVF.Univariate and multivariate Logistic an-alyses showed that the expanding inner diameter of blood vessels was an independent risk factor for residual pregnancy products combined with UAVF after early pregnancy miscarriage(OR 37.099,P=0.027).ROC curve analysis revealed that dilated vessel diameter had an AUC of 0.78,sensitivity of 64%,specificity of 91%,and an optimal cut-off value of 0.85 cm for the diagnosis of UAVF.②Out of 90 patients,44(48.9%)experienced sponta-neous massive bleeding.Univariate and multivariate Logistic analyses showed that the presence of vascular pools or dilated vessels was an independent risk factor for spontaneous massive bleeding(OR 5.163,P=0.004).③A-mong70 patients undergoing surgical treatment,7 experienced intraoperative bleeding(11.7%).Univariate and multivariate Logistic analyses showed that the enlargement of the maximum diameter of the lesion was an inde-pendent risk factor for intraoperative massive bleeding(OR 7.278,P=0.007).ROC curve analysis revealed that the AUC of the maximum diameter of the lesion for predicting the risk of intraoperative bleeding was 0.92,with a sensitivity of 100%,specificity of 82%,and an optimal threshold of 3.95 cm.Conclusions:Dilated vessel diameter in ultrasound examination parameters has high diagnostic value for residual pregnancy products combined with UAVF after early pregnancy miscarriage.Patients with vascular pools or dilated vessels and large lesions have a higher risk of spontaneous and intraoperative bleeding,and clinical prediction models can be used to assess risk of bleeding.

OBJECTIVE T o carry out the health economics evaluation and cost-benefit analysis of the type b Hae-mophilus influenzae(Hib)vaccination for the children who were hospitalized due to Hib infection so as to provide evidence for public health policies.METHODS The children who were diagnosed with Hib-related respiratory tract infections or meningitis and were hospitalized in respiratory medicine department,infection management depart-ment,emergency rooms and neurology department of Jiangxi Provincial Children's Hospital from Jan.1,2021 to Dec.31,2023 were recruited as the research subjects.Based on a 1∶1 matching condition,the matching variables included four items such as the same age for the admission to the hospital,same gender,same department and same grade of disease severity.The children for whom the primary immunization of Hib vaccination(including Hib monovalent vaccine and Hib-containing combination vaccine)were completed and the integrity of vaccination infor-mation could be checked out were assigned as the intervention group,while the children for whom the primary im-munization of Hib vaccination was not completed were chosen as the control group.The clinical data,vaccination data and the data such as length of hospital stay and hospitalization cost were collected from the children.The cost-benefit of the Hib vaccination among the children with Hib infection was observed.RESULTS A total of 622 hospi-talized children who were detected with Hib-positive respiratory tract infections or meningitis were enrolled in the study,and 73 children(20 children from infection management department,27 children from respiratory medi-cine department,26 children from emergency rooms)were finally included in the intervention group after matc-hing and multiple rounds of screening,73 children were chosen as the control group based on a 1∶1 matching con-dition.The male children accounted for 57.53％(42 cases)in both groups,and the female children accounted for 42.47％(31 cases)in both groups.With the respect to the length of hospital stay,it was 7.00(5.00,8.00)days in the intervention group,7.00(6.00,8.00)days in the control group(Z=-0.341,P=0.733).In terms of the hospitalization cost,it was 7 756.17(6 617.92,10 617.69)yuan in the intervention group,9 040.65(8 033.76,10 935.84)yuan in the control group(Z=-2.795,P=0.005).The cost of Hib vaccination was 343.03 yuan per capita in the intervention group,and the benefit-cost ratio(BCR)was 1∶3.74(343.03 yuan/1 284.48 yuan).CONCLUSIONS The Hib vaccination can save the hospitalization cost and has high cost effectiveness.It is sugges-ted that the Hib vaccination should be promoted and the coverage rate of Hib vaccination should be raised among the age-eligible children.

Objective To conduct a scoping review of studies on nurses' self-efficacy in disaster contexts,and to provide references for enhancing nurses' self-efficacy in disaster response.Methods Guided by the methodology of scoping review,we systematically searched PubMed,Web of Science,Cochrane Library,CINAHL,China National Knowledge Infrastructure(CNKI),Wanfang Data,VIP Database,and China Biology Medicine disc(CBM)from inception to July 3,2025.Totally 2 researchers independently screened the search results,summarized them,and extracted relevant data.Results A total of 21 studies were included.Nurses' self-efficacy in disaster contexts was generally at a moderate level,influenced by multiple factors including sociodemographic characteristics,occupational background,and physical and mental health status.The main assessment tools were the General Self-Efficacy Scale and the Disaster Response Self-Efficacy Scale.Interventions included psychological first aid training,scenario simulation training,and immersive movie escape room training.Conclusion Nurses' self-efficacy in disaster contexts is generally at a moderate level with multiple influencing factors.Relevant assessment tools need further optimization,and interventions require further refinement.

BACKGROUND: The sirtuin family is well recognized for its crucial involvement in various cellular processes. Nevertheless, studies on its role in the human endometrium are limited. This study aimed to explore the expression and localization of the sirtuin family in the human endometrium, focusing on sirtuin 3 (SIRT3) and its potential role in the oxidative imbalance of the endometrium in polycystic ovary syndrome (PCOS). METHODS: Endometrial specimens were collected from both patients with PCOS and controls undergoing hysteroscopy at the Center for Reproductive Medicine, Peking University Third Hospital, from July to August 2015 and used for cell culture. The protective effects of SIRT3 were investigated, and the mechanism of SIRT3 in improving endometrial receptivity of patients with PCOS was determined using various techniques, including cellular bioenergetic analysis, small interfering ribonucleic acid (siRNA) silencing, real-time quantitative polymerase chain reaction, Western blot, immunofluorescence, immunohistochemistry, and flow cytometry analysis. RESULTS: The sirtuin family was widely expressed in the human endometrium, with SIRT3 showing a significant increase in expression in patients with PCOS compared with controls ( P <0.05), as confirmed by protein and gene assays. Concurrently, endometrial antioxidant levels were elevated, while mitochondrial respiratory capacity was reduced, in patients with PCOS ( P <0.05). An endometrial oxidative stress (OS) model revealed that the downregulation of SIRT3 impaired the growth and proliferation status of endometrial cells and reduced their receptivity to day 4 mouse embryos. The results suggested that SIRT3 might be crucial in maintaining normal cellular state by regulating antioxidants, cell proliferation, and apoptosis, thereby contributing to enhanced endometrial receptivity. CONCLUSIONS Our findings proposed a significant role of SIRT3 in improving endometrial receptivity in patients with PCOS by alleviating OS and regulating the balance between cell proliferation and apoptosis. Therefore, SIRT3 could be a promising target for predicting and improving endometrial receptivity in this patient population.
Humans ; Female ; Polycystic Ovary Syndrome/metabolism* ; Endometrium/metabolism* ; Sirtuin 3/genetics* ; Oxidative Stress/genetics* ; Adult ; Animals ; Mice ; Apoptosis/physiology* ; Immunohistochemistry ; Cell Proliferation/physiology*

OBJECTIVE T o carry out the health economics evaluation and cost-benefit analysis of the type b Hae-mophilus influenzae(Hib)vaccination for the children who were hospitalized due to Hib infection so as to provide evidence for public health policies.METHODS The children who were diagnosed with Hib-related respiratory tract infections or meningitis and were hospitalized in respiratory medicine department,infection management depart-ment,emergency rooms and neurology department of Jiangxi Provincial Children's Hospital from Jan.1,2021 to Dec.31,2023 were recruited as the research subjects.Based on a 1∶1 matching condition,the matching variables included four items such as the same age for the admission to the hospital,same gender,same department and same grade of disease severity.The children for whom the primary immunization of Hib vaccination(including Hib monovalent vaccine and Hib-containing combination vaccine)were completed and the integrity of vaccination infor-mation could be checked out were assigned as the intervention group,while the children for whom the primary im-munization of Hib vaccination was not completed were chosen as the control group.The clinical data,vaccination data and the data such as length of hospital stay and hospitalization cost were collected from the children.The cost-benefit of the Hib vaccination among the children with Hib infection was observed.RESULTS A total of 622 hospi-talized children who were detected with Hib-positive respiratory tract infections or meningitis were enrolled in the study,and 73 children(20 children from infection management department,27 children from respiratory medi-cine department,26 children from emergency rooms)were finally included in the intervention group after matc-hing and multiple rounds of screening,73 children were chosen as the control group based on a 1∶1 matching con-dition.The male children accounted for 57.53％(42 cases)in both groups,and the female children accounted for 42.47％(31 cases)in both groups.With the respect to the length of hospital stay,it was 7.00(5.00,8.00)days in the intervention group,7.00(6.00,8.00)days in the control group(Z=-0.341,P=0.733).In terms of the hospitalization cost,it was 7 756.17(6 617.92,10 617.69)yuan in the intervention group,9 040.65(8 033.76,10 935.84)yuan in the control group(Z=-2.795,P=0.005).The cost of Hib vaccination was 343.03 yuan per capita in the intervention group,and the benefit-cost ratio(BCR)was 1∶3.74(343.03 yuan/1 284.48 yuan).CONCLUSIONS The Hib vaccination can save the hospitalization cost and has high cost effectiveness.It is sugges-ted that the Hib vaccination should be promoted and the coverage rate of Hib vaccination should be raised among the age-eligible children.

Objective To conduct a scoping review of studies on nurses' self-efficacy in disaster contexts,and to provide references for enhancing nurses' self-efficacy in disaster response.Methods Guided by the methodology of scoping review,we systematically searched PubMed,Web of Science,Cochrane Library,CINAHL,China National Knowledge Infrastructure(CNKI),Wanfang Data,VIP Database,and China Biology Medicine disc(CBM)from inception to July 3,2025.Totally 2 researchers independently screened the search results,summarized them,and extracted relevant data.Results A total of 21 studies were included.Nurses' self-efficacy in disaster contexts was generally at a moderate level,influenced by multiple factors including sociodemographic characteristics,occupational background,and physical and mental health status.The main assessment tools were the General Self-Efficacy Scale and the Disaster Response Self-Efficacy Scale.Interventions included psychological first aid training,scenario simulation training,and immersive movie escape room training.Conclusion Nurses' self-efficacy in disaster contexts is generally at a moderate level with multiple influencing factors.Relevant assessment tools need further optimization,and interventions require further refinement.

Objective:To explore the diagnostic value of ultrasound for retained products of conceptions com-plicated with uterine arteriovenous fistula(UAVF)after early pregnancy miscarriage and the predictive value for massive bleeding by constructing a risk model for bleeding.Methods:A total of 90 patients who were diagnosed by ultrasound in West China Second Hospital of Sichuan University as having retained products of conceptions complicated with UAVF after early pregnancy miscarriage from July 2013 to September 2021 were selected,among which 37 cases underwent digital subtraction angiography(DSA).Clinical and ultrasound data were collected and statistical analysis was conducted on the ultrasound parameters of whether DSA examination was accompanied by UAVF and whether there was major bleeding(spontaneous and intraoperative).We performed multivariate Lo-gistic regression analysis on parameters with statistical differences,plotted receiver operating characteristic(ROC)curve for predicting major bleeding(spontaneous and intraoperative),and calculated the area under the curve(AUC).Results:① After DSA examination,14 out of 37 patients(37.8%)were diagnosed with UAVF based on ultrasound diagnosis of pregnancy residue combined with UAVF.Univariate and multivariate Logistic an-alyses showed that the expanding inner diameter of blood vessels was an independent risk factor for residual pregnancy products combined with UAVF after early pregnancy miscarriage(OR 37.099,P=0.027).ROC curve analysis revealed that dilated vessel diameter had an AUC of 0.78,sensitivity of 64%,specificity of 91%,and an optimal cut-off value of 0.85 cm for the diagnosis of UAVF.②Out of 90 patients,44(48.9%)experienced sponta-neous massive bleeding.Univariate and multivariate Logistic analyses showed that the presence of vascular pools or dilated vessels was an independent risk factor for spontaneous massive bleeding(OR 5.163,P=0.004).③A-mong70 patients undergoing surgical treatment,7 experienced intraoperative bleeding(11.7%).Univariate and multivariate Logistic analyses showed that the enlargement of the maximum diameter of the lesion was an inde-pendent risk factor for intraoperative massive bleeding(OR 7.278,P=0.007).ROC curve analysis revealed that the AUC of the maximum diameter of the lesion for predicting the risk of intraoperative bleeding was 0.92,with a sensitivity of 100%,specificity of 82%,and an optimal threshold of 3.95 cm.Conclusions:Dilated vessel diameter in ultrasound examination parameters has high diagnostic value for residual pregnancy products combined with UAVF after early pregnancy miscarriage.Patients with vascular pools or dilated vessels and large lesions have a higher risk of spontaneous and intraoperative bleeding,and clinical prediction models can be used to assess risk of bleeding.

OBJECTIVE To investigate ameliorative effects and mechanisms of two probiotics(Bacillus subtilis,Lactobacillus acidophilus)combined with Aurantii Fructus Immaturus(AFI)on functional dyspepsia(FD)in rats.METHODS Rats were randomly divided into blank group,model group,positive control group(domperidone group,2.7 mg/kg),AFI group(9 g/kg),L.acidophilus group(5×107 cfu/kg),B.subtilis group(5×107 cfu/kg),L.acidophilus+AFI group(L.acidophilus 5×107 cfu/kg+AFI 9 g/kg),and B.subtilis+AFI group(B.subtilis 5×107 cfu/kg+AFI 9 g/kg),with 8 rats in each group.Except for the blank group,FD model was established by tail-clamping stimulation+hunger and satiety disorder+swimming exhaustion in other groups.After modeling,each group was given the corresponding drug/probiotic suspensions/physiological saline intragastrically,once a day,for 14 consecutive days.After the last medication,gastric emptying rate and the rate of propulsion of the small intestine in rats were measured;the levels of brain-gut peptide-related indicators[gastrin(GAS),substance P(SP),vasoactive intestinal peptide(VIP),somatostatin(SS)and cholecystokinin(CCK)]in the serum of rats were measured.The pathological morphology of the gastric antrum tissue and duodenal tissue was observed.Cecal contents from the rats were collected for gut microbiota sequencing analysis.The protein expression levels of tyrosine kinase receptor c-Kit and stem cell factor(SCF)in the gastric antrum tissue,as well as Toll-like receptor 4(TLR4),myeloid differentiation factor 88(MyD88),and nuclear factor κB(NF-κB)in the duodenal tissue of the rats were detected.RESULTS Compared with the blank group,model group showed significantly lower gastric emptying rate,small intestinal propulsion rate,serum levels of GAS and SP,relative abundance of Firmicutes,Ace,Chao and Sobs indexes of the gut microbiota,and protein levels of SCF and c-Kit in gastric antrum(P＜0.05),while serum levels of VIP,SS and CCK,relative abundance of Bacteroidetes,as well as protein expressions of TLR4,MyD88,and NF-κB,were significantly higher(P＜0.05).The histological structure of the gastric antrum tissue appeared basically normal;however,abnormalities were observed in the duodenal structure,with a significant infiltration of inflammatory cells visible.Compared with the model group,all treatment groups significantly modulated most of the above indexes(P＜0.05).The histological structure of the gastric antrum tissue was normal.Except for the B.subtilis group and the B.subtilis+AFI group,the pathological states of the duodenum in the remaining rats gradually recovered.Compared with each single drug group,most of above indexes in rats from each combination group showed further improvement(P＜0.05).CONCLUSIONS The combination of AFI with two probiotics can improve gastrointestinal motility in FD rats,and the effect is superior to that of using the drugs alone.The specific underlying mechanisms may be related to the activation of the SCF/c-Kit signaling pathway and the inhibition of the TLR4/MyD88/NF-κB signaling pathway.

Objective:Through the analysis of five cases of occupational heat illness caused by high temperature, we expounded the pathogenesis and summarized the clinical characteristics of heat cramp and heat exhaustion of the newly revised diagnostic criteria for occupational heat illness (GBZ41-2019), in order to prevent the occurrence of occupational heat illness to put forward controllable countermeasures.Methods:According to the occupational history, clinical diagnosis and treatment and the other relevant data submitted by five patients, the diagnosis process was analyzed and summarized.Results:Five patients developed symptoms from July to August in summer, belonging to high-temperature operation. They improved by timely treatment. The symptoms, signs and laboratory tests of the five patients were different, but they were diagnosed as occupational heat illness.Conclusion:Employers should pay attention to the high temperature protection and cooling work, and strengthen the labor protection. If patients with heat cramp and heat exhaustion were timely treated, they could basically recover. Occupational disease diagnosticians should seriously study the new diagnostic criteria of occupational disease and constantly improve their diagnostic ability.

Objective:Through the analysis of five cases of occupational heat illness caused by high temperature, we expounded the pathogenesis and summarized the clinical characteristics of heat cramp and heat exhaustion of the newly revised diagnostic criteria for occupational heat illness (GBZ41-2019), in order to prevent the occurrence of occupational heat illness to put forward controllable countermeasures.Methods:According to the occupational history, clinical diagnosis and treatment and the other relevant data submitted by five patients, the diagnosis process was analyzed and summarized.Results:Five patients developed symptoms from July to August in summer, belonging to high-temperature operation. They improved by timely treatment. The symptoms, signs and laboratory tests of the five patients were different, but they were diagnosed as occupational heat illness.Conclusion:Employers should pay attention to the high temperature protection and cooling work, and strengthen the labor protection. If patients with heat cramp and heat exhaustion were timely treated, they could basically recover. Occupational disease diagnosticians should seriously study the new diagnostic criteria of occupational disease and constantly improve their diagnostic ability.