Objective: To investigate the prevalence and influencing factors of menopausal syndrome among postmenopausal women in Pan'an County, Zhejiang Province, so as to provide the basis for guiding the health management of postmenopausal women. Methods: From May 2023 to April 2024, the postmenopausal women aged 40 to 69 years in Pan'an County were selected using the random cluster sampling method. Demographic information, lifestyle and prevalence of gynecological diseases were collected through questionnaire surveys. The prevalence of menopausal syndrome was assessed by modified Kupperman Score Scale. Factors affecting menopausal syndrome were analyzed by a multivariable logistic regression model. Results: A total of 816 postmenopausal women were surveyed, with an mean age of (57.63±2.92) years and a mean natural menopause age of (49.85±2.13) years. There were 574 cases with menopausal syndrome, with a prevalence of 70.34%. Flashes and sweating, insomnia and irritability were common symptoms, accounting for 62.87%, 47.43% and 41.18%, respectively. Multivariable logistic regression analysis showed that monthly personal income of ≤5 000 yuan (<3 000 yuan, OR=3.124, 95%CI: 1.829-5.335; 3 000-5 000 yuan, OR=2.399, 95%CI: 1.370-4.201) and having gynecological diseases (OR=1.970, 95%CI: 1.292-3.004) were associated with a higher risk of menopausal syndrome, while average (OR=0.141, 95%CI: 0.072-0.276) or sufficient sleep quality (OR=0.095, 95%CI: 0.049-0.185) were associated with a lower risk of menopausal syndrome. Conclusion The prevalence of menopausal syndrome among postmenopausal women in Pan'an County is relatively high, and is mainly influenced by personal economic status, sleep quality and the presence of gynecological diseases.

Objective:The objective of this study is to analyze the detection rate, the pathogenic fungus distribution, risk factors and drug sensitivity of fungal infection of external auditory canal in patients diagnosed with chronic otitis media. Methods:The data of a total of 419 patients with chronic suppurative otitis media or middle ear cholesteatoma who were admitted from January 2019 to February 2023 were retrospectively analyzed. Results:A total of 419 patients were included, and 71 patients（16.9%） were positive for fungal culture. The disease mostly occurred in subjects aged 51-60 years old, and patients over 60 years old（47 cases, 66.2%）. From the fungal culture of external auditory canal secretions, 48 cases（11.4%） of Aspergillus and 14 cases（3.3%） of Candida were identified. The prevalence of fungal cultures in patients with chronic suppurative otitis media（20.8%） was significantly higher than that in patients with middle ear cholectestoma（4.9%）. The detection rate of Fungal was significantly increased after topical treatment with antibiotic ear drops（47.0% vs 13.6%）. Most of the isolated fungal strains are wild-type, and they are the sensitivity to voriconazole and fluconazole was the highest（97.2%）. For patients with positive fungal culture, iodoform gauze with triamcinolone acetonide and econazole cream was used to fill the external auditory canal during surgery. There was no significant difference in the tympanic membrane healing rate between patients with positive fungal culture and patients with negative fungal culture at 3 weeks after surgery（98.6% vs 97.7%）. Conclusion:Fungal infections of external auditory canal in patients with chronic otitis media tend to occur in older patients, which is more common in patients with chronic suppurative otitis media. Long-term topical treatment with antibiotic ear drops is an independent risk factor for fungal infection of external auditory canal in patients with chronic otitis media. The isolated fungal strains were highly sensitive to antifungal drugs. Therefore, it is advisable to refrain from employing topical antibiotic treatment for elderly patients with chronic suppurative otitis media/middle ear cholesteatoma, abuse of local antibiotic therapy should be avoided, and Fungal-related pathogenic examinations should be actively performed and anti-fungal drugs should be added if necessary.
Humans ; Middle Aged ; Female ; Male ; Risk Factors ; Retrospective Studies ; Chronic Disease ; Otitis Media, Suppurative/microbiology* ; Ear Canal/microbiology* ; Antifungal Agents/therapeutic use* ; Adult ; Mycoses/epidemiology* ; Aspergillus/isolation & purification* ; Candida/isolation & purification* ; Otitis Media/complications* ; Aged ; Cholesteatoma, Middle Ear/microbiology*

Objective To investigate the nutritional quality characteristics of vitamin D3-fortified yogurt and explore its improving effect on vitamin D metabolism in the body under simulated weightlessness,thereby providing a theoretical basis for the development of functional foods.Methods Using reconstituted milk as the matrix and Vitamin D3(VD3)microcapsule powder as the fortifier,VD3-fortified yogurt was prepared.A systematic study was conducted to investigate the effects of different gradients(1.25 μg/100 mL,2.50 μg/100 mL,3.75 μg/100 mL,5.00 μg/100 mL,6.25 μg/100 mL)of VD3 microcapsule addition on its quality characteristics(titratable acidity,solid content,water-holding capacity,syneresis).In vivo assessments were conducted using a Sprague-Dawley(SD)rat tail-suspension model to simulate weightlessness.Levels in serum 25(OH)D3,1,25-(OH)2D3,calcium(Ca),and phosphorus(P)were detected using the enzyme-linked immunosorbent assay(ELISA)to evaluate its metabolic capacity.Results During fermentation(3 h),titratable acidity of VD?-fortified yogurt initially increased,then decreased,and eventually stabilized with rising microcapsule dosage,while total solid content remained consistent.WHC exhibited an initial increase followed by a decline,whereas syneresis showed an inverse trend.At an optimal dosage of 3.75 μg/100 mL,the yogurt displayed a dense and uniform network structure,characterized by non-Newtonian fluid behavior with shear-thinning properties.This formulation demonstrated robust structural stability under high-frequency mechanical stress,alongside desirable textural,flavor,and sensory attributes.Animal experiments revealed that the serum concentrations of 25(OH)D3,1,25-(OH)2D3,calcium,and phosphorus in the vitamin D?-fortified yogurt intervention group were significantly higher than those in the tail-suspended control group(P<0.05).Conclusion VD? microencapsulation technology effectively preserves and enhances the nutritional quality characteristics of yogurt and mitigates vitamin D metabolic dysregulation under simulated weightlessness.

ObjectiveTo investigate the awareness and clinical practice of guidelines for the prevention and treatment of chronic hepatitis B （2022 edition） among clinicians. MethodsFrom July 19 to December 31， 2024， a self-designed electronic questionnaire was distributed via the WeChat mini program to collect related data from 1 588 clinicians nationwide， including their awareness and practice based on 18 questions regarding testing and referral， diagnosis and treatment， and follow-up. ResultsAmong all respondents， only 350 clinicians correctly understood all the updated key points of antiviral indications and treatment for special populations in the 2022 edition of guidelines for the prevention and treatment of chronic hepatitis B， with an overall awareness rate of 22.0%. Only 20% ‍—‍ ‍40% of the patients with positive HBV DNA and an age of >30 years receive antiviral therapy， while 80% ‍—‍ ‍100% of the patients with positive HBV DNA and a family history of hepatitis B cirrhosis or hepatocellular carcinoma receive antiviral therapy. The median follow-up rates at 1 year， 3 years， and 5 years were 67.5% 57.5% and 47.5%，respectively， showing a trend of gradual reduction， which might be associated with the influencing factors such as insufficient time for follow-up management by clinicians， insufficient awareness of the disease among patients， and poor adherence to follow-up. ConclusionThere is a gap between the awareness and practice of guidelines for the prevention and treatment of chronic hepatitis B （2022 edition） among clinicians. It is recommended to further strengthen training and focus on the whole process of “detection， diagnosis， treatment， and management” for patients with chronic hepatitis B in healthcare institutions， in order to promote the implementation of the guidelines.

Objective To analyze changes in sleep,mood state,and brain function in healthy populations living in near-sea-level environments before and after exposure to high-altitude environment,and to explore the correlations between regional brain functional changes and variations in sleep and mood states.Methods A total of 45 healthy volunteers were enrolled.The participants came from regions of near-sea-level altitudes and were exposed to the high-altitude environment for a short period of time.The Pittsburgh Sleep Quality Index(PSQI),Zung Self-Rating Depression Scale(SDS),Patient Health Questionnaire-9(PHQ-9),Zung Self-Rating Anxiety Scale(SAS),and Generalized Anxiety Disorder-7(GAD-7)were administered to assess sleep quality as well as depressive and anxiety symptoms at 4 time points—prior to high-altitude exposure,immediately after exposure,one month after returning to low-altitude regions,and three months after returning to low-altitude regions.Resting-state functional magnetic resonance imaging(rs-fMRI)data were collected before and after high-altitude exposure,and regional brain functional parameters,including the amplitude of low-frequency fluctuations(ALFF)and functional connectivity strength,were analyzed.Statistical analyses were performed,including a linear mixed-effects model to evaluate longitudinal changes in scale scores,paired-sample t-tests to compare brain function differences before and after exposure,and Pearson correlation analyses to examine the relationship between brain functional changes and alterations in sleep and mood states.Results Compared with the pre-exposure findings,the participants exhibited significantly increased PSQI scores(8.89±4.41 vs.5.08±2.69,P<0.05)and PHQ-9 scores(3.60±4.19 vs.1.54±2.30,P<0.05)immediately after high-altitude exposure.One month after returning to the low-altitude environment,both sleep and depression scores decreased relative to the findings immediately after exposure(PSQI:3.88±2.13 vs.8.89±4.41,P<0.05;PHQ-9:1.50±2.25 vs.3.60±4.19,P<0.05)and showed no statistically significant difference compared with the pre-exposure findings(P>0.05).Three months after returning to near-sea-level environment,sleep,depression,and anxiety scores were all reduced compared with the findings immediately after exposure(PSQI:3.76±2.31 vs.8.89±4.41,P<0.05;PHQ-9:1.24±2.13 vs.3.60±4.19,P<0.05;SAS:23.84±5.93 vs.27.93±7.05,P<0.05),also showing no significant difference compared with the pre-exposure levels(P>0.05).Brain function analysis revealed that,relative to the pre-exposure levels,ALFF in the bilateral superior temporal gyrus,insula,and dorsolateral prefrontal cortex(DLPFC)increased after high-altitude exposure(P<0.05),and that functional connectivity strength in the DLPFC was also elevated(P<0.05).Furthermore,changes in DLPFC functional connectivity strength were positively correlated with changes in sleep and mood scores(P<0.05).Conclusion High-altitude exposure has a significant impact on the sleep,mood states,and brain function of populations from near-sea-level regions,and DLPFC,in particular,is closely associated with changes in sleep and mood states.The findings of this study provide a theoretical basis for health management and intervention strategies in high-altitude environments.

Objective To evaluate the effect of relaxation training combined with basic psychological intervention on attention deficit factor score in children with attention deficit hyperactivity disorder.Methods A total of 320 children with attention deficit hyperactivity disorder were enrolled in Anhui Children's Hospital affiliated to Anhui Medical University from April 2022 to April 2024.The children were divided into 2 groups by random number table method with 160 cases in each.The control group received basic psychological intervention and the observation group received relaxation training combined with psychological intervention.Attention deficit factor score,hyperac-tivity factor score,oppositional defiant factor score,Weiss Functional Deficit Scale(parent version)score and satis-faction were compared between the two groups.Results The Pittsburgh Sleep Quality Index(PSQI)score of the observation group was higher(17.35±1.42)than that of the control group(P＜0.05).The scores of Attention Defi-cit Hyperactivity Disorder Rating Scale-Parent Version(SNAP-Ⅳ)in observation group were lower than those in control group(P＜0.05),including attention deficit factor(14.25±1.58),hyperactivity factor(12.01±1.33)and oppositional defiant factor(9.79±1.27).There was no difference in Weiss functional deficit Scale(parent version)between the two groups before intervention,and Weiss functional deficit scale(parent version)score of the obser-vation group was higher than that of the control group after intervention(P＜0.05).The satisfaction of observation group was higher than that of control group(P＜0.05).Conclusions The effect of relaxation training combined with psychological intervention is obvious in children with attention deficit hyperactivity disorder,and the symptoms of attention deficit are significantly improved.

Objective To investigate the impact of blood sampling from different sites on coagula-tion results during systemic heparin anticoagulation period treated by continuous renal replacement therapy(CRRT).Methods Seventy-eight patients undergoing CRRT with systemic heparin anticoag-ulation were selected.Using a self-control method,blood samples were simultaneously collected from sampling port at input end of the CRRT extracorporeal circuit,the arterial pressure monitoring cathe-ter,and the peripheral vein of the patients.The four coagulation parameters were tested,and the differences in coagulation results among the blood sampling sites were compared.Results During CRRT with systemic heparin anticoagulation,the four coagulation parameters using blood samples col-lected from the sampling port at the input end of the CRRT extracorporeal circuit,the arterial pressure monitoring catheter,and the peripheral vein showed no statistically significant differences(P＞0.05).Subgroup analyses based on different hemofiltration machines and heparin doses also showed no statisti-cally significant differences(P＞0.05).Conclusion During CRRT,blood sampling from the sam-pling port at the input end of the circuit or the arterial pressure monitoring catheter can be used as an alternative to peripheral venous blood sampling,with no impact on coagulation results.

Objective To evaluate the effectiveness of information quality control for venous thromboembolism(VTE)in Shanghai municipal hospitals.Methods Retrospective analysis of VTE information statistics of hospitalized pa-tients in Shanghai municipal hospitals in 2023,combined with questionnaire surveys and on-site visits,to evaluate the effectiveness of VTE information quality control in municipal hospitals.Results Shanghai municipal hospitals have established a relatively complete hospital VTE prevention and control management system.In 2023,the risk assess-ment rate of VTE for hospitalized patients in Shanghai municipal hospitals was 88.43％,the risk assessment rate of VTE bleeding was 55.97％,the appropriate prophylaxis rate of VTE was 74.14％,the incidence rate of VTE was 0.86％,and the incidence rate of hospital related VTE was 0.47％.Conclusion The establishment of the VTE information monitoring platform for inpatients in Shanghai municipal hospital has effectively improved the stan-dardized prevention and treatment level of VTE and hospital management efficiency in hospitals.

Objective:To evaluate the efficacy of eculizumab in treating hematopoietic stem cell transplantation-associated thrombotic microangiopathy (TA-TMA) .Methods:This retrospective study included 11 patients who developed TA-TMA after allogeneic hematopoietic stem cell transplantation and subsequently received eculizumab treatment at Peking University People′s Hospital between June 2018 and May 2024. The incidence of TA-TMA, treatment details, and clinical outcomes were analyzed.Results:Among the 11 included patients [4 males, 7 females; median age: 29 years (range: 9-56) ], underlying diseases were severe aplastic anemia (SAA) in 5 patients, acute lymphoblastic leukemia (ALL) in 3 patients, and acute myeloid leukemia (AML) in 3 patients. The median time to TA-TMA diagnosis was 48 days post-transplantation (range: 4-213 days), and all patients met the diagnostic criteria for high-risk TA-TMA. The median interval from TA-TMA diagnosis to the initiation of eculizumab treatment was 12 days (range: 1-56 days). Patients received a median of 3 doses of eculizumab (range: 1-14). Ten of the 11 patients were assessed as having no response (NR) to eculizumab at the end of treatment or at death. One patient achieved a partial response (PR) but subsequently died after TA-TMA relapsed due to infection. At the last follow-up, all patients were either lost to follow-up or had died. The median follow-up duration was 88 days (range: 33-326 days), and the median time from TA-TMA diagnosis to the last follow-up was 31 days (range: 21-113 days) .Conclusion:Eculizumab demonstrated poor efficacy in this TA-TMA cohort. This might be attributable to the critical and complex condition of the patients, delayed initiation of eculizumab treatment, and insufficient dosage.

Objective:To investigate the prognostic value of circulating plasma cell (CPC) in patients with newly diagnosed multiple myeloma (NDMM) undergoing induction therapy with bortezomib, lenalidomide, and dexamethasone (VRD) regimen.Methods:This study retrospectively analyzed clinical data of 152 patients with NDMM treated with the VRD regimen as induction therapy in the Hematology Department of Jiangsu Provincial People’s Hospital from January 2019 to March 2024. The clinical characteristics, efficacy, and prognosis of patients with high and low CPC proportions are compared. The prognosis of patients in the CPC-positive group, CPC-negative conversion group, and CPC-negative group was analyzed.Results:This study included 152 patients with NDMM, comprising 76 males and 76 females, with a median age at onset of 62 (40–77) years. Compared with the group with CPC proportion of <0.105%, patients with CPC proportion of ≥0.105% demonstrated a higher proportion of International Staging System (ISS) stage Ⅲ ( P<0.001), Revised ISS stage Ⅲ ( P=0.023), HGB≤100 g/L ( P=0.015), β 2-microglobulin ≥3.5 g/L ( P<0.001), shorter median progression-free survival (PFS) period (24 months vs 52 months, P<0.001), and shorter median overall survival (OS) period (52 months vs not achieved, P=0.005). Patients in the CPC-negative group demonstrated a longer median PFS period (not reached vs 41 months vs 19 months, P<0.001) and median OS period (not reached vs not reached vs 26 months, P<0.001) compared with patients in the CPC-negative conversion group and CPC-positive group. Multivariate analysis revealed CPC proportion of ≥0.105% ( HR=3.79, 95% CI: 1.95–7.38, P<0.001), positive CPC after induction therapy ( HR=3.54, 95% CI: 1.41–8.87, P=0.007), and cytogenetic high risk ( HR=3.69, 95% CI: 1.85–7.37, P<0.001) as independent risk factors affecting the PFS of patients. Meanwhile, CPC of ≥0.105% ( HR=3.50, 95% CI: 1.29–9.48, P=0.014) and positive CPC after induction therapy ( HR=4.12, 95% CI: 1.13–15.03, P=0.032) are independent risk factors affecting the OS of patients. Conclusion:Patients with NDMM demonstrating high CPC expression have a worse prognosis, with CPC level as an independent prognostic factor.