Objective:To compare the impact of preoperative pulmonary vascular resistance(PVR) levels on the prognosis of patients undergoing left ventricular assist device(LVAD)implantation.Methods:A retrospective analysis was conducted on the clinical data of 33 patients among September 2021 and June 2024, who underwent LVAD implantation at Zhongshan Hospital, Fudan University. 29 males and 4 females, with a mean age of(53.61±9.65)years old. The cohort included 30 cases of dilated cardiomyopathy, 2 cases of ischemic cardiomyopathy, and 1 case of noncompaction cardiomyopathy. Patients were grouped based on a preoperative PVR threshold of 3 WU, Preoperative data from Swan-Ganz catheterization, liver and renal function indicators, as well as other relevant clinical parameters were recorded. Patients were followed up to assess differences in survival outcomes.Results:Preoperative PVR was elevated in 18 cases(60%)of the patients, with a mean preoperative PVR of(3.16±1.71)WU. Immediate postoperative right heart catheterization was performed in 20 patients, showing a significant reduction in PVR from(3.85±1.72)WU preoperatively to(1.80±1.38)WU postoperatively( P<0.05). The cardiac index improved significantly from(1.95±0.63)L·min -1·m -2 preoperatively to(4.25±1.26)L·min -1·m -2 postoperatively( P<0.001). The mean follow-up duration was(14.78±12.06)months, no significant difference in postoperative survival was observed between the two groups(100% vs. 80%, P=0.667). Conclusion:Increased pulmonary resistance is often secondary to left heart dysfunction. After the implantation of a LVAD, pulmonary resistance can be improved. For patients with relatively normal right heart function before surgery, elevated pulmonary resistance does not affect the short-term outcomes of the implantation.

Objective:To construct and evaluate a training program for health management specialist nurses.Methods:Mainly qualitative analysis, The training system of health management specialist nurses was preliminarily drawn up based on literature review and semi-structured interview. The Delphi expert consultation method was used to conduct a two-round expert letter inquiry with 17 experts in the professions such as health management medicine, health management nursing, nursing management, and nursing education; and the analytic hierarchy process was applied to determine the weights of the indicators.Results:The effective recall rates of the questionnaires for the 2 rounds of expert consultation was 94.44%(17/18) and 100%(17/17), with expert authority coefficients of 0.90 and 0.92 and Kendall harmony coefficients of 0.207 and 0.249, respectively (all P<0.001). The training system of health management specialist nurses included 4 parts: training objective, training content, training management, training assessment and evaluation. There were 8 indicators in the training objective part. There were 5 first-level indicators, 15 second-level and 67 third-level indicators in the training content part. There were 5 first-level indicators, 12 second-level indicators in the training management part. There were 3 first-level indicators, 10 second-level indicators in the training assessment and evaluation part. Conclusion:The training program for specialized nurses in health management developed in this study demonstrates high levels of expert enthusiasm, authority, and consensus, indicating its feasibility.

Objective:To observe the changes in serum estradiol (E 2) levels in pregnant women of different gestational weeks and their predictive value for early intrauterine pregnancy outcomes. Methods:A retrospective study was conducted involving 375 pregnant women who were treated at the Affiliated Yangming Hospital of Ningbo University (Yuyao People's Hospital) from September 2021 to September 2023. The clinical data were categorized based on pregnancy outcomes into three groups: a normal pregnancy group ( n = 150), a threatened miscarriage with continued pregnancy group ( n = 150), and a miscarriage group ( n = 75). The serum estradiol (E 2) levels at different gestational weeks were compared among the three groups: 5 to < 6 weeks (35-41 days), 6 to < 7 weeks (42-48 days), and 7 to 8 weeks (49-55 days). The predictive value of serum E 2 levels for early intrauterine pregnancy outcomes across different gestational weeks was analyzed using Receiver Operating Characteristic (ROC) curves. Results:In the normal pregnancy group, the serum E 2 levels at different gestational weeks were as follows: (1 691.87 ± 532.21) pmol/L for 5 to < 6 weeks, (2 376.64 ± 788.36) pmol/L for 6 to < 7 weeks, and (3 576.30 ± 1,190.06) pmol/L for 7 to 8 weeks. These values were significantly higher than those in the threatened miscarriage with continued pregnancy group [(1 409.28 ± 473.49) pmol/L, (1 893.13 ± 563.15) pmol/L, (2 035.79 ± 612.47) pmol/L, t = 5.15, 11.68, 6.60, all P < 0.05] and the miscarriage group [(906.49 ± 338.09) pmol/L, (923.63 ± 365.39) pmol/L, (950.27 ± 378.89) pmol/L, t = 16.19, 15.45, 21.50, all P < 0.05]. The serum E 2 levels at different gestational weeks in the threatened miscarriage with continued pregnancy group were significantly higher than those in the miscarriage group ( t = 7.48, 10.81, 8.89, all P < 0.05). Both the normal pregnancy group and the threatened miscarriage with continued pregnancy group showed an increasing trend in serum E 2 levels with advancing gestational weeks ( t = 6.74, 18.55, 7.58, 9.82, 11.81, 2.24, all P < 0.05). In contrast, the serum E 2 levels in the miscarriage group also increased with advancing gestational weeks, but the differences were not statistically significant ( P > 0.05). The results from the receiver operating characteristic curve analysis indicated that the areas under the curve for predicting early intrauterine pregnancy outcomes based on serum E 2 levels at different gestational weeks were 0.857, 0.810, and 0.839, demonstrating excellent diagnostic efficacy. Conclusions:Dynamic monitoring of serum E 2 levels is beneficial for predicting early intrauterine pregnancy outcomes and providing guidance for clinical diagnosis and treatment.

Objective:To observe the changes in serum estradiol (E 2) levels in pregnant women of different gestational weeks and their predictive value for early intrauterine pregnancy outcomes. Methods:A retrospective study was conducted involving 375 pregnant women who were treated at the Affiliated Yangming Hospital of Ningbo University (Yuyao People's Hospital) from September 2021 to September 2023. The clinical data were categorized based on pregnancy outcomes into three groups: a normal pregnancy group ( n = 150), a threatened miscarriage with continued pregnancy group ( n = 150), and a miscarriage group ( n = 75). The serum estradiol (E 2) levels at different gestational weeks were compared among the three groups: 5 to < 6 weeks (35-41 days), 6 to < 7 weeks (42-48 days), and 7 to 8 weeks (49-55 days). The predictive value of serum E 2 levels for early intrauterine pregnancy outcomes across different gestational weeks was analyzed using Receiver Operating Characteristic (ROC) curves. Results:In the normal pregnancy group, the serum E 2 levels at different gestational weeks were as follows: (1 691.87 ± 532.21) pmol/L for 5 to < 6 weeks, (2 376.64 ± 788.36) pmol/L for 6 to < 7 weeks, and (3 576.30 ± 1,190.06) pmol/L for 7 to 8 weeks. These values were significantly higher than those in the threatened miscarriage with continued pregnancy group [(1 409.28 ± 473.49) pmol/L, (1 893.13 ± 563.15) pmol/L, (2 035.79 ± 612.47) pmol/L, t = 5.15, 11.68, 6.60, all P < 0.05] and the miscarriage group [(906.49 ± 338.09) pmol/L, (923.63 ± 365.39) pmol/L, (950.27 ± 378.89) pmol/L, t = 16.19, 15.45, 21.50, all P < 0.05]. The serum E 2 levels at different gestational weeks in the threatened miscarriage with continued pregnancy group were significantly higher than those in the miscarriage group ( t = 7.48, 10.81, 8.89, all P < 0.05). Both the normal pregnancy group and the threatened miscarriage with continued pregnancy group showed an increasing trend in serum E 2 levels with advancing gestational weeks ( t = 6.74, 18.55, 7.58, 9.82, 11.81, 2.24, all P < 0.05). In contrast, the serum E 2 levels in the miscarriage group also increased with advancing gestational weeks, but the differences were not statistically significant ( P > 0.05). The results from the receiver operating characteristic curve analysis indicated that the areas under the curve for predicting early intrauterine pregnancy outcomes based on serum E 2 levels at different gestational weeks were 0.857, 0.810, and 0.839, demonstrating excellent diagnostic efficacy. Conclusions:Dynamic monitoring of serum E 2 levels is beneficial for predicting early intrauterine pregnancy outcomes and providing guidance for clinical diagnosis and treatment.

Objective:To construct and evaluate a training program for health management specialist nurses.Methods:Mainly qualitative analysis, The training system of health management specialist nurses was preliminarily drawn up based on literature review and semi-structured interview. The Delphi expert consultation method was used to conduct a two-round expert letter inquiry with 17 experts in the professions such as health management medicine, health management nursing, nursing management, and nursing education; and the analytic hierarchy process was applied to determine the weights of the indicators.Results:The effective recall rates of the questionnaires for the 2 rounds of expert consultation was 94.44%(17/18) and 100%(17/17), with expert authority coefficients of 0.90 and 0.92 and Kendall harmony coefficients of 0.207 and 0.249, respectively (all P<0.001). The training system of health management specialist nurses included 4 parts: training objective, training content, training management, training assessment and evaluation. There were 8 indicators in the training objective part. There were 5 first-level indicators, 15 second-level and 67 third-level indicators in the training content part. There were 5 first-level indicators, 12 second-level indicators in the training management part. There were 3 first-level indicators, 10 second-level indicators in the training assessment and evaluation part. Conclusion:The training program for specialized nurses in health management developed in this study demonstrates high levels of expert enthusiasm, authority, and consensus, indicating its feasibility.

Objective:To compare the impact of preoperative pulmonary vascular resistance(PVR) levels on the prognosis of patients undergoing left ventricular assist device(LVAD)implantation.Methods:A retrospective analysis was conducted on the clinical data of 33 patients among September 2021 and June 2024, who underwent LVAD implantation at Zhongshan Hospital, Fudan University. 29 males and 4 females, with a mean age of(53.61±9.65)years old. The cohort included 30 cases of dilated cardiomyopathy, 2 cases of ischemic cardiomyopathy, and 1 case of noncompaction cardiomyopathy. Patients were grouped based on a preoperative PVR threshold of 3 WU, Preoperative data from Swan-Ganz catheterization, liver and renal function indicators, as well as other relevant clinical parameters were recorded. Patients were followed up to assess differences in survival outcomes.Results:Preoperative PVR was elevated in 18 cases(60%)of the patients, with a mean preoperative PVR of(3.16±1.71)WU. Immediate postoperative right heart catheterization was performed in 20 patients, showing a significant reduction in PVR from(3.85±1.72)WU preoperatively to(1.80±1.38)WU postoperatively( P<0.05). The cardiac index improved significantly from(1.95±0.63)L·min -1·m -2 preoperatively to(4.25±1.26)L·min -1·m -2 postoperatively( P<0.001). The mean follow-up duration was(14.78±12.06)months, no significant difference in postoperative survival was observed between the two groups(100% vs. 80%, P=0.667). Conclusion:Increased pulmonary resistance is often secondary to left heart dysfunction. After the implantation of a LVAD, pulmonary resistance can be improved. For patients with relatively normal right heart function before surgery, elevated pulmonary resistance does not affect the short-term outcomes of the implantation.

The upset insomnia caused by life and work pressure has seriously affected the physical and mental health of modern people and induced many diseases. The quality of Chinese medicine for nourishing heart and tranquilizing mind is stable, and it has a significant effect on the treatment of insomnia, with fewer adverse reactions, and no dependence on sedative and hypnotic as chemical drugs. The Chinese herbal pieces and preparations for nourishing heart and tranquilizing mind can be divided into psychotropic and sedative drugs according to their functions. Their active ingredients mainly include flavonoids, alkaloids, organic acids, polysaccharides, amino acids and vitamins, etc. They are mostly used in the treatment of cardiovascular diseases and central nervous system inhibition. In this paper, the types and active ingredients and development tendency and application status of the Chinese herbal pieces and preparations of nourishing heart and tranquilizing mind were reviewed individually, in order to provide reference for the development of drugs of nourishing heart and tranquilizing mind in the field of clinical application and related drugs.

AIM:To explore the mechanism of ac-tion of the microtubular inhibitor of CA-4 deriva-tive LGD5 on human cervical cancer HeLa cells.METHODS:HeLa cells were selected and divided in-to blank group,CA-4 positive control group,and dif-ferent concentrations of LGD5 were formed into the experimental group.MTT was used to investi-gate the growth inhibition of LGD5 on HeLa cells and to determine the assay concentration.Cell morphology and apoptosis were observed before and after drug administration by inverted micro-scope and acridine orange staining.Immunofluo-rescence staining was used to examine the effect of LGD5 on microtubules using DAPI.The effect of LGD5 on cell cycle by PI flow cytometry.Protein im-munoblotting was used to examine the effect of LGD5 on cyclins and apoptosis-related proteins.RE-SULTS:MTT experiments showed that LGD5 inhibit-ed HeLa cells in a time-and dose-dependent man-ner.Timed photography and acridine orange stain-ing observed that LGD5 induced apoptosis in HeLa cells and produced significant chromatin agglutina-tion and apoptotic bodies.Inhibition of microtu-bule polymerization in HeLa cells by LGD5 was ob-served by DAPI staining.The PI flow cytometry re-sults showed that LGD5 induced G2/M cycle arrest in HeLa cells,was time-dependent and dose-depen-dent within 12 h,and had a significant difference(P＜0.01),apoptosis was induced after 24 h and it was time-dependent.The results of Western blot show that,LGD5 downregulates Cdc 2 and Cdc25C,up-regulation of p-Cdc 2,and Cyclin B1 and p-histone H3,further verified that LGD5 induced G2/M cycle arrest in HeLa cells,besides,LGD5 caused in-creased Caspase 3 expression in HeLa cells,upregu-lated Caspase 9 and Bax,down-regulation of Pro-caspase 9 and Bcl-2,this result indicates that HeLa cell apoptosis induced by LGD5 is related to the mi-tochondrial pathway.CONCLUSION:The CA-4 deriv-ative LGD5 inhibited microtubule polymerization in HeLa cells,induced their G2/M cycle arrest,and subsequently induced cell apoptosis through the mitochondrial pathway.

Objective:To investigatethe maternal and infant adverse outcomes of group B streptococcus (GBS) colonization during the late pregnancy.Methods:A total of 567 pregnant women who underwent obstetrics and gynecology examination in Yuyao People′s Hospital from December 2018 to June 2019 were selected for the study. Internal vaginal secretions of all the pregnant women were extracted from the lower 1/3 of the vagina for bacterial culture, and GBS culture and screening were performed on pregnant women. According to the results of GBS screening, pregnant women were divided into GBS negative group (8 cases) and GBS positive group (559 cases). The general condition and pregnancy outcomes of pregnant women were compared between the two groups, and the correlation between pregnancy outcomes and streptococcus colonization was analyzed.Results:There were no statistically significant differences in age, gestational weeks, number of births, number of pregnancies, history of abortion, residence area and ethnicity between the two groups ( P>0.05). The incidence of premature rupture of membranes and fetal distress in GBS positive group were higher than those in GBS negative group:5/8 vs. 7.69%(43/559), 3/8 vs. 5.01%(28/559), and the differences were statistically significant ( P<0.05). Spearman single factor correlation analysis showed that GBS colonization in pregnant women were positively correlated with premature rupture of membranes and fetal distress ( r = 0.632, 0.573, P<0.05). Conclusions:GBS colonization in late pregnancy is closely related to pregnancy outcomes, and strengthening GBS screening has great significance to reduce adverse pregnancy outcomes.

【Objective】 To analyze the frequency and profile of irregular antibodies in different ethnic groups through screening and identification of irregular antibodies in 67 552 blood recipients in the Affiliated Hospital of Guizhou Medical University. 【Methods】 Irregular antibody screening was carried out in patients with different ethnic groups from August 1, 2016 to July 31, 2019 by microcolumn gel anti human globulin method, and the irregular antibody specificity were identified by panel cells. 【Results】 1)307 out of 67 552 cases were positive for irregular antibody, with the positive rate at 0.45%(307/67 552). Among them, Chuanqing was 1.27%(6/473), Yi 1.15%(4/348), Buyi 1.03%(10/975), Dong 0.58%(3/514), Han 0.44%(273/62 365), Miao 0.42%(5/1 187) and Tujia 0.34%(2/596), with significant differences among nationalities. Irregular antibody detection: the positive rate of female patients(0.56%, 223/41 359) was higher than that of male patients(0.32%, 84/26 193)(P<0.05). The positive rate of patients transfused before(1.22%, 129/10 553) was higher than non-transfusion patients(0.31%, 178/56 999)(P<0.05). The positive rate of female patients with pregnancy history(0.52%, 192/37 176) was higher than non-pregnancy females(0.17%, 7/4 183)(P<0.05). The positive rate increased with age, without any significant differences(P>0.05). The yields of irregular antibodies did not differ by ABO blood groups(P>0.05). 3)The specificity of 307 irregular antibody positive cases involved 7 blood group systems, including Rh system 59.28%(182/307), MNSs system 9.12%(28/307), Kidd system 0.65%(2/307), Duffy system 0.98%(3/307), Lewis system 5.86%(18/307), P system 0.65%(2/307), and Digeo system 0.33%(1/307). In addition, 15.64%(48/307) of autoantibodies, 0.65%(2/307) of cold antibodies and 4.93%(15/307) of unclear antibodies were detected. 4)The distribution of anti-D, anti-C and autoantibodies were statistically significant among the Han, Buyi, Chuanqing, Miao, Yi and Dong nationalities(P<0.05), while the others were similar(P>0.05). 【Conclusion】 The distribution of irregular antibodies in Guizhou is different by nationalities. Routine screening of irregular antibodies for transfused or pregnant patients can increase the safety and efficacy of blood transfusion. Most of the irregular antibodies detected are Rh blood group system. The exposure to irregular antibodies can be reduced by additional detection of blood group antigen other than RhD for blood recipients and donors, as well as the blood transfusion with matched blood group antigens.