Objective:To explore risk factors for delayed onset of lactogenesis in prenatally overweight women and construct risk prediction models based on machine learning for early identification of high-risk individuals.Methods:Convenience sampling was adopted to select 338 prenatally overweight women who delivered in the Obstetrics Departments of four ClassⅢ Grade A hospitals in Hengyang City from October 2023 to June 2024 for the study. Delivery women were randomly divided into training set and test set in the ratio of 7∶3. The survey was conducted with the General Information Questionnaire, Breastfeeding Self-efficacy Scale Short Form, Edinburgh Postnatal Depression Scale, LATCH Scale and Pittsburgh Sleep Quality Index. One-way analysis and LASSO regression were used to screen predictors using delayed onset of lactogenesis as the outcome variable. Risk prediction models were constructed based on three machine learning algorithms of Logistic regression, support vector, and random forest, respectively. The models were tuned by ten-fold cross-validation to filter out the best models.Results:Delayed onset of lactogenesis occurred in 140 of 338 prenatally overweight women, an incidence of 41.4%. Among the three predictive model performances, the random forest model had the highest area under the receiver operating characteristic curve, accuracy, precision, recall, and F1 value. The importance of each predictor was ranked according to the fandom forest algorithm, and in descending order of importance, they were breastfeeding 1 h after the birth of the newborn, number of previous deliveries, age, feeding mode 3 d postpartum, pregnancy complications, mode of delivery, number of breastfeeding 24 h postpartum, and monthly household income.Conclusions:Risk prediction models for delayed onset of lactogenesis in prenatally overweight women are constructed based on three machine learning algorithms, aiming to help provide a scientific basis for clinical healthcare professionals to take relevant decisions.

Objective:To explore risk factors for delayed onset of lactogenesis in prenatally overweight women and construct risk prediction models based on machine learning for early identification of high-risk individuals.Methods:Convenience sampling was adopted to select 338 prenatally overweight women who delivered in the Obstetrics Departments of four ClassⅢ Grade A hospitals in Hengyang City from October 2023 to June 2024 for the study. Delivery women were randomly divided into training set and test set in the ratio of 7∶3. The survey was conducted with the General Information Questionnaire, Breastfeeding Self-efficacy Scale Short Form, Edinburgh Postnatal Depression Scale, LATCH Scale and Pittsburgh Sleep Quality Index. One-way analysis and LASSO regression were used to screen predictors using delayed onset of lactogenesis as the outcome variable. Risk prediction models were constructed based on three machine learning algorithms of Logistic regression, support vector, and random forest, respectively. The models were tuned by ten-fold cross-validation to filter out the best models.Results:Delayed onset of lactogenesis occurred in 140 of 338 prenatally overweight women, an incidence of 41.4%. Among the three predictive model performances, the random forest model had the highest area under the receiver operating characteristic curve, accuracy, precision, recall, and F1 value. The importance of each predictor was ranked according to the fandom forest algorithm, and in descending order of importance, they were breastfeeding 1 h after the birth of the newborn, number of previous deliveries, age, feeding mode 3 d postpartum, pregnancy complications, mode of delivery, number of breastfeeding 24 h postpartum, and monthly household income.Conclusions:Risk prediction models for delayed onset of lactogenesis in prenatally overweight women are constructed based on three machine learning algorithms, aiming to help provide a scientific basis for clinical healthcare professionals to take relevant decisions.

OBJECTIVE To report the analysis and treatment of liver function injury caused by heparin sodium injection in the positive control group in an early clinical study of new drugs, in order to provide reference for the clinical use of heparin sodium injection and provide ideas for the treatment of adverse reactions. METHODS Analyzed and summarized one case of liver injury in a tolerance and pharmacokinetics study of a new anticoagulant drug with both placebo and heparin sodium as control, described the case process, analyzed the cause, and discussed the enlightenment for treatment of adverse event in early clinical research and the safety of heparin sodium in clinical use. RESULTS Three cases occurred different degrees increasing of alanine aminotransferase and aspartate aminotransferase after 4 healthy subjects were infused with heparin sodium for 5 consecutive days. It was considered that those were adverse reactions caused by heparin sodium. Timely treatment was performed by strengthening monitoring and administrating liver protective drugs. Protocol was revised to avoid further injury to the follow-up subjects. CONCLUSION Continuous infusion of heparin sodium injection can easily cause liver function damage, and should be given sufficient attention during clinical use. Early clinical research should promptly analyze and handle adverse reactions to ensure the safety of subjects.

Objective:To explore the association of DNA methylation with immune response to hepatitis B (HepB) vaccine in Han nationality children from Guangxi province.Methods:A total of 263 children aged 8-9 months who had completed HepB immunization program were recruited from three hospitals in Guangxi province by using unmatched case-control method. Children with the HepB surface antibody concentration(Anti -HBs)<100 mIU/ml was set as the case group and ≥100 mIU/ml as the control group. Multiplex PCR and heavy sulfite sequencing were used to treat the samples. Illumina platform was used for high-throughput DNA methylation sequencing of IFNG gene target regions and CpG sites. Unconditional logistic regression was used to analyze the association between cytosine-phospho-guanosine DNA methylation at 18 loci of IFNG gene and HepB immune response level. Results:There were 104 children in the case group and 159 in the control group. The median ( Q1, Q3) level of anti -HBs in two groups were 62.34 (30.06, 98.88) mIU/ml and 1 089.10 (710.35, 1 233.45) mIU/ml. The methylation levels of IFNG_1 gene 44 and 93 locus in the case group were higher than those in the control group ( P<0.05). The unconditional logistic regression model showed that the DNA methylation level of IFNG_1 gene at 44 ( OR=1.18, 95% CI: 1.03-1.35) and 93 ( OR=1.21, 95% CI: 1.07-1.38) locus was associated with the HepB response level. Conclusion:The changes of DNA methylation at locus 44 and 93 of IFNG_1 gene may be relevant factors affecting the response level of HepB in Han nationality children from Guangxi province.

Objective:To explore the association of DNA methylation with immune response to hepatitis B (HepB) vaccine in Han nationality children from Guangxi province.Methods:A total of 263 children aged 8-9 months who had completed HepB immunization program were recruited from three hospitals in Guangxi province by using unmatched case-control method. Children with the HepB surface antibody concentration(Anti -HBs)<100 mIU/ml was set as the case group and ≥100 mIU/ml as the control group. Multiplex PCR and heavy sulfite sequencing were used to treat the samples. Illumina platform was used for high-throughput DNA methylation sequencing of IFNG gene target regions and CpG sites. Unconditional logistic regression was used to analyze the association between cytosine-phospho-guanosine DNA methylation at 18 loci of IFNG gene and HepB immune response level. Results:There were 104 children in the case group and 159 in the control group. The median ( Q1, Q3) level of anti -HBs in two groups were 62.34 (30.06, 98.88) mIU/ml and 1 089.10 (710.35, 1 233.45) mIU/ml. The methylation levels of IFNG_1 gene 44 and 93 locus in the case group were higher than those in the control group ( P<0.05). The unconditional logistic regression model showed that the DNA methylation level of IFNG_1 gene at 44 ( OR=1.18, 95% CI: 1.03-1.35) and 93 ( OR=1.21, 95% CI: 1.07-1.38) locus was associated with the HepB response level. Conclusion:The changes of DNA methylation at locus 44 and 93 of IFNG_1 gene may be relevant factors affecting the response level of HepB in Han nationality children from Guangxi province.

Objective:To explore the influential factors of lumbar inter-vertebral disc degeneration and provide the references on flying personnel′s recruitment, physical checkup for transformation and medical identification.Methods:Lumbar MRI images and relevant data of 458 flying personnel who underwent medical identification in the Second Area of Air Force Healthcare Center for Special Services Hangzhou from March 2018 to May 2019 were retrospectively analyzed. Two thousand two hundred and ninety lumbar inter-vertebral discs of 458 flying personnel were semi quantitatively scored according to the Pfirrmann standard. The sum of five inter-vertebral disc scores of each flying personnel was taken as the lumbar inter-vertebral disc degenerative factor (LIVDDF). This factor was taken as the dependent variable ( y), and the age ( x1), height ( x2), weight ( x3), and flying hours ( x4) of flying personnel were taken as independent variables for linear regression analysis. The subgroup analysis was carried out based on the grouping of aircraft type and flight post. Results:The range of LIVDDF was 5-18, with an average of 10.87±2.83. Total analysis showed that age and weight were the influential factors of lumbar inter-vertebral disc degeneration in flying personnel. The regression equation was y=1.029+0.182 x1+0.038 x3 ( r=0.68, P<0.01). Subgroup analysis on the different aircraft types showed that the influential factor was age in the fighter subgroup. The regression equation was y=2.569+0.225 x1 ( r=0.59, P<0.01). Age and height were the influential factors in the trans-bomber aircraft subgroup. The regression equation was y=-8.848+0.186 x1+7.160 x2( r=0.69, P<0.01). Flying hours was the influential factor in the helicopter subgroup. The regression equation was y=7.823+0.001 x4 ( r=0.65, P<0.01). Subgroup analysis on different flight post showed that the influential factors were age in flying personnel. The regression equation was y=3.176+0.207 x1 ( r=0.65, P<0.01). Age and weight were the influential factors in crew members. The regression equation was y=-0.113+0.171 x1+0.056 x3( r=0.74, P<0.01). Conclusions:Age and weight are the main influential factors of lumbar inter-vertebral disc degeneration in flying personnel, but these factors show different influence on aircraft type and flight post. Due to the small sample size in this study, aviation related factors are not fully included. So other influential factors of lumbar inter-vertebral disc degeneration of flying personnel may exist.

Objective:To explore the influential factors of lumbar inter-vertebral disc degeneration and provide the references on flying personnel′s recruitment, physical checkup for transformation and medical identification.Methods:Lumbar MRI images and relevant data of 458 flying personnel who underwent medical identification in the Second Area of Air Force Healthcare Center for Special Services Hangzhou from March 2018 to May 2019 were retrospectively analyzed. Two thousand two hundred and ninety lumbar inter-vertebral discs of 458 flying personnel were semi quantitatively scored according to the Pfirrmann standard. The sum of five inter-vertebral disc scores of each flying personnel was taken as the lumbar inter-vertebral disc degenerative factor (LIVDDF). This factor was taken as the dependent variable ( y), and the age ( x1), height ( x2), weight ( x3), and flying hours ( x4) of flying personnel were taken as independent variables for linear regression analysis. The subgroup analysis was carried out based on the grouping of aircraft type and flight post. Results:The range of LIVDDF was 5-18, with an average of 10.87±2.83. Total analysis showed that age and weight were the influential factors of lumbar inter-vertebral disc degeneration in flying personnel. The regression equation was y=1.029+0.182 x1+0.038 x3 ( r=0.68, P<0.01). Subgroup analysis on the different aircraft types showed that the influential factor was age in the fighter subgroup. The regression equation was y=2.569+0.225 x1 ( r=0.59, P<0.01). Age and height were the influential factors in the trans-bomber aircraft subgroup. The regression equation was y=-8.848+0.186 x1+7.160 x2( r=0.69, P<0.01). Flying hours was the influential factor in the helicopter subgroup. The regression equation was y=7.823+0.001 x4 ( r=0.65, P<0.01). Subgroup analysis on different flight post showed that the influential factors were age in flying personnel. The regression equation was y=3.176+0.207 x1 ( r=0.65, P<0.01). Age and weight were the influential factors in crew members. The regression equation was y=-0.113+0.171 x1+0.056 x3( r=0.74, P<0.01). Conclusions:Age and weight are the main influential factors of lumbar inter-vertebral disc degeneration in flying personnel, but these factors show different influence on aircraft type and flight post. Due to the small sample size in this study, aviation related factors are not fully included. So other influential factors of lumbar inter-vertebral disc degeneration of flying personnel may exist.

AIM: To determine the median effective plasma concentration (Cp50) of propofol inhibiting body movement when combined with butorphanol in patients undergoing hysteroscopic surgery. METHODS: Twenty-one patients scheduled for elective hysteroscopic surgery under non-intubated intravenous anesthesia, age 20-55 years old, ASA physical status or Ⅱ, were enrolled in this study, and anesthesia was induced by target-controlled infusion of propofol. Hysteroscopy was performed only when the plasma concentration and the concentration of the effector chamber were balanced. Butorphanol 20 μg/kg was injected intravenously at 5 min before surgery. The depth of anesthesia and adverse reactions during anesthesia was monitored. The plasma target concentration (Cp) of propofol was determined by up-and-down method, the first patient was 2.5 μg/mL, each time Cp increased/decreased by 10% in the next patient depending on whether or not body movement occurred. The patients were divided into positive and negative groups according to the results. The Cp50 and 95% confidence inlerval (CI) of propofol inhibiting body movement were calculated by up-and-down formula when combined with butorphanol in patients undergoing hysteroscopic surgery. RESULTS: The Cp50(95%CI) of propofol required to inhibit body movement was 2.23(2.12-2.34) μg/mL when combined with butorphanol in patients undergoing hysteroscopic surgery. None of the patients had serious adverse reactions. CONCLUSION: The Cp50 of propofol required to inhibit body movement is 2.23 μg/mL when combined with 20 μg/kg butorphanol in patients undergoing hysteroscopic surgery. It provides a reference for safe dosage of anesthesia in hysteroscopic surgery.

Objective To study the effects of dexmedetomidine on the swallowing reflex. Methods Sixty adult volunteers (ASAⅠ-Ⅱ) were randomly divided into two groups, dexmedetomidine sedation group and propofol sedation group respectively. The BIS value was maintained between 60-65 in both groups. Swallowing reflex was induced by water injection in the pharynx at different depths of sedation, and the swallowing movements were observed. Meanwhile, the RR, SpO2 and OAA/S scores were recorded. Results The swallowing reflex existed in dexmedetomidine sedation group when BIS values was maintained at 60, which had significant difference compared with that in propofol sedation group. The RR, SpO2, OAA/S score in dexmedetomidine sedation group also had statistical difference compared with that in propofol sedation group during swallowing reflex test. Conclusions Slow infusion of dexmedetomidine to maintain the BIS value above 60 will not affect swallowing reflex, and can obtain satisfactory hemodynamic stability. It′clinical safety is high.

Objective To explore the application value of early humanistic care hospitalization mode in nursing of patients with acute myocardial infarction (AMI) treated by elective interventional therapy.Methods A total of 140 patients with AMI treated by elective percutaneous coronary intervention (PCI) in our hospital from November 2015 to December 2016 were enrolled in the study, and were randomly divided into observation group and control group, with 70 cases in each group.The control group was given routine nursing during hospitalization, and the observation group was given early humanistic care.The success rate of PCI, incidence of complications and recurrence rate of myocardial infarction were compared between the two groups.The left ventricular ejection fraction (LVEF), heart rate (HR) and serum creatine kinase isoenzyme (CK-MB) were determined.The emotion and degree of angina pectoris in the two groups were evaluated by the Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS) and Seattle Angina Questionnaire (SAQ), and nursing satisfaction were compared between the two groups.Results The success rate of PCI was significantly higher in the observation group than the control group.The incidence of postoperative complications and the recurrence rate of myocardial infarction were significantly lower in the observation group than the control group (P<0.05).After nursing, LVEF in the observation group was higher while HR and CK-MB level were significantly lower than those in the control group (P<0.05).After nursing, the SAS score and SDS score of the observation group were lower than that of the control group, and the SAQ score was higher than that of the control group (P<0.05).The nursing satisfaction of the observation group was higher than that of the control group (P<0.05).Conclusion The application of early humanistic care hospitalization mode in nursing of patients with AMI treated by elective PCI can significantly improve the success rate of PCI and nursing satisfaction, enhance laboratory indicators and emotion, relieve the degree of angina pectoris, and reduce the recurrence rate and incidence of complications.