ObjectiveTo understand the utilization of preconception healthcare services and the influencing factors among the women expecting additional childbirth in Jiading District， Shanghai， and to provide references for promoting the utilization of preconception healthcare services under the new population policy. MethodsA questionnaire survey on the utilization of preconception healthcare services and related influencing factors was carried out among 682 women expecting additional childbirth across six subdistricts in Jiading District， Shanghai. The results were statistically analyzed. ResultsThe average age of the women was （31.7±4.5） years， 30.2% of whom were ≥35 years old. The proportion of women having their third or subsequent children was low， at 16.4%. A significant majority， 92.4%， were found to have various risk factors during initial pregnancy screening. The utilization rate of preconception healthcare services among women seeking additional childbirth was relatively low at 26.7%. Awareness of the free preconception check-up program in Jiading District was also low at 28.6%， and the utilization rate for these services was even lower at 7.69%. Unplanned pregnancies were the primary reason for not utilizing preconception healthcare services， accounting for 63.6%. The results of multifactorial binary logistic regression analysis showed that the utilization rate of preconception healthcare services before the current pregnancy was higher for women aged between 35 and 39 compared to women aged ≤29 years old （OR=1.789， 95%CI： 1.033‒3.099）. Women with planned pregnancies had a higher utilization of preconception healthcare services prior to this pregnancy （OR=4.164， 95%CI： 2.627‒6.602）. Women who had received preconception care prior to their first birth had a higher utilization rate of preconception care prior to the current pregnancy （OR=7.534， 95%CI： 4.954‒11.456）. Women without a family history of chronic diseases had a higher utilization rate of preconception healthcare services （OR=1.903， 95%CI： 1.083‒3.345）. ConclusionUnder the context of three-child policy， the proportion of women seeking three or more children in Jiading District is low. Most of these women have risk factors identified during initial pregnancy screenings. The utilization rate of preconception healthcare services and the awareness of the free preconception screening program in Jiading District are both low. Unplanned pregnancies remain the primary reason for failing to receive timely preconception healthcare services. Age， whether the pregnancy was planned， whether the women had received preconception healthcare services before their first baby and family history of chronic diseases are the main factors affecting the utilization of preconception healthcare services. Relevant departments should enhance the promotion of preconception healthcare service programs， especially for women of childbearing age who have not yet given birth， so as to improve the utilization rate of preconception health care services.

【Objective】 To investigate the effects of miR-126-3p targeting chemokine receptor 1 (CCR1) in exosomes derived from bone marrow mesenchymal stem cells (BMSC) on the proliferation, migration, and invasion of lung cancer cells. 【Methods】 BMSC cells were cultured; exosomes were extracted and identified by the exosomal marker proteins CD63 and TSG101. After exosome culture of A549 cells for different durations (0, 24, 48, and 72 h), cell survival rate was detected by CCK-8, mRNA levels of miR-126-3p and CCR1 were detected by qRT-PCR, and cell migration and invasion abilities were detected by Transwell assay. The relative expressions of CCR1, epithelial cadherin (E-cad), neural cadherin (N-cadherin), and Vimentin were detected by Western blotting. 【Results】 Exosomes had round or oval cup-shaped structures with bright edges and dark middle, with a particle size distribution of about 152 nm, expressing CD63 and TSG101 proteins. The expression of miR-126-3p in exosomes was higher than that in A549 cells. The expression of miR-126-3p was low in A549 cells and that of CCR1 mRNA was high. However, after co-culture with exosomes, the expression of miR-126-3p in A549 cells was increased, while the expression of CCR1 was decreased. A549 cells were cocultured with exosomes for 0, 24, 48, and 72 h. The survival rate, migration and invasion abilities, CCR1 gene and protein expression levels, and N-cad and Vimentin protein expression levels of A549 cells decreased gradually with the extension of culture time. The level of miR-126-3p and the expression of E-cad protein increased gradually with the extension of culture time. 【Conclusion】 The co-culture of exosomes derived from bone marrow mesenchymal stem cells with A549 cells can increase the expression level of miR-126-3p, and miR-126-3p can reduce the proliferation, migration, and invasion of A549 cells by targeting the inhibition of CCR1 expression.

欧阳洋，李娟娟，涂毅，孙圣荣（武汉大学人民医院 乳腺甲状腺外科，湖北 武汉 430060） [摘 要] 目的：借助多种癌症生物信息数据库研究乳腺癌组织中缺氧诱导因子1亚基α（HIF1A）的表达水平及其与乳腺癌患者预后及肿瘤免疫细胞浸润的关系。方法：利用Oncomine、人类蛋白质图谱、基因表达谱交互式分析（GEPIA）及TCGA数据库分析HIF1A基因在乳腺癌组织中的表达及其与患者预后、临床病理特征的关系，并在中国人乳腺癌组织标本（选用2011年1月至2015年12月中国武汉大学人民医院手术切除的93例乳腺癌组织和14例良性乳腺疾病组织）中进行验证。对HIF1A高低表达组间的差异基因进行基因本体（GO）和京都基因与基因组百科全书（KEGG）富集分析，用Cibersort R软件评估HIF1A高低表达样本中免疫细胞浸润丰度差异。结果：生物信息数据显示，HIF1A在乳腺癌组织中高表达，预示着患者DFS预后更好（P<0.05）。HIF1A的表达与雌激素受体（ERP）、孕激素受体（PR）和人表皮生长因子受体2（HER2）表达相关（均P<0.05）。GO生物功能及KEGG通路富集分析结果提示，HIF1A可能参与肿瘤免疫调节等生物活动。使用Cibersort分析结果显示，HIF1A与肿瘤免疫细胞浸润之间具有相关性（均P<0.01），发现活化记忆CD4 + T细胞、M0和M1型巨噬细胞与HIF1A表达呈正相关，在乳腺癌组织中高表达，Treg细胞、活化NK细胞、M2型巨噬细胞与HIF1A表达呈负相关（均P<0.01）。结论：HIF1A参与调节肿瘤微环境的免疫活性，与乳腺癌患者DFS相关，其可能成为乳腺癌分级诊断、免疫治疗和预后判断的生物标志物。

ObjectiveTo understand the influencing factors of women’s intention to utilize preconception health care services， so as to promote the utilization of preconception care among women with future pregnancy plan. MethodsThe study was conducted at 8 outpatient health clinics of medical institutions providing perinatal health care in Jiading District of Shanghai. Women who had fertility intention for another child were invited to complete an electronic questionnaire from November 2020 to February 2021. ResultsWomen with better pregnancy and birth care behaviors during the last periconception were more likely to utilize preconception care service before the next conception than those with previous poorer behaviors （OR=1.980， 95%CI= 1.061‒3.694， P=0.032）. Women with higher preconception care knowledge scores had better pregnancy and birth care behaviors during the last periconception than those with lower knowledge scores （OR=1.362， 95%C1= 1.004‒1.846， P=0.047）. ConclusionsIn order to improve the utilization of preconception care among the population with future pregnancy plan， it is necessary to further strengthen health education and social mobilization to promote the preconception eugenic knowledge， planned pregnancy and pregnancy and birth care behaviors.

The application of big data and artificial intelligence technology in the medical field is key to hospital informatization. In October 2018, a tertiary hospital launched a clinical intelligent application platform. The platform took AI assistant as the carrier of intelligent application, supported the role expansion, function expansion and connotation expansion of intelligent application, and layed the foundation for the construction of clinical intelligence. As of July 2022, the platform had been embedded into the outpatient, emergency and inpatient business systems with the help of AI assistant, realizing such intelligent applications as auxiliary diagnosis, auxiliary treatment, risk warning, AI medical record quality control, research entry group and infectious disease management, as well as enriching the connotation of such specialty applications as orthopedics and ear, nose and throat. The platform satisfied the integration and integration of hospital information construction and provided convenient and effective intelligent auxiliary tools for clinical use.

With the application of high throughput sequencing and other technologies, in recent years people have found that bacteria are not only the causative factors of common breast diseases such as mastitis, but also may be involved in the occurrence and development of breast cancer. There are unique bacterial communities in the internal tissues of the breast, and their existence may be related to the incidence of breast cancer. Recent studies have found that intestinal flora may also affect the incidence of breast cancer by regulating estrogen and other pathways. Further exploration of the influence of bacteria on breast cancer will provide new ideas for diagnosis and treatment of breast cancer.

Single-disease management is an important means of medical quality management, and data is the basis of single-disease management. Aiming at the problem of difficult data collection of single disease in hospital, the authors designed a solution to realize the fine management of single-disease data based on data center. The hospital optimized the data quality through overall management, unified the data collection source based on the data center, built a single-disease intelligent collection platform to complete the data collection, and calibrated the data to ensure its accuracy, so as to form a single-disease index management process and realize high-quality data collection. The average actual backfill rate was as high as 95.7%. On this basis, the hospital optimized the single-disease reporting and quality control management mode to further promote the fine management of medical quality.

As medical record management is key to hospital management, a hospital introduced paperless practice of automatic archiving in the following practices. Clarification and identification of the scope of business system transformation, establishment of an architecture integrating various business systems, integration platform, hospital data center, archiving system and certification authority, creation of three automatic archiving processes: initial archiving, late return archiving and modification archiving, for refined management of the review and tracking of archived medical records. Thanks to this paperless management, the automatic archiving rate was as high as 95.95%for medical records, 96.47%for laboratory reports and 99.58%for medical orders respectively. A full-process and whole-cycle informationized closed loop management was achieved for the collection, archiving, review and utilization of medical records, substantially upgrading hospital informationization and medical record management.

Objective To study the preventive effect of epigallocatechin gallate(EGCG)on hyperoxiainduced bronchopulmonary dysplasia in mice.Methods Eighty-eight Kunming mice born 36-40 hours were randomly divided into four groups:air + saline group (n =22),air + EGCG group (n =22),hyperoxia + saline group(n =22) and hyperoxia + EGCG group(n =22).Drug was administrated once a day by air-driven atomization,till 28 days.Furthermore,the hyperoxia groups were transferred into the room air for recovery after raised in (70 ± 3) ％ oxygen for 28 days.Lung pathological morphology and homogenization ELISA were performed on the 21th,28th and 49th day.The pathological changes of lung tissue radical alveolar counts(RAC) were observed and the levels of interleukin-2 (IL-2),tumor necrosis factor(TNF-α) and myeloperoxidase(MPO) were measured.Results The levels of IL-2 and TNF-α in the air groups were significantly lower than those in hyperoxia group(IL-2:air(1 760.83 ±303.38)pg/g vs hyperoxia(4 251.00 ±644.07) pg/g;TNF-a:air(4 308.83 ±1 114.91) pg/g vs hyperoxia(8301.83 ± 802.26) pg/g) (P ＜ 0.01),and MPO level decreased in hyperoxia +EG-CG group(7 472.83 ± 1 922)U/g,hyperoxia +NS group(4 767.68 ± 1 110.72)U/g,air + EGCG group(3712.68 ± 734.40)U/g,air + NS group(2 711.68 ± 763.39)U/g(P ＜0.05).In the hyperoxia groups,though IL-2 on 21th day and TNF-αt on 49th day were no statistic difference in hyperoxia group and air group,the inflammatory factors in EGCG group were lower than in hyperoxia + NS group.Pathology showed that the RAC count of the air groups increased gradually,while the hyperoxic groups were gradually decreased,however,the EGCG group tend to recover after 21 days recovery in room air.Conclusion Inhalation of EGCG can reduce the level of inflammatory response in lung tissue of hyperoxia exposed mice.EGCG attenuated lung injury in hyperoxia-exposed mice,and accelerated lung recovery after hyperoxia exposure in experimental animals.EGCG has potential effect to prevent hyperoxia induced bronchopulmonary dysplasia.

The treatment of breast cancer is becoming more individualized and minimally invasive,which makes sentinel lymph node biopsy becoming the standard treatment for axillary in patients with early-stage breast cancer who are negative in clinical axillary lymph nodes.Tracers image sentinel lymph nodes or lymphatic vessels for the successful detection of sentinel lymph node biopsy.Tracers selection is also more diverse,such as nano carbon mixed suspension,methylene blue,radioisotope,indocyanine green,etc.Different tracers and combined applications have their advantages and limitations.As for the selection of tracing methods,many factors need to be weighed.