ObjectiveTo evaluate the pregnancy outcomes of assisted reproductive technology （ART） in women with a history of thyroid cancer who retained fertility intentions after completing cancer treatment. MethodsA retrospective analysis was performed on 61 patients with a history of thyroid cancer who underwent in vitro fertilization/intracytoplasmic sperm microinjection and embryo transfer （IVF/ICSI-ET）. These patients were included as the case group. A total of 122 non-cancer patients who received ART during the same period were selected as the control group using 1∶2 matching based on age and oocyte retrieval time. Baseline characteristics， outcomes of the first ART cycle， and cumulative pregnancy outcomes were compared between the two groups. ResultsThere was no significant difference in the basic data， the total amount of gonadotropin （Gn） and the days of use between the case group and the control group （P>0.05）. However， the case group had significantly fewer retrieved oocytes， mature oocytes （MII）， lower fertilization and cleavage rates， and fewer transferable and high-quality embryos， as well as fewer embryos transferred during the first cycle （P < 0.05）. However， there was no significant difference in the rate of first embryo implantation and first clinical pregnancy between the two groups （P>0.05）. In the analysis of cumulative outcomes， the two groups did not show statistically significant differences in the cumulative pregnancy rate， clinical pregnancy rate per transfer cycle， the number of oocyte retrieval cycles required per live birth， the number of embryo transfer cycles required per live birth， and the number of embryos used for each live birth （P>0.05）. However， the cumulative live birth rate was significantly lower in the case group compared to the control group （P=0.005）. ConclusionAfter treatment for thyroid cancer， when ART is used to help pregnant women， the pregnancy outcome is comparable to that of women without tumors. Individualized reproductive management and timely fertility preservation strategies are recommended to optimize reproductive outcomes in this population.

ObjectiveTo observe the clinical efficacy of Anshen Buxin Gao in patients with coronary artery disease （CAD） complicated with somatization disorder after percutaneous coronary intervention （PCI）， as well as its effect on heart rate variability （HRV）. MethodsA total of 96 patients with somatization disorder after PCI were selected and randomized into control and treatment groups （48 cases）. On the basis of standardized Western medical treatment for CAD， the control group received Dailixin， while the treatment group received Dailixin combined with Anshen Buxin Gao. The somatic symptom scale （SSS）， generalized anxiety disorder 7-item scale （GAD-7）， patient health questionnaire-9 （PHQ-9）， and self-rating scale of sleep （SRSS） scores in both groups were recorded before and after treatment. The traditional Chinese medicine symptom efficacy， HRV， and incidence of adverse drug reactions were observed. ResultsA total of 90 patients completed the trial， encompassing 45 patients in the control group and 45 patients in the treatment group. Baseline characteristics between the two groups showed no statistically significant differences， indicating comparability. After treatment， both groups exhibited reductions in SSS， GAD-7， and PHQ-9 scores （P<0.05）， and the treatment group outperformed the control group in alleviating somatic symptoms and anxiety-depression symptoms （P<0.05）. The control group did not achieve a significant reduction in SRSS score， whereas the treatment group effectively lowered the SRSS score （P<0.05）. Regarding traditional Chinese medicine symptom efficacy， the total response rate in the treatment group was 91.1% （41/45）， which was higher than that （71.1%， 32/45） in the control group （Z=-2.663， P<0.05）. Both groups improved HRV in patients with somatization disorder， and the treatment group showed greater improvement （P<0.05）. There were no serious clinical adverse events during the study period. The incidence of adverse reactions in the treatment group was 6.7% （3/45）， which was lower than that （14/45， 31.10%） in the control group （χ²=7.252， P<0.05）. ConclusionThe addition of Anshen Buxin Gao to Dailixin therapy significantly alleviates the clinical symptoms and improves the sleep quality， treatment efficacy， and HRV in patients with CAD complicated with somatization disorder after PCI， while reducing the adverse effects associated with Dailixin alone. This approach demonstrates considerable clinical value and warrants further promotion.

Objective To explore the value of three-dimensional pseudo-continuous arterial spin labeling(3D pCASL)and diffu-sion weighted imaging(DWI)in the differential diagnosis of stage T1 nasopharyngeal carcinoma(NPCT1)and lymphoid hyperplasia(LH).Methods A total of 21 patients with pathological diagnosis and clinical stage of NPCT1(NPCT1 group)and 50 patients with pathological diagnosis of LH(LH group)were selected.All patients underwent nasopharyngeal 3D pCASL and DWI scans before treatment.The blood flow(BF)values of all lesions[minimum BF(BFmin),mean BF(BFmean),maximum BF(BFmax)],and the rel-ative blood flow(rBF)values of the ratio of lesions to lateral pterygoid muscle at the same plane[minimum rBF(rBFmin),mean rBF(rBFmean),maximum rBF(rBFmax)],the apparent diffusion coefficient(ADC)values[minimum ADC(ADCmin),mean ADC(ADCmean),maximum ADC(ADCmax)]of all lesions were measured.The differences in parameters between NPCT1 group and LH group were analyzed,and the diagnostic efficiency of each parameter was analyzed via receiver operating characteristic(ROC)curve.Results The values of BFmean,BFmax,rBFmin,rBFmean and rBFmax of NPCT1 group were higher than those of LH group,with statisti-cally significant difference(P<0.05).However,there were no significant difference in the values of ADCmin,ADCmean and ADCmax between the two groups(P>0.05).The area under the curve(AUC)of BFmean,BFmax,rBFmin,rBFmean and rBFmax values for differen-tial diagnosis of NPCT1 and LH were 0.677,0.804,0.748,0.746 and 0.858,respectively.Conclusion 3D pCASL technique can reflect non-invasively the difference of blood perfusion between NPCT1 and LH,and can be used as an effective method to distin-guish NPCT1 from LH,with the better diagnostic efficiency of BFmax and rBFmax.However,DWI is difficult to distinguish the difference of water molecule diffusion between NPCT1 and LH,which has limited value in differential diagnosis.

Objective:To identify the relevant factors for the first-course remission of acute myeloid leukemia (AML) and to develop a predictive model as well as assess its predictive capability.Methods:Clinical data of 749 patients newly diagnosed with AML admitted to the Department of Hematology, the First Affiliated Hospital, Zhejiang University, School of Medicine from January 1, 2019, to April 30, 2023, were collected and randomly divided into training and validation sets. Multivariate logistic regression analysis was conducted to determine variables associated with complete remission in the first course of induction therapy, and a predictive model was established based on these variables. The receiver operating characteristic (ROC) curve of the predictive model was plotted, and the area under the curve (AUC) was calculated.Results:The indicators predicting the first remission course included peripheral blood white blood cell count during onset, CBF::MYH11 fusion gene, CEBPA bZIP region mutation, myelodysplastic syndrome-related gene mutation, and induction chemotherapy regimen selection as independent factors for the first remission course. The model’s area under the training and validation curves was 0.738 (95% CI: 0.696-0.780) and 0.726 (95% CI: 0.650-0.801), respectively. The Hosmer-Lemeshow test results yielded P-values of 0.993 and 0.335, respectively. Conclusion:In this study, the developed model demonstrates a strong predictive capability for the efficacy of the first course of patients with AML, providing valuable guidance to clinicians in assessing patient prognosis and selecting appropriate treatment strategies.

Objective Using meta-analysis to identify the risk factors for slow-flow or no-reflow during percutaneous coronary intervention(PCI)in patients with ST-segment elevation acute myocardial infarction(AMI).Methods A computerized retrieval of academic papers concerning the risk factors for slow-flow or no-reflow during PCI in patients with ST-segment elevation AMI from the databases of CNKI,Wanfang Database,VIP,SinoMed,PubMed,Web of Science,Embase,and Cochrane Library was conducted.The retrieval time period was from the establishment of the database to January 2024.In order to ensure the accuracy and reliability of the study,two independent reviewers screened the literature according to the preset inclusion and exclusion criteria,extracted key data,and strictly evaluated the quality of the literature.RevMan5.4 software was used to make meta-analysis.Results A total of 23 articles with a total of 9 780 cases were included in this analysis.The results of meta-analysis showed that reperfusion time ≥6 h(OR=1.52),preoperative TIMI blood flow≤level-Ⅰ(OR=1.12),heavy thrombus burden(OR=1.60),advanced age(OR=1.56),diabetes(OR=1.83),preoperative Killip grade≥Ⅲ(OR=2.52),long target vessel disease(OR=1.95),and collateral flow≤level-Ⅰ(OR=1.61)were the risk factors for slow-flow or no-reflow during PCI in patients with ST-segment elevation AMI.Preoperative systolic blood pressure＜90 mmHg(OR=1.17)and high white blood cell(WBC)count(OR=1.27)were not the risk factors for slow-flow or no-reflow during PCI in patients with ST-segment elevation AMI.Conclusion Reperfusion time ≥ 6 h,preoperative TIMI blood flow≤level-Ⅰ,heavy thrombus burden,advanced age,diabetes,preoperative Killip grade≥level-Ⅲ,long target vessel lesion,and collateral blood flow≤level-Ⅰ are the independent risk factors for slow-flow or no-reflow during PCI in patients with ST-segment elevation AMI.

Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.

Objective To explore the value of multi-parameter MRI in predicting the Ki-67 expression level in nasopharyngeal carcinoma(NPC).Methods The clinical and MRI data of 63 patients with pathologically confirmed NPC were prospectively collected.All patients underwent routine plain and enhanced nasopharyngeal MRI,diffusion weighted imaging(DWI),and arterial spin labeling(ASL)scans before treatment.Multivariate logistic regression analysis was used to identify the independent risk factors for the Ki-67 expression level.Results The degree of enhancement,the maximum blood flow(BFmax),and the minimum apparent diffusion coefficient(ADCmin)were independent risk factors for the Ki-67 expression level in NPC patients.The area under the curve(AUC)of the prediction model established based on these three factors was 0.920,with a sensitivity of 0.792 and a specificity of 0.897,respectively.Conclusion Multi-parameter MRI based on conventional enhancement,ASL,and DWI can effectively predict the Ki-67 expression level in NPC patients.

Objective:To investigate the longitudinal trajectories of symptom clusters in elderly patients with laparoscopic surgery for colon cancer, and explore the predictive factors for each trajectories subgroup.Methods:Using a longitudinal survey, elderly patients with laparoscopic surgery for colon cancer patients from Shanxi Bethune Hospital from January 2021 to January 2024 were collected by convenient sampling method. The Chinese Version of the MD Anderson Symptom Inventory Gastrointestinal Cancer Module was used to conduct follow-up surveys of the selected patients at 2 weeks, 1 month, 3 months and 6 months after surgery. The symptom cluster was extracted by exploratory factor analysis, and the latent category growth model was conducted to identify the trajectory subgroups of each symptom cluster, the predictive factors of each trajectory subgroup was analyzed by multiple Logistic regression analysis.Results:A total of 118 cases were concluded in the present study, there were 69 males and 49 females with an age of (74.85 ± 3.29) years old. There were 4 symptom clusters after surgery, which were named as energy deficit symptom cluster, digestive tract symptom cluster, sleep mental symptom cluster, and psychological fatigue symptom cluster, the variance contribution rates were respectively 62.486%, 71.209%, 73.937%, 63.476%. The results from latent class growth model showed that there were 3 trajectory subgroups in the symptom cluster: high level-slow decline group accounted for 33.0% (39/118), moderate level-stable decline group accounted for 39.0% (46/118), low level-rapid decline group accounted for 28.0% (33/118). College education or above tends to developed into low level-rapid decline group ( OR=0.365, 95% CI 0.083-0.603, P<0.05), while patients undergoing traditional laparoscopic surgery ( OR=3.679, 95% CI 1.297-4.432, P<0.05) and primary tumor stages of Ⅲ-Ⅳ were more likely to developed into high level-slow decline group ( OR=0.333, 95% CI 0.120-0.920, P<0.05). Conclusions:There are 4 symptom clusters in elderly patients with laparoscopic surgery for colon cancer, and the characteristics of postoperative symptom cluster changes demonstrate significant heterogeneity, medical staff should pay attention to the management of symptom clusters trajectory categories, dynamically adjust intervention plans to improve nursing quality.

Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.