Pregnancy with chronic kidney disease (CKD), particularly in stages 4-5, carries high risks of adverse outcomes including maternal renal failure, preeclampsia/eclampsia, fetal growth restriction, and preterm birth. This report described a 26-year-old woman with congenital solitary kidney, polycystic ovaries, and uterine septum due to PAX2 gene variant, complicated by CKD stage 4. Through multidisciplinary team precision management and individualized treatment strategies, including timely initiation of dialysis, the patient successfully maintained pregnancy until 34 +1 weeks and delivered a female infant via cesarean section. This case summarizes key management experiences for end-stage renal disease in pregnancy, highlighting early risk assessment, precise nutritional management, hemodialysis protocol optimization, and the crucial role of multidisciplinary collaboration, providing valuable references for managing CKD-complicated pregnancies.

Pregnancy with chronic kidney disease (CKD), particularly in stages 4-5, carries high risks of adverse outcomes including maternal renal failure, preeclampsia/eclampsia, fetal growth restriction, and preterm birth. This report described a 26-year-old woman with congenital solitary kidney, polycystic ovaries, and uterine septum due to PAX2 gene variant, complicated by CKD stage 4. Through multidisciplinary team precision management and individualized treatment strategies, including timely initiation of dialysis, the patient successfully maintained pregnancy until 34 +1 weeks and delivered a female infant via cesarean section. This case summarizes key management experiences for end-stage renal disease in pregnancy, highlighting early risk assessment, precise nutritional management, hemodialysis protocol optimization, and the crucial role of multidisciplinary collaboration, providing valuable references for managing CKD-complicated pregnancies.

Objective:To explore the application effect of checklist teaching in clinical nursing internship teaching in nephrology.Methods:A total of 49 full-time undergraduate nursing students who interned between July and December 2023 were selected as the observation group, while 49 full-time undergraduate nursing students who interned between July and December 2022 were selected as the control group. During the internship teaching process, the observation group received a checklist teaching, while the control group received traditional teaching. The effectiveness of the checklist teaching method was evaluated by comparing the internship performance, sense of belonging, and satisfaction of both students and teachers between two groups of nursing students. SPSS 26.0 was used for chi-square test and t test. Results:After teaching, the theoretical scores [(97.45±1.63) vs. (93.26±2.38)] and operational skills scores [(96.15±1.90) vs. (93.25±2.46)] were significantly higher in the observation group than in the control group ( P<0.05). After teaching, the observation group had significantly higher scores for the sense of belonging and satisfaction scores in all dimensions during the internship compared to the control group ( P<0.05). After teaching, the teaching staff showed significantly higher satisfaction scores in all dimensions in the observation group than in the control group ( P<0.05). Conclusions:Applying checklist teaching to clinical teaching of nephrology nursing can significantly improve the internship assessment scores of students, promote the teaching performance of teaching staff, and enhance the satisfaction of both teachers and students.

Purpose To explore the value of predicting risk classification of gastrointestinal stromal tumors(GIST)based on the model established by dural-phase enhanced CT based radiomics.Materials and Methods Totally 200 patients with pathologically confirmed GIST from October 2017 to July 2023 in the Affiliated Hospital of Zunyi Medical University were enrolled,including 69 cases with low-risk group(very low-risk,low-risk)and 131 with high-risk group(medium-risk,high-risk).All patients were randomly divided into training set(n=139)and validation set(n=61)at the ratio of 7∶3.Univariate and multivariate Logistic regression analysis were used on clinical data and CT sings in the training set to obtain clinical-CT features for predicting the risk grade of GIST,and clinical-CT models were constructed.The radiomics features were extracted and screened from the three data sets of enhanced CT arterial phase,venous phase and arterial+venous phase,and the radiomics model was constructed to obtain the optimal radiomics features,respectively.The optimal radiomics features were obtained and combined with the clinical-CT features,a combination model was constructed and the normogram was drawn.The predictive efficiency of these models was evaluated by area under the curve(AUC).Results Tumor diameter was an independent predictor of GIST risk classification(OR=1.070,P＜0.001).The AUC of the combination model,model arterial+venous phase radiomics and model clinical-CT in the training set were 0.948,0.896 and 0.873,respectively;those in the validation set were 0.886,0.825 and 0.870,respectively.The AUC of the above three models showed statistical difference(Z=-3.167,-2.316,P＜0.05).Conclusion The radiomics features based on enhanced CT have good value in predicting risk classification of GIST.Compared with model clinical-CT and model radiomics,the combination model is the most effective in predicting the risk classification of GIST.

OBJECTIVE: To ensure the supply of prevention materials in the tertiary public hospitals in prefecturelevel cities, and to make the process of allocating prevention materials more scientific and reasonable. METHODS: Open the green passage, simplify the procurement process, carry out emergency procurement of related materials, ensure timely delivery of prevention materials, distribute them at different levels, and strengthen the warehouse management of prevention materials. RESULTS: The scheme of emergancy supplies was constantly improved, and the supply of prevention materials was completed with good quality. CONCLUSIONS Using scientific and efficient management methods, the supply of prevention materials in medical institutions has been guaranteed, which has experience and reference significance for the prevention and control of similar public health emergencies in the future.
Emergencies ; Humans ; Public Health ; Tertiary Care Centers

Objective: To understand the current situation and associated factors of myopia in junior middle school students, and to provide scientific basis for prevention and control of myopia in junior middle school students. Methods: A total of 5 393 junior middle school students were selected from middle schools in Guangdong, Guangxi, Guizhou, Liaoning, Shandong, Shanxi provinces. The visual acuity of middle school students was examined, and the data of general population, economy, sociology and natural environment were obtained through statistical yearbook of each province. The influencing factors of myopia of middle school students were analyzed by univariate and multivariate Logistic regression. Results: The results of single factor analysis showed that the myopia rate of junior high school students was different by gender, grades, parents average wage, sunshine duration, temperature, altitude, longitude and latitude(χ2=47.76，59.05，10.79，106.19，53.56，85.02，76.23，107.07，P<0.05). The results of multi factor analysis showed that gender, grade, average wage, temperature and latitude was positively associated with myopia vision; sunshine duration and longitude were negatively associated with the risk for myopia(OR=1.54，1.34，1.62，7.58，27.10，0.42，0.39，P<0.05). Conclusion The myopia of junior high school students is affected by a variety of factors, economic and social factors and natural environmental factors have an impact on the screening of sexual myopia in junior high school students. Economic and social factors and natural environmental factors should be taken into account in the formulation of myopia prevention and control measures.

Objective: To understand the current situation and associated factors of myopia among primary school students, and to provide scientific basis for prevention and control of myopia among primary school students. Methods: In Gansu, Guangdong, Guangxi, Guizhou, Liaoning, Shandong, Shanxi and other provinces, 1 prefecture was selected, and a number of primary schools were selected from each region. All the students in the class were selected as the object of this survey. A total of 8 365 middle school students were examined for their eyesight, and the data of general population economic indicators and natural environment indicators were obtained through the statistical yearbook of various provinces and cities. The influencing factors of primary school students myopia were analyzed by chi-square test and multivariate Logistic regression. Results: Univariate analysis showed that different provinces and different sex, different nationalities, different grade, parents average salary, sunshine duration, air temperature, altitude, longitude, latitude, different economic zone(χ2=116.22, 18.08, 26.33, 1 059.04, 14.86, 10.28, 16.95, 10.01, 23.15, 29.43, 88.14, P<0.05). Multivariate analysis results showed that gender, grade, sunshine duration, longitude were risk factor for poor vision(OR=1.31, 1.71, 1.45, 1.54, P<0.05); Economic zone and parents salary were protective factors for poor eyesight of students (OR=0.65, 0.86, P<0.05). Conclusion Myopia of primary school students is affected by a variety of factors, economic and social factors and natural environmental factors have an impact on the screening.

Objective: To analyze the mechanism of metformin in improving oxaliplatin resistance of colorectal cancer cells. Methods: The expression levels of EIF3G in 71 cases of colorectal cancer and adjacent tissues were detected by RT-qPCR. The survival curve was established by Kaplan-Meier method. The survival rate difference between the two groups was compared by Log-rank test.HCT-116 cells were infected with shEIF3G lentivirus, HCT-116 L-OHP-resistant cell line was constructed.After treated with metformin, sensitivity to L-OHP was detected by CCK-8 assay, RT-qPCR and Western blot were used to analyze the EIF3G mRNA and protein levels. The subcutaneous tumor model of nude mice was constructed to observe the effect of metformin on tumor growth. Results: The expression level of EIF3G mRNA in colorectal cancer tissues was up-regulated by (3.24±0.43) times compared with paraneoplastic tissues (P<0.01). EIF3G level was significantly correlated with the prognosis of colon cancer patients. Knockdown EIF3G could enhance the L-OHP sensitivity of HCT116/L-OHP cells (P<0.05); Metformin can reduce the expression level of EIF3G and improve the drug resistance of HCT116/L-OHP cells (P<0.05), and inhibit the development of colorectal cancer in vivo (P<0.05). Conclusion Metformin can inhibit the expression of EIF3G and improve the L-OHP resistance of HCT-116 cells.

Objective To analyze the correlation between apolipoprotein E(ApoE) gene polymorphisms and the incidence rate of chronic cardiovascular disease as well as the blood lipid levels of patients.Methods ApoE gene polymorphism and lipid levels were measured by suing gene chip analysis system and biochemical analyze in 1 414 cases of chronic cardiovascular disease patients(experimental groups) and 374 cases of healthy subjects(control group).Results Compared with control group,E3/4 genotype frequency was increased in experimental group,while E2/E3 genotype frequency decreased(P<0.05).Compared with control group,the levels of total cholesterol(TC),triglyceride(TG),low density lipoprotein-cholesterol(LDL-C) were obviously increased and the level of HDL-C was decreased in experimental group(P<0.05).Compared with patients with E2/E3 genotype,the level of HDL-C in patients with E3/E4 genotype was decreased and the levels of TC,LDL-C were increased significantly(P<0.05).Proportions of different ApoE genotypes in patients with cerebral infarction,cerebral hemorrhage,hypertension,coronary heart disease,type-2 diabete and fatty liver were different.Compared with the E2/E3 genotype,the proportion of the E3/E4 genotype in patients with cerebral infarction,cerebral hemorrhage,hypertension,coronary heart disease,type-2 diabete and fatty liver were increased(P<0.05).Conclusion ApoE gene polymorphism might be important cause of the individual difference of lipid levels and a risk factor for the occurrence and development of chronic cardiovascular diseases.

BACKGROUND:Umbilical cord blood stem cel s can be differentiated into functional liver cel s in vivo, instead of mature liver cel s in the treatment of liver diseases. OBJECTIVE:To observe the effect of umbilical cord blood stem cel transplantation on decompensated cirrhosis in rats. METHODS:Twenty Sprague-Dawley rats were enrol ed and given 40%carbon tetrachloride peanut oil to make decompensated cirrhosis models. Eight weeks after modeling, model rats were randomized into control and experimental groups (n=10 per group), and subjected to injection of umbilical cord blood stem cel suspension (2 mL, 1.0×107/L) or cel culture medium (2 mL) via the tail vein, respectively. At 4 weeks after injection, levels of serum aspartate aminotransferase, alanine aminotransferase, albumin, total bilirubin, hyaluronic acid, laminin, procol agen III and type IV col agen were detected;rat liver tissues were sliced for pathological observation. RESULTS AND CONCLUSION:Compared with the control group, the albumin level was significantly increased but the levels of serum aspartate aminotransferase, alanine aminotransferase, total bilirubin, hyaluronic acid, laminin, procol agen III and type IV col agen decreased significantly in the experimental group (P<0.05). From the pathological view, severity of liver cirrhosis was lower in the experimental group than the control group. Therefore, umbilical cord blood stem cel transplantation can effectively restore the liver function of decompensated cirrhosis in rats.