ObjectiveTo evaluate the efficacy of immediate postoperative oral administration of 2 mg estradiol/estradiol dydrogesterone tablets in reducing secondary surgery for retainedproducts of conception（RPOC）， preventing intrauterine adhesions（IUA）， and promoting endometrial repair following induced abortion. MethodsA retrospective analysis was conducted on 494 patients who underwent induced abortion. The control group （n=214） received conventional postoperative treatment with antibiotics and Yimucao granules， while the observation group （n=280） received immediate administration of estradiol/dydrogesterone tablets （each tablet contains 2 mg of estradiol），combined with antibiotics and Yimucao granules. The two groups were compared for the secondary surgery rate for RPOC， incidence of IUA， endometrial thickness at 2 weeks postoperatively， duration of postoperative vaginal bleeding， time to menstrual resumption， incidence of reduced menstrual volume after resumption， and postoperative complications （pelvic infection， intrauterine fluid accumulation）. ResultsThe observation group showed a lower rate of secondary surgery for RPOC compared to the control group （0.4% vs 2.3%）， but the difference was not statistically significant （P=0.13， Fisher’s exact test）. The observation group also had a significantly lower incidence of IUA （P<0.05）， greater postoperative endometrial thickness at 2 weeks （P<0.05）， and significantly shorter duration of postoperative vaginal bleeding and time to menstrual resumption. The incidence of reduced menstrual volume postoperatively and complications （pelvic infection， intrauterine fluid accumulation） were also significantly lower in the observation group （all P<0.05）. ConclusionImmediate oral administration of estradiol/dydrogesterone tablets after induced abortion significantly prevents intrauterine adhesions， shortens postoperative vaginal bleeding duration， promotes endometrial repair， improves menstrual recovery， and potentially reduces the risk of secondary surgery for retained products of conception.

With the advancement of China's healthcare reform,enhancing the capacity of primary healthcare services has become a pivotal task.Colorectal cancer,one of the most prevalent malignancies in China,highlights the critical importance of early screening and diagnosis to improve patient survival rates.This study,guided by the principles of Party building and Xi Jinping Thought on Socialism with Chinese Characteristics,examines the implementation and outcomes of a rural outreach program focused on colorectal cancer screening and diagnostic technologies.By promoting the dissemination of colorectal cancer screening initiatives,the paper aims to provide empirical evidence to support the deepening of primary-care services,foster high-quality ad-vancement of grassroots health services,and align with the national Healthy China Initiative,thereby more effectively safeguarding population health.

Objective:To investigate the differences in acute intestinal injury and regulatory mechanisms in mice following carbon ion FLASH radiotherapy (FLASH-RT) and conventional dose rate radiotherapy (CONV-RT).Methods:Healthy C57BL/6J mice were randomly divided into three groups: control group, FLASH-RT group (100 Gy/s), and CONV-RT group (0.1 Gy/s), with 9 mice in each group. All mice received carbon ion whole abdominal radiotherapy. DNA double-strand breaks (DSB) and cell proliferation were evaluated by measuring the expression of phosphorylated histone H2AX (γ-H2AX) and nuclear-associated antigen 67 (Ki67) using immunohistochemistry; apoptosis was analyzed using terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL); transcriptome sequencing was used to analyze the differences in molecular pathways between FLASH-RT and CONV-RT.Results:Compared with the CONV-RT group, the FLASH-RT group showed significantly reduced intestinal γ-H2AX signal at 3 h after radiotherapy ( t=3.80, P<0.01), significantly increased expression of Ki67 at the base of intestinal crypts at 6 h after radiotherapy ( t=4.30, P<0.001), and a significantly decreased number of TUNEL-positive cells at 12 h after radiotherapy ( t=3.08, P<0.01). Transcriptome sequencing analysis showed that FLASH-RT specifically activated the insulin-like growth factor (IGF) pathway, avoiding the excessive activation of CONV-RT-induced nuclear factor-κB and B cell receptor inflammatory pathways as well as the inhibition of energy metabolism. Conclusions:Compared with CONV-RT, carbon ion FLASH-RT can reduce DSB damage, preserve the proliferative activity of intestinal stem cells, activate the IGF pathway, and regulate inflammatory, immune, and metabolic pathways, thereby significantly alleviating acute intestinal epithelial injury. Specifically, the regulation of repair pathways mediated by reduced DSB and the inhibition of inflammatory pathways are potential protective mechanisms for normal tissues.

Minimally invasive enucleation of pancreatic tumors has become a focal topic in the field of pancreatic surgery. This technique, which allows for complete tumor removal while preserving maximal pancreatic function, has seen widespread application in clinical practice in recent years. Preoperative evaluation is essential, requiring a thorough assessment of the necessity, feasibility, and appropriateness of surgery, and a careful choice between follow-up observation, parenchyma-sparing resection, or radical resection. If the lesion carries a potential risk of malignancy, radical resection, such as pancreaticoduodenectomy, should be performed. During minimally invasive local resection, selecting an appropriate surgical approach, accurately localizing the tumor, protecting the main pancreatic duct (MPD), and effectively repairing and reconstructing the MPD in case of injury are key to ensuring both surgical safety and efficacy. In addition, pancreatic wound management and the long-term prognosis of patients who undergo MPD repair and reconstruction are also areas of significant concern.

Objective:To systematically evaluate the predictive value of the reverse shock index multiplied by the Glasgow coma scale score (rSIG) for mortality of trauma patients.Methods:A comprehensive literature search was conducted to identify studies on the predictive value of rSIG for mortality of trauma patients in the following databases from inception to April 2025, including CNKI, Wanfang Data, SinoMed, PubMed, Cochrane Library, Web of Science, and Embase. Two investigators independently screened the literature, extracted data, and assessed study quality according to predefined inclusion and exclusion criteria. The Quality assessment of diagnostic accuracy studies-2 (QUADAS-2) tool was used to evaluate the risk of bias in the included studies. Meta analysis was performed using Stata 17.0 software with a bivariate mixed-effects model. The following metrics were used to assess the predictive value of rSIG for mortality in trauma patients, including sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the summary receiver operating characteristic (SROC) curve (AUC). The influence of various factors on the predictive performance of rSIG was examined, including injury type, study design, region, sample size, cut-off value, rSIG measurement time, and outcome measures. Additionally, sensitivity analysis, Fagan′s nomogram, and Deeks′ funnel plot were employed to assess the robustness of the findings, clinical applicability, and publication bias.Results:A total of 15 studies involving 710 612 trauma patients were included, 26 105 of whom were deceased. Meta analysis results showed that rSIG had a pooled sensitivity of 0.78(95% CI 0.71, 0.84), a pooled specificity of 0.78(95% CI 0.68, 0.86), a pooled PLR of 3.60(95% CI 2.46, 5.27), a pooled NLR of 0.28(95% CI 0.22, 0.36), a pooled DOR of 12.70(95% CI 8.10, 19.91), and an AUC of 0.85(95% CI 0.81, 0.87) for predicting mortality of trauma patients. Subgroup analysis identified injury type as one of the major sources of heterogeneity, and the predictive specificity of rSIG was significantly higher in patients with multiple trauma (0.82) than in those with isolated traumatic brain injury (0.65) ( P<0.05). Sensitivity analysis indicated that the findings were robust and stable. Fagan′s nomogram showed that when the pre-test probability was 7%, the post-test probability of death increased to 21% in patients with low rSIG and decreased to 2% in those with high rSIG. Deeks′ funnel plots suggested no significant publication bias among the included studies ( P>0.05). Conclusion:Low rSIG has good predictive performance for mortality of trauma patients and can serve as an effective tool for early and rapid prognosis assessment with superior predictive performance in patients with multiple trauma compared to those with traumatic brain injury.

Objective To predict the quality markers of Alismatis Rhizoma and salted Alismatis Rhizoma based on fingerprints and multivariate statistical analysis combined with network pharmacology.Methods HPLC-DAD method was used to establish fingerprints of Alismatis Rhizoma and salted Alismatis Rhizoma.Based on the peak area data of the fingerprints,clustering analysis,principal component analysis and orthogonal partial least squares-discriminant analysis were employed to evaluate the quality of 10 batches of Alismatis Rhizoma and 12 batches of salted Alismatis Rhizoma.The main components with quality differences were screened.Network pharmacology was used to analyze the targets and related pathways of the screened components,A component-target-pathway network was constructed,and molecular docking was used to verify.Quality markers of Alismatis Rhizoma and salted Alismatis Rhizoma were predicted.Results The HPLC fingerprints of Alismatis Rhizoma and salted Alismatis Rhizoma were established.The similarity evaluation showed that the similarity of 10 batches of Alismatis Rhizoma and 12 batches of salted Alismatis Rhizoma ranges from 0.991 to 0.998,0.992 to 1.000,respectively.Nine components with quality differences were identified through multivariate statistical analysis,and five of them were identified as alismoxide,alisol C,alismol,alisol B,23-acetate alisol B.Network pharmacological analysis suggested 278 targets of action associated with the five components.The main signaling pathways of KEGG pathway enrichment analysis were closely related to the main efficacy and modern pharmacological effects of Alismatis Rhizoma and salted Alismatis Rhizoma.These 5 components were preliminary predicted as quality markers for Alismatis Rhizoma and salted Alismatis Rhizoma.Conclusion This study predicted 5 quality markers for Alismatis Rhizoma and salted Alismatis Rhizoma,which can provide reference for their quality control and further research.

Objective To establish a method for predicting the risk of endometrial cancer(EC)and endometrial atypical hyperplasia(AH)in women with postmenopausal bleeding(PMB)by collecting clinical data on routine medical history.Methods The clinical data of a total of 408 PMB patients admitted to Fuxing Hospital,Capital Medical University were consecutively collected in this retrospective study from December 2013 to December 2023.According to the results of endometrial pathology,patients were divided into case group and control group.EC and AH were included in the malignant group(case group)and the other endometrial pathologies were included in the non-malignant group(control group).Clinical data,including clinical history,high risk factors,and common gynecological ultrasound measurement indicators,were collected and studied by univariate and multivariate Logistic regression analysis.Results The mean age of 408 patients was(60.4±7.8)years.A total of 74 cases(18.1％)were in case group and 334 cases(81.9％)were in control group.Based on Logistic regression analysis,the best predictors of endometrial malignant lesions were selected to create a"LRDNT"(light bleeding,recurrent bleeding,diabetes,non-uniform echogenicity & thickness)model.LRDNT scores range from 0 to 22.The score of LRDNT ≥15 has the largest Yoden index,and the sensitivity to predict endometrial malignant lesions is 79.73％,the specificity is 80.84％,and the prediction accuracy is 80.64％.Conclusions The risk prediction model LRDNT,which combines clinical information and common gynecological ultrasound measurement indicators of PMB patients,can help clinicians classify patients at high and low risk of endometrial malignant lesions,and optimize the strategy of diagnosis and treatment.

[Objective] To report a new technique that combines microfracture surgery under local anesthesia with injection of platelet-rich plasma (PRP) at the fracture site, so as to improve fracture healing rates. [Methods] Data from patients who visited our hospital from March 2020 to June 2023 and underwent the treatment for delayed union of limb fractures were retrospectively analyzed. Under local infiltrative anesthesia, with the assistance of a C-arm X-ray machine or ultrasound, percutaneous loosening was done at the fracture site and the medullary cavity, followed by cortical drilling around the fracture. The previously prepared PRP was then injected locally at the fracture site. Patients were followed up and their postoperative recovery was recorded. [Results] All patients were followed up, and the fracture healing rate was 94.12% (16/17), with an average healing duration of (5.88±2.50) months. None of the patients experienced any neural or vascular injuries, nor adverse events such as wound infections or osteomyelitis. Before the operation and at the last follow-up, the patients' pain visual analogue scores were (5.12±1.11) vs (0.71±1.21) respectively. The postoperative VAS scores showed a significant decrease compared to preoperative values (P<0.05). The excellent and good rate for limb function on the affected side was 88.24% (14/17) at the last follow-up, which was a significant increase from 0.00% before surgery (P<0.05). [Conclusion] The injection of PRP at the fracture site combined with microfracture surgery at the fracture site is minimally invasive, simple to perform, and well-accepted by patients. It has demonstrated some clinical efficacy in treating delayed fracture healing.

Objective To predict the quality markers of Alismatis Rhizoma and salted Alismatis Rhizoma based on fingerprints and multivariate statistical analysis combined with network pharmacology.Methods HPLC-DAD method was used to establish fingerprints of Alismatis Rhizoma and salted Alismatis Rhizoma.Based on the peak area data of the fingerprints,clustering analysis,principal component analysis and orthogonal partial least squares-discriminant analysis were employed to evaluate the quality of 10 batches of Alismatis Rhizoma and 12 batches of salted Alismatis Rhizoma.The main components with quality differences were screened.Network pharmacology was used to analyze the targets and related pathways of the screened components,A component-target-pathway network was constructed,and molecular docking was used to verify.Quality markers of Alismatis Rhizoma and salted Alismatis Rhizoma were predicted.Results The HPLC fingerprints of Alismatis Rhizoma and salted Alismatis Rhizoma were established.The similarity evaluation showed that the similarity of 10 batches of Alismatis Rhizoma and 12 batches of salted Alismatis Rhizoma ranges from 0.991 to 0.998,0.992 to 1.000,respectively.Nine components with quality differences were identified through multivariate statistical analysis,and five of them were identified as alismoxide,alisol C,alismol,alisol B,23-acetate alisol B.Network pharmacological analysis suggested 278 targets of action associated with the five components.The main signaling pathways of KEGG pathway enrichment analysis were closely related to the main efficacy and modern pharmacological effects of Alismatis Rhizoma and salted Alismatis Rhizoma.These 5 components were preliminary predicted as quality markers for Alismatis Rhizoma and salted Alismatis Rhizoma.Conclusion This study predicted 5 quality markers for Alismatis Rhizoma and salted Alismatis Rhizoma,which can provide reference for their quality control and further research.

Objective:To systematically evaluate the predictive value of the reverse shock index multiplied by the Glasgow coma scale score (rSIG) for mortality of trauma patients.Methods:A comprehensive literature search was conducted to identify studies on the predictive value of rSIG for mortality of trauma patients in the following databases from inception to April 2025, including CNKI, Wanfang Data, SinoMed, PubMed, Cochrane Library, Web of Science, and Embase. Two investigators independently screened the literature, extracted data, and assessed study quality according to predefined inclusion and exclusion criteria. The Quality assessment of diagnostic accuracy studies-2 (QUADAS-2) tool was used to evaluate the risk of bias in the included studies. Meta analysis was performed using Stata 17.0 software with a bivariate mixed-effects model. The following metrics were used to assess the predictive value of rSIG for mortality in trauma patients, including sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the summary receiver operating characteristic (SROC) curve (AUC). The influence of various factors on the predictive performance of rSIG was examined, including injury type, study design, region, sample size, cut-off value, rSIG measurement time, and outcome measures. Additionally, sensitivity analysis, Fagan′s nomogram, and Deeks′ funnel plot were employed to assess the robustness of the findings, clinical applicability, and publication bias.Results:A total of 15 studies involving 710 612 trauma patients were included, 26 105 of whom were deceased. Meta analysis results showed that rSIG had a pooled sensitivity of 0.78(95% CI 0.71, 0.84), a pooled specificity of 0.78(95% CI 0.68, 0.86), a pooled PLR of 3.60(95% CI 2.46, 5.27), a pooled NLR of 0.28(95% CI 0.22, 0.36), a pooled DOR of 12.70(95% CI 8.10, 19.91), and an AUC of 0.85(95% CI 0.81, 0.87) for predicting mortality of trauma patients. Subgroup analysis identified injury type as one of the major sources of heterogeneity, and the predictive specificity of rSIG was significantly higher in patients with multiple trauma (0.82) than in those with isolated traumatic brain injury (0.65) ( P<0.05). Sensitivity analysis indicated that the findings were robust and stable. Fagan′s nomogram showed that when the pre-test probability was 7%, the post-test probability of death increased to 21% in patients with low rSIG and decreased to 2% in those with high rSIG. Deeks′ funnel plots suggested no significant publication bias among the included studies ( P>0.05). Conclusion:Low rSIG has good predictive performance for mortality of trauma patients and can serve as an effective tool for early and rapid prognosis assessment with superior predictive performance in patients with multiple trauma compared to those with traumatic brain injury.