Objective: To investigate the prevalence and influencing factors of menopausal syndrome among postmenopausal women in Pan'an County, Zhejiang Province, so as to provide the basis for guiding the health management of postmenopausal women. Methods: From May 2023 to April 2024, the postmenopausal women aged 40 to 69 years in Pan'an County were selected using the random cluster sampling method. Demographic information, lifestyle and prevalence of gynecological diseases were collected through questionnaire surveys. The prevalence of menopausal syndrome was assessed by modified Kupperman Score Scale. Factors affecting menopausal syndrome were analyzed by a multivariable logistic regression model. Results: A total of 816 postmenopausal women were surveyed, with an mean age of (57.63±2.92) years and a mean natural menopause age of (49.85±2.13) years. There were 574 cases with menopausal syndrome, with a prevalence of 70.34%. Flashes and sweating, insomnia and irritability were common symptoms, accounting for 62.87%, 47.43% and 41.18%, respectively. Multivariable logistic regression analysis showed that monthly personal income of ≤5 000 yuan (<3 000 yuan, OR=3.124, 95%CI: 1.829-5.335; 3 000-5 000 yuan, OR=2.399, 95%CI: 1.370-4.201) and having gynecological diseases (OR=1.970, 95%CI: 1.292-3.004) were associated with a higher risk of menopausal syndrome, while average (OR=0.141, 95%CI: 0.072-0.276) or sufficient sleep quality (OR=0.095, 95%CI: 0.049-0.185) were associated with a lower risk of menopausal syndrome. Conclusion The prevalence of menopausal syndrome among postmenopausal women in Pan'an County is relatively high, and is mainly influenced by personal economic status, sleep quality and the presence of gynecological diseases.

Objective:To explore the effectiveness of SECI (socialization, externalization, combination, and internalization) model in clinical practice training of hematology nurses.Methods:A total of 86 students from the clinical practice training course for hematology nurses from October 2022 to September 2023 were selected as the research subjects. The 43 trainees who received practical training from October 1, 2022 to March 31, 2023 were included in the traditional group, and the 43 trainees who received practical training from April 1, 2023 to September 30, 2023 were included in the observation group. The traditional group received traditional teaching, while the observation group received SECI teaching. After the training, basic assessment and satisfaction evaluation were conducted, and a long-term evaluation was conducted at 6 months after the training. The t test and chi-square test were performed using SPSS 25.0. Results:The observation group had higher scores in case reports [(92.03±2.21) vs. (88.14±2.36)], theoretical assessments [(95.61±3.79) vs. (86.58±3.75)], and operational assessments [(96.24±1.45) vs. (90.13±1.41)] compared with the traditional group (all P<0.05). The observation group had higher scores for teaching plans, teaching methods, teaching effectiveness, teaching atmosphere, internship content, and overall satisfaction with practical training than the traditional group ( P<0.05). The long-term evaluation showed that the theoretical and operational assessment scores of the observation group were higher than those of the traditional group at 6 months after training (both P<0.05). Conclusions:The application of SECI teaching in the clinical practice training of hematology nurses has shown good results, which can help nurses better grasp clinical theoretical knowledge and significantly improve their practical operation ability and training satisfaction.

Objective:To construct a chain mediating model based on two mediating variables of positive psychological capital and general self-efficacy, so as to explore the impact mechanism of social support on posttraumatic growth in thyroid cancer patients.Methods:From March to December 2023, convenience sampling was used to select 270 postoperative patients with thyroid cancer from the Chinese People's Liberation Army General Hospital as participants. The patients were surveyed using the General Information Questionnaire, Post Traumatic Growth Inventory, Social Support Rating Scale, Positive Psychological Questionnaire, and General Self-efficacy Scale. Spearman correlation was used to analyze the correlation between social support, positive psychological capital, general self-efficacy, and posttraumatic growth in thyroid cancer patients. SPSS PROCESS program was used to test for the chain mediating effect.Results:A total of 270 questionnaires were distributed, and 257 questionnaires were collected. After excluding questionnaires with missing items exceeding 10% and regular responses, 246 valid questionnaires were collected, with a valid response rate of 91.11% (246/270). Spearman correlation showed that there was positive correlations between social support, positive psychological capital, general self-efficacy, and posttraumatic growth in patients ( P<0.01). Mediating effect analysis showed that social support directly and positively predicted posttraumatic growth in thyroid cancer [ β=0.403, 95% CI (0.258, 0.547) ], and also affected patients' posttraumatic growth through three indirect pathways, namely social support → positive psychological capital → posttraumatic growth, with an effect value of 0.083 [95% CI (0.002, 0.173) ], accounting for 13.63% of the total effect, and social support → general self-efficacy → posttraumatic growth, with an effect value of 0.099 [95% CI (0.040, 0.166) ], accounting for 16.26% of the total effect, and social support → positive psychological capital → general self-efficacy → posttraumatic growth, with an effect value of 0.025 [95% CI (0.005, 0.051) ], accounting for 4.11% of the total effect. The total indirect effect accounted for 33.83% of the total effect. Conclusions:Social support can not only directly affect the post-traumatic growth of thyroid cancer patients, but also indirectly affect post-traumatic growth through the mediating effect of positive psychological capital and general self-efficacy.

Multimorbidity is significantly associated with life quality decline, disability, and increased mortality risk. Additionally, it leads to greater consumption of healthcare resources, presenting substantial challenges to healthcare systems globally. To better assess the burden of multimorbidity, its impact on patient health outcomes and healthcare services, and to explore the underlying mechanisms in its development, this paper summarizes the existing methods used for measuring and analyzing multimorbidity in research and practice, including disease count, disease-weighted indices, multimorbidity pattern recognition (such as disease association analysis, clustering analysis, and network analysis) and longitudinal methods to provide references for the accurate assessment of the prevalence of multimorbidity and its changes and improve the validity and universality of research findings.

Zuoguiyin， which first recorded in Jingyue Quanshu written by ZHANG Jiebin in the Ming dynasty， was included in the Catalogue of Ancient Famous Classical Formulas（The Second Batch）. This study followed the Principles of Textual Research on Key Information of Ancient Famous Classical Formulas to determine the key information of Zuoguiyin in ancient and modern literature， such as the formula origin， the composition of the formula and the origin of the drugs. It was found that the composition， dosage， preparation and processing methods of Zuoguiyin were basically the same as the original formula. The original dosage of this formula is 41.03 g of Rehmanniae Radix Praeparata（the fresh or dried tuberous roots of Rehmannia glutinosa， processed by wine stewing or wine steaming）， 7.46 g of Dioscoreae Rhizoma（the dried rhizomes of Dioscorea opposita）， 7.46 g of Lycii Fructus（the dried mature fruit of Lycium barbarum）， 3.73 g of Glycyrrhizae Radix et Rhizoma Praeparata cum Melle（the dried roots and rhizomes of Glycyrrhiza uralensis， processed by honey-roasted method）， 5.595 g of Poria（the sclerotium of Poria cocos）， 5.595 g of Corni Fructus（the dried mature fruit pulp of Cornus officinalis）. The method of administration is to add 600 mL of water to all the herbs， decoct to 140 mL and take before meals. The function of Zuoguiyin is to nourish Yin and tonify the kidney， and it is often used in the treatment of lumbar soreness and ejaculation， night sweating， dry mouth and throat， thirst and desire to drink， glossy red tongue， thin and rapid pulse， etc. Since ancient times， Zuoguiyin has been used to treat a variety of internal and gynaecological diseases as well as diseases of the nervous， circulatory and reproductive systems that are predominantly caused by kidney Yin deficiency. However， there is not much research on the modern application and therapeutic mechanism of this formula， and there is no standardized preparation in the market， so the degree of development and utilization is not high， and there is still a lot of room for research.

We present a case of nephrogenic diabetes insipidus secondary to primary Sj?gren′s syndrome. At onset, the patient exhibited a urine output of up to 10 liter per day. Diagnostic evaluation and clinical features confirmed renal diabetes insipidus due to primary Sj?gren′s syndrome. A review of the literature indicates that primary Sj?gren′s syndrome can involve renal manifestations, including renal tubulointerstitial inflammation and impaired renal concentration ability. However, nephrogenic diabetes insipidus with such high urine output is uncommon. Management of this condition requires proactive control of the underlying disease, potassium supplementation, and urine management.

Objective:To analyze the characteristics of chronic hepatitis B (CHB) patients clinically cured, and to explore the advantageous population and regimen of pegylated interferon-α-2b (Peg-IFN-α-2b) treatment.Methods:A total of 188 CHB patients who were treated with Peg-IFN-α-2b in the Department of Infectious Diseases of the First Hospital of Shanxi Medical University from February 2018 to January 2024 and enrolled in the "China research (Oasis) project on reducing the incidence of hepatocellular carcinoma in hepatitis B patients" in Shanxi Province from September 2020 to January 2024 with clinically cured by Peg-IFN-α-2b therapy were selected as subjects. The basic information and efficacy indicators of patients were collected and analyzed, and the levels of hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody (HBsAb) at baseline, 12 weeks, 24 weeks, 36 weeks, 48 weeks, 72 weeks and 96 weeks of treatment were counted. Patients were divided into negative conversion group and non-negative conversion group according to the status of HBsAg at week 48, and HBsAg levels were compared between the two groups at 12 weeks of treatment. Patients were grouped according to the treatment plan and treatment duration, and the proportions of patients who achieved clinical cure at each monitoring point were compared between groups of sequential combination therapy of nucleo(s)tide analogues (NAs) with Peg-IFN-α-2b and Peg-IFN-α-2b alone, among groups of patients with combination treatment of NAs<5 years, 5 to <10 years and ≥10 years, and among groups of patients with NAs treatment duration <5 years, 5 to <10 years and ≥10 years before the application of Peg-IFN-α-2b. Statistical analysis was performed using chi-square test or Mann-Whitney U test. Results:The age of 188 patients was (43.7±9.9) years old, including 126 males (67.02%) and 62 females (32.98%). There were 150 patients (79.79%) treated with sequential combination therapy of NAs with Peg-IFN-α-2b, and 38 patients (20.21%) treated with Peg-IFN-α-2b alone. The baseline HBsAg level of 188 patients was 51.99(3.26, 250.00) IU/mL, and there were 169 cases (89.89%) with negative hepatitis B e antigen (HBeAg). There were 93 patients (49.47%) with HBsAg <50 IU/mL and 162 cases (86.17%) with negative hepatitis B virus (HBV) DNA at baseline. After 12 weeks, 24 weeks, 36 weeks, 48 weeks, 72 weeks and 96 weeks of treatment, there were 47 cases (25.00%), 47 cases (25.00%), 41 cases (21.81%), 35 cases (18.61%), 14 cases (7.45%) and four cases (2.13%) of HBsAg loss, respectively, and there were 28 cases (14.89%), 33 cases (17.55%), 35 cases (18.62%), 24 cases (12.77%), nine cases (4.79%) and four cases (2.13%) of HBsAg seroconversion, respectively. The levels of HBsAb were 0.63(0.20, 2.08) IU/mL, 3.69(0.68, 19.00) IU/mL, 8.47(1.43, 54.98) IU/mL, 10.96(2.93, 63.42) IU/mL, 15.55(1.10, 82.17) IU/mL and 23.45(2.30, 129.50) IU/mL, respectively. The HBsAg levels at week 12 in the HBsAg negative group (170 cases) and the non-negative group (18 cases) according to the status of HBsAg at week 48 were 0.67(0.03, 36.09) IU/mL and 18.31(5.99, 162.19) IU/mL, respectively. The difference was statistically significant ( Z=2.71, P=0.007). There was no significant difference in the proportion of patients who achieved clinical cure at each monitoring point between patients treated with NAs sequential combined with Peg-IFN-α-2b and patients treated with Peg-IFN-α-2b alone ( χ2=1.60, P=0.918). The total duration of NAs treatment and the duration of NAs treatment before the application of Peg-IFN-α-2b had no significant difference in the proportion of patients achieving clinical cure at each monitoring point ( χ2=5.67 and 5.47, respectively, P=0.854 and 0.857, respectively). Conclusions:For young and middle-aged CHB patients, baseline HBsAg<50 IU/mL, HBeAg and HBV DNA negative are the characteristics of clinical cure. These patients have a high probability of clinical cure with 12 weeks to 48 weeks of Peg-IFN-α-2b treatment. HBsAg decline to a low level at 12 weeks of treatment can be used as a reference index for good efficacy at 48 weeks of treatment. Some patients can achieve clinical cure after a short course of treatment with Peg-IFN-α-2b (12 weeks or 24 weeks), and even produce high levels of HBsAb. The course of Peg-IFN-α-2b treatment can be personalized.

Objective:To analyze the characteristics of chronic hepatitis B (CHB) patients clinically cured, and to explore the advantageous population and regimen of pegylated interferon-α-2b (Peg-IFN-α-2b) treatment.Methods:A total of 188 CHB patients who were treated with Peg-IFN-α-2b in the Department of Infectious Diseases of the First Hospital of Shanxi Medical University from February 2018 to January 2024 and enrolled in the "China research (Oasis) project on reducing the incidence of hepatocellular carcinoma in hepatitis B patients" in Shanxi Province from September 2020 to January 2024 with clinically cured by Peg-IFN-α-2b therapy were selected as subjects. The basic information and efficacy indicators of patients were collected and analyzed, and the levels of hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody (HBsAb) at baseline, 12 weeks, 24 weeks, 36 weeks, 48 weeks, 72 weeks and 96 weeks of treatment were counted. Patients were divided into negative conversion group and non-negative conversion group according to the status of HBsAg at week 48, and HBsAg levels were compared between the two groups at 12 weeks of treatment. Patients were grouped according to the treatment plan and treatment duration, and the proportions of patients who achieved clinical cure at each monitoring point were compared between groups of sequential combination therapy of nucleo(s)tide analogues (NAs) with Peg-IFN-α-2b and Peg-IFN-α-2b alone, among groups of patients with combination treatment of NAs<5 years, 5 to <10 years and ≥10 years, and among groups of patients with NAs treatment duration <5 years, 5 to <10 years and ≥10 years before the application of Peg-IFN-α-2b. Statistical analysis was performed using chi-square test or Mann-Whitney U test. Results:The age of 188 patients was (43.7±9.9) years old, including 126 males (67.02%) and 62 females (32.98%). There were 150 patients (79.79%) treated with sequential combination therapy of NAs with Peg-IFN-α-2b, and 38 patients (20.21%) treated with Peg-IFN-α-2b alone. The baseline HBsAg level of 188 patients was 51.99(3.26, 250.00) IU/mL, and there were 169 cases (89.89%) with negative hepatitis B e antigen (HBeAg). There were 93 patients (49.47%) with HBsAg <50 IU/mL and 162 cases (86.17%) with negative hepatitis B virus (HBV) DNA at baseline. After 12 weeks, 24 weeks, 36 weeks, 48 weeks, 72 weeks and 96 weeks of treatment, there were 47 cases (25.00%), 47 cases (25.00%), 41 cases (21.81%), 35 cases (18.61%), 14 cases (7.45%) and four cases (2.13%) of HBsAg loss, respectively, and there were 28 cases (14.89%), 33 cases (17.55%), 35 cases (18.62%), 24 cases (12.77%), nine cases (4.79%) and four cases (2.13%) of HBsAg seroconversion, respectively. The levels of HBsAb were 0.63(0.20, 2.08) IU/mL, 3.69(0.68, 19.00) IU/mL, 8.47(1.43, 54.98) IU/mL, 10.96(2.93, 63.42) IU/mL, 15.55(1.10, 82.17) IU/mL and 23.45(2.30, 129.50) IU/mL, respectively. The HBsAg levels at week 12 in the HBsAg negative group (170 cases) and the non-negative group (18 cases) according to the status of HBsAg at week 48 were 0.67(0.03, 36.09) IU/mL and 18.31(5.99, 162.19) IU/mL, respectively. The difference was statistically significant ( Z=2.71, P=0.007). There was no significant difference in the proportion of patients who achieved clinical cure at each monitoring point between patients treated with NAs sequential combined with Peg-IFN-α-2b and patients treated with Peg-IFN-α-2b alone ( χ2=1.60, P=0.918). The total duration of NAs treatment and the duration of NAs treatment before the application of Peg-IFN-α-2b had no significant difference in the proportion of patients achieving clinical cure at each monitoring point ( χ2=5.67 and 5.47, respectively, P=0.854 and 0.857, respectively). Conclusions:For young and middle-aged CHB patients, baseline HBsAg<50 IU/mL, HBeAg and HBV DNA negative are the characteristics of clinical cure. These patients have a high probability of clinical cure with 12 weeks to 48 weeks of Peg-IFN-α-2b treatment. HBsAg decline to a low level at 12 weeks of treatment can be used as a reference index for good efficacy at 48 weeks of treatment. Some patients can achieve clinical cure after a short course of treatment with Peg-IFN-α-2b (12 weeks or 24 weeks), and even produce high levels of HBsAb. The course of Peg-IFN-α-2b treatment can be personalized.

Objectives:This study aimed to assess the efficacy and safety of bendamustine in combination with rituximab (BR regimen) for the treatment of newly diagnosed indolent B-cell non-Hodgkin's lymphoma (B-iNHL) and elderly mantle cell lymphoma (eMCL) .Methods:From December 1, 2020 to September 10, 2022, a multi-center prospective study was conducted across ten Grade A tertiary hospitals in Shandong Province, China. The BR regimen was administered to evaluate its efficacy and safety in newly diagnosed B-iNHL and eMCL patients, and all completed at least four cycles of induction therapy.Results:The 72 enrolled patients with B-iNHL or MCL were aged 24-74 years, with a median age of 55 years. Eastern Cooperative Oncology Group (ECOG) performance status scores of 0-1 were observed in 76.4% of patients, while 23.6% had scores of 2. Disease distribution included follicular lymphoma (FL) (51.4% ), marginal zone lymphoma (MZL) (33.3% ), eMCL (11.1% ), and the unknown subtype (4.2% ). According to the Ann Arbor staging system, 16.7% and 65.3% of patients were diagnosed with stage Ⅲ and stage Ⅳ lymphomas, respectively. Following four cycles of BR induction therapy, the overall response rate was 98.6%, with a complete response (CR) rate of 83.3% and a partial response (PR) rate of 15.3%. Only one eMCL patient experienced disease progression during treatment, and only one FL patient experienced a relapse. Even when evaluated using CT alone, the CR rate was 63.9%, considering the differences between PET/CT and CT assessments. The median follow-up duration was 11 months (range: 4-22), with a PFS rate of 96.8% and an OS rate of 100.0%. The main hematologic adverse reactions included grade 3-4 leukopenia (27.8%, with febrile neutropenia observed in 8.3% of patients), grade 3-4 lymphopenia (23.6% ), grade 3-4 anemia (5.6% ), and grade 3-4 thrombocytopenia (4.2% ). The main non-hematologic adverse reactions such as fatigue, nausea/vomiting, rash, and infections occurred in less than 20.0% of patients.Conclusion:Within the scope of this clinical trial conducted in China, the BR regimen demonstrated efficacy and safety in treating newly diagnosed B-iNHL and eMCL patients.

The goal of this study was to investigate the regulatory effect of angiotensin converting enzyme 2 (ACE2) on cellular inflammation caused by avian infectious bronchitis virus (IBV) and the underlying mechanism of such effect. Vero and DF-1 cells were used as test target to be exposed to recombinant IBV virus (IBV-3ab-Luc). Four different groups were tested: the control group, the infection group[IBV-3ab-Luc, MOI (multiplicity of infection)=1], the ACE2 overexpression group[IBV-3ab Luc+pcDNA3.1(+)-ACE2], and the ACE2-depleted group (IBV-3ab-Luc+siRNA-ACE2). After the cells in the infection group started to show cytopathic indicators, the overall protein and RNA in cell of each group were extracted. real-time quantitative polymerase chain reaction (RT-qPCR) was used to determine the mRNA expression level of the IBV nucleoprotein (IBV-N), glycoprotein 130 (gp130) and cellular interleukin-6 (IL-6). Enzyme linked immunosorbent assay (ELISA) was used to determine the level of IL-6 in cell supernatant. Western blotting was performed to determine the level of ACE2 phosphorylation of janus kinase 2 (JAK2) and signal transducer and activator of transcription 3 (STAT3). We found that ACE2 was successfully overexpressed and depleted in both Vero and DF-1 cells. Secondly, cytopathic indicators were observed in infected Vero cells including rounding, detaching, clumping, and formation of syncytia. These indicators were alleviated in ACE2 overexpression group but exacerbated when ACE2 was depleted. Thirdly, in the infection group, capering with the control group, the expression level of IBV-N, gp130, IL-6 mRNA and increased significantly (P < 0.05), the IL-6 level was significant or extremely significant elevated in cell supernatant (P < 0.05 or P < 0.01); the expression of ACE2 decreased significantly (P < 0.05); protein phosphorylation level of JAK2 and STAT3 increased significantly (P < 0.05). Fourthly, comparing with the infected group, the level of IBV-N mRNA expression in the ACE2 overexpression group had no notable change (P > 0.05), but the expression of gp130 mRNA, IL-6 level and expression of mRNA were elevated (P < 0.05) and the protein phosphorylation level of JAK2 and STAT3 decreased significantly (P < 0.05). In the ACE2-depleted group, there was no notable change in IBV-N (P > 0.05), but the IL-6 level and expression of mRNA increased significantly (P < 0.05) and the phosphorylation level of JAK2 and STAT3 protein decreased slightly (P > 0.05). The results demonstrated for the first time that ACE2 did not affect the replication of IBV in DF-1 cell, but it did contribute to the prevention of the activation of the IL-6/JAK2/STAT3 signaling pathway, resulting in an alleviation of IBV-induced cellular inflammation in Vero and DF-1 cells.
Animals ; Chlorocebus aethiops ; Humans ; Interleukin-6/genetics* ; Janus Kinase 2/pharmacology* ; Infectious bronchitis virus/metabolism* ; STAT3 Transcription Factor/metabolism* ; Angiotensin-Converting Enzyme 2/pharmacology* ; Cytokine Receptor gp130/metabolism* ; Vero Cells ; Signal Transduction ; Inflammation ; RNA, Messenger