OBJECTIVE To compare the efficacy and safety of different daily doses of aspirin in the prevention of preeclampsia （PE）. METHODS The case-control studies and prospective randomized controlled trials on aspirin with daily dose ≥ 100 mg （trial group） vs. ＜100 mg （control group） in the prevention of PE were retrieved from PubMed， Medline， Embase， the Cochrane Library， CNKI， China Biomedical Literatue Database and Wanfang Data from base-building to January 2025. After literature screening， data extraction and quality evaluation， meta-analysis was performed by using RevMan 5.3 software. RESULTS A total of 11 literatures were included， involving 3 052 pregnant women. Meta-analysis showed the incidence of PE [RR＝0.63， 95%CI （0.53，0.76）， P＜0.000 01]， gestational hypertension [RR＝0.69， 95%CI （0.50，0.94），P＝0.02]， preterm birth [RR＝0.56， 95%CI （0.47，0.66）， P＜0.000 01]， and intrauterine growth retardation [RR＝0.73，95%CI （0.61，0.87），P＝0.000 5] in trial groups were significantly lower than control group. The incidence of postpartum hemorrhage between the two groups had no statistically significant difference [RR＝1.17， 95%CI （0.90，1.53），P＝0.25]. Subgroup analysis showed that the incidence of PE in Chinese pregnant women taking 150 mg of aspirin was significantly higher than taking 100 mg of aspirin [RR＝3.40， 95%CI （1.29， 8.93）， P＝0.01]； but there was no significant difference between the two groups in the incidences of postpartum hemorrhage， preterm birth （P＞0.05）. CONCLUSIONS Aspirin with daily dose ≥100 mg is more effective in preventing PE than daily dose ＜100 mg， with lower rates of gestational hypertension， preterm birth， and intrauterine growth retardation. It does not increase the risk of postpartum hemorrhage. For pregnant women in China， daily dose 100 mg of aspirin may be more effective in preventing PE than 150 mg.

Objective To explore the association between mammalian sterile 20-like kinase 1(MST1)gene poly-morphism and haplotype and the risk of colorectal cancer,rectal cancer,and colon cancer in the Han population in Baotou area by case-control association study.Methods A total of 390 patients with colorectal cancer diagnosed by pathology and 413 normal physical examination population were collected,and 2 ml of peripheral blood was taken for subsequent gene genotyping.Single nucleotide polymorphisms(SNPs)of MST1 gene were screened according to the genetic polymorphism data of Chinese Han population provided by the National Center for Biotechnology In-formation-Haplotype Mapping database.Gene genotyping was performed by Taqman method.Logistic regression was used to calculate the association between each SNP and the risk of colorectal cancer,colon cancer,and rectal cancer under codominant,dominant,overdominant,and recessive genetic models.Results Four SNPs of MST1 gene were screened,namely rs8000,rs2234197,rs2267853,and rs6073629.Among them,SNP rs2234197 was associated with the risk of rectal cancer.Compared with the GG+AA genotype,the AG genotype could reduce the risk of rectal cancer,OR[95%confidence interval(CI)]=0.657(0.442-0.976).SNP rs8000 was associated with the risk of colon cancer.Compared with the TT+GT genotype,the GG genotype could reduce the risk of colon cancer[OR(95%CI)=0.425(0.182-0.992)].Conclusion MST1 gene SNP rs2234197 AG genotype and SNP rs8000 GG genotype may be protective factors for rectal cancer and colon cancer,respectively.

Objective To investigate the associations of the single nucleotide polymorphism (SNP) rs2304733 in TEA domain transcription factor 1 (TEAD1) , rs7135838 and rs1990330 in TEA domain transcription factor 4 (TEAD4) genes with the risk of non-cardia gastric carcinogenesis.Methods Enzyme linked immunosorbent assay (ELISA) was used to detect specific antibodies against Helicobacter pylori(Hp) in serum samples of the normal con-trol group.470 normal controls were divided into Hp infection negative group (n=223) and positive group (n=247) based on antibody titers.In the 450 non-cardia gastric cancer cases and 470 controls, polymerase chain reac-tion-restriction fragment length polymorphism (PCR-RFLP) was used to genotype the each SNP locus.The uncon-ditional Logistic regression method was used to evaluate the associations between each SNP locus and the risk of non-cardia gastric carcinogenesis.Results The SNPs of TEAD1 and TEAD4 were not associated with Hp infec-tion.TEAD1 rs2304733 was associated with the risk of non-cardia gastric cancer.Compared with the carriers of TT genotype, the carries of CT and CC genotypes had an increased risk of non-cardia gastric cancer (CT vs TT:OR=2.321 , 95％CI:1.690-3.188;CC vs TT:OR=5.140 , 95％CI:1.080-24.463) .TEAD4 rs1990330 was as-sociated with the risk of non-cardia gastric cancer.Compared with the carriers of GG genotype, those with GT geno-type had an increased risk of non-cardia gastric cancer (OR = 2.405 , 95％ CI: 1.480 - 3.908) .TEAD4 rs7135838 was not associated with the risk of non-cardia gastric cancer.TEAD1 rs2304733, TEAD4 rs7135838 and rs1990330 had interaction effects on the risk of non-cardia gastric cancer (P<0.05).Conclusion In Baotou Han population, TEAD1 rs2304733 and TEAD4 rs1990330 do not play a major role in Hp infection, but may play a role in the risk of non-cardia gastric cancer.TEAD4 rs7135838 may not play a major role in the risk of Hp infec-tion and non-cardia gastric cancer.TEAD1 rs2304733 and TEAD4 rs1990330 have the strongest synergistic effect on the risk of non-cardia gastric cancer, which is the best interaction model.

ObjectiveTo evaluate the validity of four screening questionnaires on chronic obstructive pulmonary disease (COPD) among community residents in Shanghai, and to provide a scientific basis for selecting suitable screening questionnaires and plans for the community use. MethodsA multi-stage random sampling method was used to select community residents aged ≥40 for COPD questionnaire screening and spirometry. The screening questionnaires included the COPD Population Screener Questionnaire (COPD-PS), the COPD Screening Questionnaire (COPD-SQ), the COPD Diagnosis Questionnaire (CDQ), and the Lung Function Questionnaire (LFQ). The diagnostic gold standard for COPD was defined as a ratio of post-bronchodilator forced expiratory volume in one second to forced vital capacity (FEV1/FVC) less than 0.7. The receiver operating characteristic (ROC) curve was used to assess the validity of each questionnaire, and DeLong’s test was used to compare the area under the curve (AUC) of different questionnaires. ResultsAmong the 1 122 residents screened, 99 (8.8%) were diagnosed with COPD based on the gold standard criteria. The AUC values for the four questionnaires ranged from 0.643 to 0.682, with no statistically significant differences in screening accuracy among them (P>0.05). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for each questionnaire at recommended cut-off points were as follows: COPD-PS (sensitivity: 33.3%, specificity: 84.9%, PPV: 17.6%, NPV: 92.9%), COPD-SQ (34.3%, 85.8%, 19.0%, 93.1%), CDQ (73.7%, 42.4%, 11.0%, 94.4%), and LFQ (48.5%, 74.8%, 15.7%, 93.8%). Optimal cut-off values for this population differed from the recommended values. When selecting the optimal cut-off value, the sensitivity of COPD-PS (58.6%), COPD-SQ (55.6%), and LFQ (64.7%) increased, while the specificity of CDQ (75.9%) increased. The AUC of sequential lung function testing for all four screening questionnaires increased to 0.7 or above. The optimal cut-off values for the four questionnaires in this population differed from the recommended values. When applying the optimal cut-off values, the sensitivity of three questionnaires increased: COPD-PS (58.6%), COPD-SQ (55.6%), and LFQ (64.7%), while the specificity of CDQ rose to 75.9%. The AUC of each questionnaire increased to above 0.7 when followed by sequential lung function testing. ConclusionThe COPD-PS, COPD-SQ, CDQ, and LFQ have limited value for COPD screening among Shanghai community residents, indicating that further refinement of these tools is needed.

Objective:To search and summarize the best evidence for preoperative prehabilitation in patients with lung cancer complicated by chronic obstructive pulmonary disease and to inform the management of preoperative prehabilitation in patients with lung cancer combined with COPD by clinical providers.Methods:Systematically guideline websites, professional society websites, evidence-based databases, and comprehensive databases were searched for types of literature including clinical decision making, guidelines, expert consensus, evidence summaries, systematic evaluations, Meta-analyses, and randomized controlled trials. The time for the retrieval was from the inception of databases until October 31th, 2023. And the quality of the included literature was evaluated and evidence was extracted, evaluated the quality of the included literature, and extracted evidence.Results:Finally, 18 articles were included, including 8 guidelines, 8 expert consensus, and 2 systematic reviews. Summarized the 30 best evidence in 4 areas of prerehabilitation: need, timing, location, content (including smoking cessation management, respiratory exercise, exercise, nutritional support, and medication management).Conclusions:This study summarizes the best evidence for preoperative prehabilitation in patients with lung cancer combined with chronic obstructive pulmonary disease, and healthcare professionals should be mindful of the need to develop preoperative prehabilitation protocols judiciously, taking into account the specific clinical context during the subsequent translation of the evidence to the clinic.

Background::Genetic variants of dopaminergic transcription factor-encoding genes are suggested to be Parkinson’s disease (PD) risk factors; however, no comprehensive analyses of these genes in patients with PD have been undertaken. Therefore, we aimed to genetically analyze 16 dopaminergic transcription factor genes in Chinese patients with PD.Methods::Whole-exome sequencing (WES) was performed using a Chinese cohort comprising 1917 unrelated patients with familial or sporadic early-onset PD and 1652 controls. Additionally, whole-genome sequencing (WGS) was performed using another Chinese cohort comprising 1962 unrelated patients with sporadic late-onset PD and 1279 controls.Results::We detected 308 rare and 208 rare protein-altering variants in the WES and WGS cohorts, respectively. Gene-based association analyses of rare variants suggested that MSX1 is enriched in sporadic late-onset PD. However, the significance did not pass the Bonferroni correction. Meanwhile, 72 and 1730 common variants were found in the WES and WGS cohorts, respectively. Unfortunately, single-variant logistic association analyses did not identify significant associations between common variants and PD. Conclusions::Variants of 16 typical dopaminergic transcription factors might not be major genetic risk factors for PD in Chinese patients. However, we highlight the complexity of PD and the need for extensive research elucidating its etiology.

Objective:To analyze the existing problems in maternal and child health services in Shanghai′s communities, so as to provide references for the continuous improvement and enhancement of maternal and child health work in community.Methods:Retrieve relevant literature on community maternal and child health services in Shanghai from databases such as CNKI, Wanfang, VIP, Chinese biomedical literature database and PubMed for text analysis, with a search period from 2009 to 2023. From August 2022 to May 2023, a purposive sampling method was used to select community health service centers in Shanghai for participatory observation. Interviews were conducted with maternal and child health service providers in community, management personnel at all levels, and obstetric experts from tertiary hospitals participating in the construction of medical alliances to understand the problems that exist in the process of providing maternal and child health services in community service centers. Based on text analysis, participatory observation, and interview results, a structure-process-outcome theory model was used to sort out a list of problems of maternal and child health services in Shanghai′s community. An electronic questionnaire was created based on the list of questions, and maternal and child health service personnel in each jurisdiction were invited to rate the existing problems from three aspects: importance, severity, and solvability. The key issues was determined based on the total score of each problem.Results:A list of 24 issues related to maternal and child health services in Shanghai′s community has been formed, with the structural dimension including team building and hardware facilities, the process dimension including mechanism construction, implementation process, and institutional coordination, and the result dimension only including system result category. According to the survey results, the three key questions with a total score greater than 7 were identified as the need for improvement in the maternal and child health knowledge and skills of service personnel; Insufficient staffing of service personnel, lack of dedicated personnel and specialized talents; The health information platform was not well-established, and institutions could not fully and timely share diagnosis and treatment data.Conclusions:This study has identified a problem list for maternal and child health care services in Shanghai′s communities, as well as key issues that urgently need to be addressed, which can provide reference for improving the quality of maternal and child health care services in Shanghai′s communities.

As an integral part of worldwide healthcare,nursing still has a big task to make in conducting implementation research.Addressing the pressing challenges of closing the gap between evidence and nursing practice,and effectively disseminating and applying evidence within the nursing discipline,remains a top priority.This paper presents a compilation of the status of evidence implementation in clinical nursing from an implementation science perspective,including the theoretical framework of barriers to evidence implementation,common research methodologies,and research progress of related factors in the field of nursing.The goal of this work is to bring more insights to further advance the implementation of evidence in nursing.

Objective:To evaluate the effect of activation of splenic plasmacytoid dendritic cells (pDCs) on myocardial ischemia-reperfusion (I/R) injury in mice.Methods:The experiment was performed in two parts. Animal experiment Thirty-six SPF healthy male C57BL/6J mice, aged 10 weeks, weighing 22-27 g, were assigned to 3 groups ( n=12 each) using a random number table method: sham operation group (Sham group), myocardial ischemia group (MI group) and myocardial I/R group (MI/R group). The myocardial ischemia was induced by occluding the left anterior descending coronary artery for 40 min in MI group, while the model of myocardial I/R was established by occlusion of the left anterior descending coronary artery for 40 min followed by 1-h reperfusion in MI/R group. Following successful preparation of the model, 3 animals from each group were randomly selected, and their hearts were removed for determination of myocardial infarct size through a combination of TTC and methylene blue double staining. Another 3 animals from each group were randomly selected, and their hearts were removed for examination of pathological changes of myocardial tissues using HE staining. Blood samples were collected from the abdominal aorta of 6 mice left in each group for determination of plasma interferon alpha (IFN-α) concentrations by enzyme-linked immunosorbent assay. Then the animals were sacrificed and hearts were harvested for collection of cardiac perfusate (CP). Cell experiment Twelve SPF healthy male C57BL/6J mice, aged 10 weeks, weighing 22-27 g, were selected and the splenic pDCs were isolated using anti-mPDCA-1 MicroBeads according to the manufacturer′s instructions (with a positivity rate of >85% for the isolated cells). The cells were divided into 4 groups: group pDCs stimulated by CP in Sham group (pDCs+ CP-Sham group), group pDCs stimulated by CP in MI group (pDCs+ CP-MI group), group pDCs stimulated by CP in MI/R group (pDCs+ CP-MI/R group) and pDCs stimulated by PBS group (pDCs+ PBS group). The CP in Sham, MI and MI/R groups and PBS were used to induce and culture pDCs for 8 h. Flow cytometry was employed to detect the expression of CD45 and co-stimulatory molecules CD80, CD86 and Major Histocompatibility Complex Ⅱ (MHC Ⅱ) on the surface of pDCs. The levels of IFN-α in the cell culture supernatant were determined using enzyme-linked immunosorbent assay. Results:Animal experiments Compared with Sham group and MI group, the percentage of myocardial infarct size was significantly increased, the concentrations of plasma IFN-α were increased ( P<0.05), and cardiomyocytes displayed evident vacuolar degeneration, severe myocardial fiber rupture, and infiltration of a substantial number of inflammatory cells in MI/R group. There was no significant difference in each parameter between Sham group and MI group ( P>0.05). Cell experiment Compared with pDCs+ CP-Sham group, the expression of CD80, CD86 and MHCⅡ was significantly up-regulated in pDCs+ CP-MI group ( P<0.05), and no significant change was found in the aforementioned parameters in pDCs+ CP-MI/R group ( P>0.05). The expression of aforementioned parameters was significantly up-regulated in pDCs+ CP-MI group as compared with pDCs+ CP-MI/R group ( P<0.05). Compared with pDCs+ CP-Sham group and pDCs+ CP-MI/R group, the concentrations of IFN-α in the cell culture supernatant were significantly increased in pDCs+ CP-MI group ( P<0.05). There was no statistically significant difference in the concentrations of IFN-α between pDCs+ CP-MI/R group and pDCs+ CP-Sham group ( P>0.05). Conclusions:The mechanism underlying myocardial I/R injury may be related to activation of splenic pDCs leading to the production of IFN-α following myocardial ischemia in mice.

Objective:To explore the application effect of information sharing assisted decision-making intervention in knee replacement patients.Methods:A total of 94 inpatients undergoing knee replacement in Department of Orthopedics in Xinxiang Central Hospital from January to December 2022 were selected by the convenient sampling method, and they were divided into the control group and the observation group according to random number table method, with 47 cases in each group. The control group adopted routine clinical decision-making management, while the observation group implemented information sharing assisted decision-making intervention based on the control group. On the 5th day after surgery, Control Preference Scale (CPS), Chinese version of Preparation Decision Making Scale (PreDM) and Decision Participation Satisfaction Scale were used to evaluate the decision participation, decision readiness and decision satisfaction of patients in two groups.Results:In the control group, active, cooperative and passive decision-making participation accounted for 21.28% (10/47), 27.66% (13/47) and 51.06% (24/47), respectively. In the observation group, 42.55% (20/47), 44.68% (21/47) and 12.77% (6/47) of the participants were active, cooperative and passive, respectively. There was a statistically significant difference in the distribution of decision participation between the two groups ( P<0.01). The PreDM score and decision participation satisfaction score of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.01) . Conclusions:Information sharing assisted decision-making intervention can effectively improve the decision-making participation of knee replacement patients and improve their decision-making readiness and satisfaction.