Objective:To analyze the validity of an enhanced nutrition management model for all pregnant women in reducing the incidence of macrosomia.Methods:This retrospective cohort study utilized data from the Beijing Birth Cohort database established by Beijing Obstetrics and Gynecology Hospital, Capital Medical University. A total of 73 193 pregnant women who underwent regular prenatal examinations and delivered at the hospital between January 2018 and December 2023 were consecutively included. From 2018 to 2020, all participants received nutrition education, and high-risk pregnancies predisposed to macrosomia were referred to nutrition clinics for further follow-up. From 2021 to 2023, obstetricians participated in nutritional assessments and gestational weight gain guidance, with repeated nutrition evaluations and education provided during early, mid, and late pregnancy. A multidisciplinary team (obstetrics and nutrition departments) collaborated to implement an enhanced nutrition management model for all pregnant women. General data, parity, gestational age at delivery, neonatal birth weight, and clinical information were collected. Annual incidences of macrosomia and low birth weight were calculated. Chi-square tests and variance analysis were used to analyzed yearly changes in macrosomia rates and evaluate the impact of the two-phase management strategies on macrosomia incidence, thereby to explore the validity of an enhanced nutrition management model for all pregnant women in reducing the incidence of macrosomia.Results:The number of deliveries included annually from 2018 to 2023 was 14 578, 15 413, 11 496, 11 146, 10 396, and 10 164, respectively. Maternal pre-pregnancy body mass indices in 2022 to 2023 were higher than those in 2018 to 2021 [(22.26±3.50) and (22.23±3.65) vs (21.87±3.27), (21.82±3.31), (21.86±3.34) and (21.94±3.39) kg/m2, respectively (all P<0.05)]. Neonatal birth weights in 2021 to 2022 were lower than those in 2018 to 2020 [(3 271±514) and (3 270±513) vs (3 323±504), (3 314±500), and (3 315±510) g], and the birth weight in 2023 was further reduced compared to that in 2018 to 2022 [(3 236±506) vs (3 323±504), (3 314±500), (3 315±510), (3 271±514) and (3 270±513) g] (all P<0.05). The incidence of macrosomia in 2021 to 2022 was lower than those in 2018 to 2020 (5.55%, 5.75% vs 6.97%, 6.68%, 6.67%), and the incidence in 2023 further decreased compared to those in 2018 to 2022 (4.16% vs 6.97%, 6.68%, 6.67%, 5.55%, 5.75%) (all P<0.05). Conclusion:The enhanced nutrition management model for all pregnant women effectively reduces the incidence of macrosomia, demonstrating significant clinical value for widespread implementation.

Objective:To explore the correlation between serum uric acid/high-density lipoprotein cholesterol ratio (UHR) and the risk of hypertension in elderly physical examination populations.Methods:This study was a cross-sectional study. A total of 1 028 patients aged≥60 years who underwent physical examinations at the Health Management Center of Fuwai Central China Cardiovascular Hospital from September 2023 to February 2024 were included in this study. The general demographic data, past medical history, physical examination and laboratory examination indicators of the physical examiners were collected, and according to whether they had hypertension or not, they were divided into hypertension group (390 cases) and non-hypertension group (638 cases), and all UHR values were arranged from small to large, and the UHR was divided into three groups by tertiles of UHR, and the general data and blood biochemical indexes between the groups were compared. Spearman rank correlation was used to analyze the correlation between UHR level and body mass index, total cholesterol, triglyceride and other indexes in the elderly population. Logistic regression was used to explore the relationship between UHR level and hypertension in the elderly population, and the stratification analysis of the physical examination population was carried out according to diabetes, coronary heart disease and dyslipidemia, and the interaction test between groups was carried out.Results:Among the 1 028 geriatric physical examination cases, 580 (56.4%) were males and 448 (43.6%) were females, aged (66.7±5.8) years. UHR levels were higher in the hypertensive group compared to the non-hypertensive group [248.88 (191.19, 322.25) vs 213.52 (165.94, 275.29); Z=-5.445, P<0.05]. With the increase of UHR level, the detection rate of hypertension in the elderly population increased (accounted for 27.8%, 38.2% and 47.8%, respectively; χ2=29.211, P<0.05). Spearman rank correlation analysis showed that UHR was positively correlated with body mass index, triglycerides, serum uric acid, serum creatinine and fasting blood glucose ( r=0.318, 0.334, 0.774, 0.474, 0.080; all P<0.05), and negatively correlated with total cholesterol, glomerular filtration rate and low-density lipoprotein cholesterol ( r=-0.239, -0.303, -0.154; all P<0.05). When the confounding factors were not adjusted (model 1), the risk of hypertension in high UHR group was 2.382 times higher than that in low UHR group and 1.607 times higher than that in medium UHR group; after adjusting for all confounding factors such as age, gender, body mass index, systolic blood pressure, diastolic blood pressure, junior high school education or below, smoking, alcohol consumption, glomerular filtration rate, etc., the risk of hypertension in the high-level UHR group was 1.732 times higher than that in the low-level UHR group (95% CI: 1.139-2.635) ( P<0.05). The elderly physical examination population was further stratified according to whether there was diabetes, dyslipidemia and coronary heart disease, and it was found that there was no interaction between UHR and diabetes, dyslipidemia and coronary heart disease on the prevalence of hypertension (all P>0.05). Conclusions:Hypertension detection rate increases with higher UHR levels. UHR is closely related to the incidence of hypertension in the elderly population.

Objective:To analyze the correlation between poor sleep status in late pregnancy and postpartum depression and anxiety.Methods:In this prospective cohort study, a total of 401 women in early pregnancy were consecutively enrolled at Beijing Tian Tan Hospital, Capital Medical University, from December 2020 to April 2021. The Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) were used to assess the sleep status in late pregnancy. The Edinburgh Postnatal Depression Scale (EPDS) and the 7-item Generalized Anxiety Disorder Scale (GAD-7) were used to assess the emotional status in late pregnancy and 6 weeks after delivery. During the follow-up, 123 subjects did not complete the sleep and emotional assessment in late pregnancy, 77 subjects did not complete the postpartum emotional assessment, and 201 cases were finally included in the study. Multivariate logistic regression analysis was used to analyze the correlation between poor sleep status in late pregnancy and postpartum depression and anxiety.Results:Among 201 women in early pregnancy included in the analysis, the detection rate of postpartum depression and anxiety was 15.4% (31/201) and 27.4% (55/201), respectively. Poor sleep quality ( OR=2.49, 95% CI: 1.02-6.07), difficulty falling asleep ( OR=6.74, 95% CI: 2.31-19.70), and excessive daytime sleepiness ( OR=6.34, 95% CI: 2.08-19.32) in late pregnancy were positively correlated with postpartum depression (all P0.05). Poor sleep quality ( OR=3.89, 95% CI: 1.81-8.40), difficulty falling asleep ( OR=6.75, 95% CI: 2.43-18.77), short-time sleep ( OR=2.89, 95% CI: 1.36-6.11), fragmented sleep ( OR=5.69, 95% CI: 2.27-14.28) and excessive daytime sleepiness ( OR=3.07, 95% CI: 1.07-8.78) in late pregnancy were positive correlation factors for postpartum anxiety (all P0.05). Conclusions:Poor sleep status in late pregnancy is associated with postpartum depression and anxiety. Strengthening screening and management of poor sleep status in late pregnancy may help maintain healthy postpartum emotion.

Objective:To analyze the correlation between serum uric acid-to-high-density lipoprotein cholesterol ratio (UHR) and risk of all-cause death or cardiovascular disease (CVD) death among urban and rural elderly in Beijing.Methods:Based on the Beijing Healthy Aging Cohort Study, 9 022 participants with complete baseline data were enrolled, and their survival and death outcomes were followed up. Multivariable Cox proportional hazard regression model were used to analyze the associations between the UHR level and the risks of all-cause mortality and CVD mortality.Results:As of March 31, 2021, the median follow-up time M( Q1, Q3) was 6.18 (5.36, 6.75) years. There were 1 166 all-deaths, with a death density of 19.26 per 1 000 person-years, and 562 CVD deaths, with a death density of 9.28 per 1 000 person-years. After adjusting sociodemographic characteristics and lifestyle factors, multivariable Cox proportional hazard regression model showed that the risk of all-cause mortality increased by 3% ( HR=1.03, 95% CI: 1.02-1.04) and the risk of CVD mortality increased by 4% ( HR=1.04, 95% CI: 1.02-1.06) for every 1% increase in UHR. Compared with the T1 group of UHR tertiles, the T3 group had a 42% increase in the risk of all-cause death ( HR=1.42, 95% CI: 1.22-1.66) and a 53% increase in the risk of CVD death ( HR=1.53, 95% CI: 1.21-1.94). Conclusions:The UHR level is significantly associated with the risks of all-cause mortality and CVD mortality among urban and rural older adults in Beijing. The UHR level may be one of the potential predictors of death risk in community-dwelling older adults.

Objective:To analyze the clinical characteristics, diagnosis and prognosis of pregnant women with fetomaternal hemorrhage (FMH) syndrome, and to guide the management of pregnant women with FMH syndrome.Methods:The clinical data of 33 pregnant women with FMH syndrome admitted to Beijing Obstetrics and Gynecology Hospital, Capital Medical University, from January 2010 to December 2024 were collected, and the general information, diagnostic characteristics, treatment and maternal and fetal prognosis were retrospectively analyzed.Results:The incidence of FMH syndrome in our hospital was 1.7/10 000 (33/194 272). The gestational age of onset of FMH syndrome in 33 pregnant women was (35.6±3.1) weeks, 15 cases (45%, 15/33) were full-term delivery and 18 cases (55%, 18/33) were preterm delivery. Decreased fetal movement (51%, 17/33) was the most common initial symptom, followed by abnormal electronic fetal monitoring (33%, 11/33). Thirty-two cases (97%, 32/33) underwent cesarean section, and only one case had spontaneous delivery. Postpartum hemorrhage occurred in 11 cases (33%, 11/33). All the neonates were transferred to neonatal intensive care unit for treatment. Two of them were treated with intrauterine blood transfusion, and the neonates did not receive blood transfusion after birth. The neonatal mortality rate was 6% (2/33), and the remaining 31 cases (94%, 31/33) survived. Complications occurred in 3 premature infants, including 1 case of neonatal neurodevelopmental disorder with cochlear implantation, 1 case of pulmonary artery stenosis, and 1 case of retinopathy of prematurity. Three pregnant women were pregnant again, and none of them had FMH syndrome.Conclusions:Decreased fetal movement or abnormal electronic fetal monitoring in late pregnancy should be alert to the occurrence of FMH syndrome. Early diagnosis and intervention are critical to improve the prognosis of FMH syndrome.

Objective To investigate the safety and feasibility of the domestic SA-1000 single-port single-arm robot-assisted laparoscopic system in total hysterectomy.Methods Data from 16 patients who underwent total hysterectomy using the SA-1000 system at the Department of Obstetrics and Gynecology,The Second Affiliated Hospital of Naval Medical University,between Mar.2023 and Jan.2024 were retrospectively collected.Surgical parameters were analyzed.Postoperative pain was assessed using the visual analogue scale(VAS)at 24 h after surgery and before discharge.Incision cosmesis was evaluated 3-5 weeks postoperatively using the body image questionnaire(BIQ,score range 3-24).Results All 16 procedures were successfully completed using the SA-1000 system without conversion to open surgery,achieving a 100.0%procedural success rate.The mean whole surgery time was(234.40±56.24)min.The median robotic arm setup time was 8.0(4.0,13.5)min,and the median console operating time was 128.0(100.0,151.0)min.The median intraoperative blood loss was 100.0(100.0,200.0)mL.No perioperative complications,such as hemorrhage,infection,injury to adjacent organs(ureters,bladder,bowel),poor wound healing,or incisional hernia,were observed.The mean wound pain score at 24 h postoperatively was 3.81±1.64,decreasing to a median of 3.0(2.0,4.0)before discharge.The BIQ score assessed at 3-5 weeks postoperatively was 21.88±1.15.Conclusion The application of the domestic SA-1000 single-port single-arm robot-assisted laparoscopic system for total hysterectomy is safe and feasible,demonstrating favorable surgical outcomes.It holds promise for broader implementation and promotion in domestic medical centers.

Objective:To investigate the improvement effect of the freeze-dried garlic powder on acute myocardial ischemia and its effect on phosphatidylinositol 3 kinase/protein kinase B/nuclear factor erythroid 2-related factor 2 (PI3K/Akt/Nrf2) signaling pathway.Methods:SD rats were randomly divided into sham-operation group, model group, positive drug group, and garlic freeze-dried powder low-, medium-, and high-dosage groups using a random number table method, with 12 rats in each group. The garlic freeze-dried powder low-, medium-, and high-dosage groups were orally administered with 0.58, 1.16, and 2.32 g/kg of garlic freeze-dried powder solution, the positive reference drug group was orally administered with 0.26 g/kg of compound Danshen tablet solution, and the model group and sham-operation group were orally administered with equal volumes of distilled water once a day for 14 consecutive days. Except for the sham-operation group, all other groups were prepared with acute myocardial ischemia models in rats by ligating the left anterior descending coronary artery. Electrocardiogram testing was performed. The incidence of ventricular premature beats, ventricular tachycardia, and ventricular fibrillation in each group was counted. Myocardial infarction was observed through TTC staining, and the myocardial infarction rate was calculated; serum creatine kinase (CK), creatine kinase isoenzyme (CK-MB), LDH, cardiac troponin T (cTnT), total antioxidant capacity (T-AOC), SOD, MDA, IL-1β, TNF-α levels were detected, and Western blot was used to detect myocardial tissue p-PI3K, p-Akt, Nrf2, HO-1 and Keap1 proteins.Results:Compared with the model group, the incidence of premature ventricular contractions, ventricular tachycardia, and ventricular fibrillation in rats in each treatment group was reduced. Compared with the model group, the positive drug group and garlic freeze-dried powder medium- and high-dosage groups showed a decrease in myocardial infarction rate in rats ( P<0.05); compared with the model group, the levels of serum T-AOC and SOD in each treatment group increased ( P<0.05 or P<0.01), while the level of MDA decreased ( P<0.05 or P<0.01); the levels of CK, LDH, cTnT, IL-1β, and TNF-α in the serum of rats in the positive drug group and garlic freeze-dried powder high-dosage group decreased ( P<0.05 or P<0.01), while the expressions of p-PI3K, p-Akt, Nrf2, and HO-1 proteins in myocardial tissue increased ( P<0.05 or P<0.01), and the expression of Keap1 protein decreased ( P<0.05 or P<0.01). Conclusions:Garlic freeze-dried powder can improve acute myocardial ischemia of rats by reducing the release of serum myocardial enzymes and exerting antioxidant and anti-inflammatory effects. The mechanism may be related to regulating PI3K/Akt/Nrf2 signaling pathway.

The therapeutic efficacy and possible mechanism of action of superficial needling therapy for knee osteoarthritis(KOA)are reviewed by analyzing relevant medical literature.Superficial needling therapy exerts certain efficacy in treating KOA,and the clinical efficacy could be further improved by combining it with conventional acupuncture,as well as Chinese medicine and other acupuncture methods alone.The therapy of stimulation of meridian qi and invigoration of yang qiare in line with the pathogenesis of KOA.Superficial needling therapy exerts certain effect on KOA by enhancing acupuncture stimulation,enlarging the treatment area,and releasing muscle and fascia.

Based on current national policies, regulations, standards, relevant literature, and departmental experience regarding the protection against radionuclides in China, this study provides a brief overview of key issues in the management of hospital wards for patients with internal radionuclide contamination. The discussion covers the detection of internal contamination, general requirements for internal radionuclide contamination wards, and inpatient management. In addition, the study explores in depth the daily responsibilities, protective measures, and management protocols for both healthcare staff and patients within such wards. This article summarizes a framework for the construction of internal radionuclide contamination wards, along with specific plans and detailed role-based guidelines. These results provide a reference for the management of hospital wards for patients with internal radionuclide contamination.

Objective:To compare the relative proportion of direct action (ray particles directly destroy biological molecules such as DNA and indirect action (radical-mediated oxidative damage) in the damage caused by X-ray and proton irradiation of lung cancer cells.Methods:Unirradiated human lung adenocarcinoma A549 cells and human large cell lung cancer NCI-H460 cells were cultured in media containing 0, 0.125, 0.25, 0.5, 0.75 mol/L dimethyl sulfoxide (DMSO) for 1 h to obtain plating efficiency (PE) values, thereby determining whether DMSO affected cell survival. Following pretreatment with each DMSO concentration, cells were exposed to X-ray irradiation at physical doses of 2, 4, 6, 8 Gy and proton irradiation at equivalent doses of 2, 4, 6, 8 GyE, respectively. Survival fractions (SF) and maximum protection (MP) values were calculated to evaluate the effects of varying DMSO concentrations on post-irradiation cell survival and to quantify the contribution of indirect radiation damage mechanisms (higher MP indicates greater indirect effect contribution). PE, SF, and MP values were determined using clonogenic assays. Comparisons among multiple groups were performed using one-way ANOVA followed by Tukey's multiple comparison, and comparisons between irradiation groups were analyzed using independent samples t-tests. Results:The PE of unirradiated cells treated with varying DMSO concentrations showed no statistically significant differences. Following pretreatment at different DMSO concentrations and subsequent irradiation with X-rays or protons, the protective effect of DMSO reached saturation at 0.5 mol/L. At this concentration, comparison of the average MP values across 4 radiation doses revealed: In A549 cells, the MP value was 54.21%±1.73% for X-ray irradiation group and 39.69%±0.72% for proton irradiation group ( t=16.82, P<0.001); in NCI-H460 cells, the MP value was 52.04%±1.00% for X-ray irradiation group and 41.31%±0.70% for proton irradiation group ( t=10.19, P<0.001). Conclusions:Under biologically equivalent doses, proton irradiation demonstrates greater reliance on direct effects in lung cancer cells killing compared with X-ray irradiation.