Objective:To construct a classification management model on the basis of Kraljic matrix for electrocardiogram(ECG)monitoring equipment in emergency intensive care unit(ICU),so as to explore its application value in the management for ECG monitoring equipment in emergency ICU.Methods:The classification management model on the basis of index for ECG monitoring equipment in emergency ICU was constructed.According to two classification dimensions included the market supply risk and the self-value,an indicator system of classification management,which aimed at strategic materials with high value and high risk,leverage materials with high value and low risk,bottleneck materials with low value and high risk,and conventional materials with low value and low risk,was constructed.A total of fifty-one ECG monitoring equipment in the emergency ICU of The People's Hospital of Longhua of Shenzhen from January to December 2023 were selected,and they were managed respectively by conventional management mode(25 sets)and classification management mode(26 sets)according to different management modes.The standardization level of operation management for equipment,the occurrence of safety risk and the level of management for equipment of the two management modes were compared,and the satisfaction of 30 relative personnel,who used and managed these equipment,for classification management of equipment also were compared.Results:The average values of the percentage of standardization level of normality of equipment operation,disinfection and sterilization,maintenance and fault repair of using classification management mode were respectively(91.58±4.33)%,(92.1±3.28)%,(91.49±3.54)%and(92.58±3.32)%,all of which were higher than those of conventional management mode,and the differences were statistically significant(t=12.537,15.706,14.196,18.946,P<0.05),repsectively.The average incidences of the risk of pressure injury,electrical injury and body fluid extravasation of adopting classification management mode were respectively(2.54±0.87)%,(3.02±0.82)%and(1.29±0.65)%,all of which were lower than those of adopting conventional management mode,and the differences were statistically significant(t=22.825,17.453,24.424,P<0.05),respectively.The satisfaction scores of 30 relative management personnel,who used equipment on the process rationality,system standardization and quality effectiveness,of adopting classification management mode were respectively(94.26±3.54),(92.57±4.36)and(91.87±3.69),all of which were higher than those of conventional management mode,and the differences were statistically significant(t=14.052,13.991,13.551,P<0.05),respectively.The reasonable placement rate,recording rate of standardization,and intact rate of equipment in the 26 equipment by adopting classification management mode were respectively 92.31%,92.31%and 88.46%,all of which were significantly higher than those by adopting conventional management mode,and the differences were statistical significant(x2=12.052,10.398,11.338,P<0.05).Conclusion:The classification management model of ECG monitoring equipment in emergency ICU can increase the management efficiency for the equipment in operating room of hospital,and improve the operation quality of equipment,and enhance the safety of equipment in clinical use,and the standardization of operation management for equipment.

Objective To explore the value of multimodal ultrasound combined with sex hormone detection in evaluating endometrial receptivity in infertile patients.Methods Ninety-five infertile patients who received in vitro fertilization and embryo transfer treatment in Hangzhou Women's Hospital from January 2020 to February 2023 were selected as study objects,and they were divided into pregnant group(55 cases)and non-pregnant group(40 cases)according to the pregnancy status of the first embryo transfer.Sex hormone levels and multimodal ultrasound scores were compared between two groups,and receiver operating characteristic(ROC)curve was drawn to evaluate the value of each indicator in predicting pregnancy of infertile patients individually and in combination.Results The endometrial thickness score,endometrial volume score,vascular blood flow score and multimodal ultrasound score of pregnant group were significantly higher than those of non-pregnant group(P＜0.05).The levels of luteinizing hormone(LH),estradiol(E2)and progesterone(P)in pregnant group were significantly higher than those in non-pregnant group(P＜0.05).ROC curve results showed that the area under the curve(AUC)of LH,E2 and multimodal ultrasound scores in predicting pregnancy in infertile patients were all＞0.7,which had certain predictive value,and the three indicators combined with P had the highest predictive value,with an AUC of 0.889.Conclusion The combination of multimodal ultrasound and sex hormone detection can effectively evaluate the endometrial receptivity of infertile patients,and has certain reference value for predicting the pregnancy status of infertile patients.

OBJECTIVE To investigate the clinical characteristics of drug-induced liver injury （DILI） induced by glucagon- like peptide-1 receptor agonists （GLP-1RAs）， and to provide a reference for safe clinical medication. METHODS Using search terms such as “GLP-1”“GLP-1RAs”“semaglutide” “drug-induced liver injury”， relevant studies from PubMed， Embase， the Cochrane Library， CNKI， Wanfang Data and VIP were retrieved. Descriptive analysis was performed on cases of DILI induced by GLP-1RAs. RESULTS A total of 11 studies， comprising 11 patients， were included. Among them， 4 were male （36.4%） and 7 were female （63.6%）. Patient ages ranged from 17 to 64 years； 5 patients （45.5%） were between 50 and 65 years old. Six patients were treated for diabetes， and five for weight loss. Ten patients had underlying diseases. The shortest time to the onset of DILI was 5 days after medication， while the longest was approximately 180 days. The DILIs induced by GLP-1RAs were mainly hepatocellular injury type （6 cases）； severity levels included severe （3 cases）， moderate （6 cases）， and mild （2 cases）. Gastrointestinal symptoms and jaundice were the most common clinical manifestations. The association between DILI and GLP- 1RAs was assessed as “probable” in 10 cases and “possible” in 1 case. All 11 patients improved after drug discontinuation and （or） corresponding treatment. CONCLUSIONS DILI induced by GLP-1RAs is relatively concentrated in patients aged 50-65， with a higher incidence in females. The risk may be further increased in patients with underlying diseases. Clinical use of these agents should enhance pharmaceutical care， including identification of high-risk populations and patient education （especially symptom recognition）. When relevant symptoms appear， the drug should be discontinued immediately， with liver-protective therapy initiated when necessary， to ensure patient safety of drug use.

Aim To detect the changes of serum cardiotrophin-1(CT-1)and angiopoietin-like protein 3(ANGPTL3)levels in patients with coronary heart disease(CHD)complicated with heart failure(HF)after percutaneous coronary intervention(PCI),and analyze their relationship with prognosis.Methods 199 patients with CHD compli-cated with HF who underwent PCI in the Second Affiliated Hospital of Zhengzhou University from March 2022 to March 2023 were selected.The serum CT-1 and ANGPTL3 levels of patients with different New York Heart Association(NYHA)cardiac function grades were compared before surgery.The prognosis was followed up after PCI,and the pa-tients who had major adverse cardiovascular event(MACE)were included in the poor prognosis group,and the rest were included in the good prognosis group.The general data and serum CT-1 and ANGPTL3 levels were compared between the poor prognosis group and the good prognosis group.Logistic regression model was used to analyze the influencing factors of poor prognosis after surgery in patients with CHD and HF.The predictive value of serum CT-1 and ANGPTL3 alone and in combination were analyzed.Results Compared with the patients with cardiac function grade Ⅰ,the serum CT-1 and ANGPTL3 levels of the patients with cardiac function grade Ⅱ,Ⅲ and Ⅳ were increased(P＜0.05).Compared with the patients with cardiac function grade Ⅱ,the serum CT-1 and ANGPTL3 levels of the patients with cardiac function grade Ⅲ and Ⅳ were increased(P＜0.05).Compared with the patients with cardiac function grade Ⅲ,the serum CT-1 and ANGPTL3 levels of the patients with acrdiac function grade Ⅳ were increased(P＜0.05).Spearman correlation a-nalysis showed that the serum CT-1 and ANGPTL3 levels were positively correlated with NYHA cardiac function grade(r=0.518,95％CI:0.408～0.613,P＜0.001,r=0.737,95％CI:0.666～0.794,P＜0.001).The poor prognosis rate of patients was 17.93％.Compared with the good prognosis group,the serum CT-1 and ANGPTL3 levels of the poor progno-sis group were increased(P＜0.05).Logistic regression model analysis showed that smoking,diabetes,lesion vessel number ≥3,irregular medication outside the hospital,serum CT-1 and ANGPTL3 levels were the influencing factors of poor prognosis in patients with CHD complicated with HF(P＜0.05).ROC curve analysis showed that the sensitivity and area under the curve(AUC)of combined serum CT-1 and ANGPTL3 levels for predicting poor prognosis of patients with CHD complicated with HF were higher than those of either marker alone,while the specificity was basically similar to that of sin-gle-marker prediction.Conclusion Serum CT-1 and ANGPTL3 levels are abnormally elevated in patients with CHD complicated with HF after PCI,and are closely related to the cardiac function and prognosis.

Uterine arteriovenous fistula (UAVF), a relatively rare vascular anomaly, may lead to life-threatening hemorrhage and poses diagnostic and management challenges for primary hospitals during initial encounters. This article reports four cases of UAVF treated with Drospirenone and ethinyl estradiol tablets at Department of Gynaecology, Zhuji Maternal and Child Health Hospital between 2023 and 2024. Combined with literature review, we systematically analyzed the etiological mechanisms, clinical characteristics, and diagnostic-therapeutic strategies of this condition, with particular focus on evaluating the efficacy and safety of conservative pharmacological management. By summarizing case features and individualized treatment protocols, this study aims to provide clinical references for early identification, accurate diagnosis, and rational intervention of UAVF, thereby reducing risks of massive hemorrhage and long-term complications while improving patient prognosis.

Uterine arteriovenous fistula (UAVF), a relatively rare vascular anomaly, may lead to life-threatening hemorrhage and poses diagnostic and management challenges for primary hospitals during initial encounters. This article reports four cases of UAVF treated with Drospirenone and ethinyl estradiol tablets at Department of Gynaecology, Zhuji Maternal and Child Health Hospital between 2023 and 2024. Combined with literature review, we systematically analyzed the etiological mechanisms, clinical characteristics, and diagnostic-therapeutic strategies of this condition, with particular focus on evaluating the efficacy and safety of conservative pharmacological management. By summarizing case features and individualized treatment protocols, this study aims to provide clinical references for early identification, accurate diagnosis, and rational intervention of UAVF, thereby reducing risks of massive hemorrhage and long-term complications while improving patient prognosis.

Objective:To explore the effectiveness of a modified puncture method in hemodialysis patients with difficult internal fistula.Methods:From January 2022 to October 2023, patients with difficult internal fistula undergoing dialysis at the Blood Purification Center of Qingdao Municipal Hospital were selected for the study using the convenience sampling method. According to the hemodialysis time, patients dialyzed on Mondays, Wednesdays, and Fridays were included in the conventional group, and patients dialyzed on Tuesdays, Thursdays, and Saturdays were included in the experimental group, with 56 cases in each group. Internal fistula puncture was performed in the conventional group using the traditional puncture method and in the experimental group using the modified puncture method. The success rate of one-time puncture of internal fistula and the injury rate of internal fistula were compared between the two groups of patients.Results:The success rate of one-time puncture of internal fistula in the experimental group was higher than that in the conventional group, with a statistical difference ( P<0.05). The injury rate of the internal fistula vessel of the experimental group was lower than that of the conventional group, and the difference was statistically significant ( P<0.05) . Conclusions:Modified puncture methods have a positive effect on increasing the success rate of a one-time puncture of the internal fistula and decreasing the rate of internal fistula injuries in patients with difficult internal fistula.

Aim To detect the changes of serum cardiotrophin-1(CT-1)and angiopoietin-like protein 3(ANGPTL3)levels in patients with coronary heart disease(CHD)complicated with heart failure(HF)after percutaneous coronary intervention(PCI),and analyze their relationship with prognosis.Methods 199 patients with CHD compli-cated with HF who underwent PCI in the Second Affiliated Hospital of Zhengzhou University from March 2022 to March 2023 were selected.The serum CT-1 and ANGPTL3 levels of patients with different New York Heart Association(NYHA)cardiac function grades were compared before surgery.The prognosis was followed up after PCI,and the pa-tients who had major adverse cardiovascular event(MACE)were included in the poor prognosis group,and the rest were included in the good prognosis group.The general data and serum CT-1 and ANGPTL3 levels were compared between the poor prognosis group and the good prognosis group.Logistic regression model was used to analyze the influencing factors of poor prognosis after surgery in patients with CHD and HF.The predictive value of serum CT-1 and ANGPTL3 alone and in combination were analyzed.Results Compared with the patients with cardiac function grade Ⅰ,the serum CT-1 and ANGPTL3 levels of the patients with cardiac function grade Ⅱ,Ⅲ and Ⅳ were increased(P＜0.05).Compared with the patients with cardiac function grade Ⅱ,the serum CT-1 and ANGPTL3 levels of the patients with cardiac function grade Ⅲ and Ⅳ were increased(P＜0.05).Compared with the patients with cardiac function grade Ⅲ,the serum CT-1 and ANGPTL3 levels of the patients with acrdiac function grade Ⅳ were increased(P＜0.05).Spearman correlation a-nalysis showed that the serum CT-1 and ANGPTL3 levels were positively correlated with NYHA cardiac function grade(r=0.518,95％CI:0.408～0.613,P＜0.001,r=0.737,95％CI:0.666～0.794,P＜0.001).The poor prognosis rate of patients was 17.93％.Compared with the good prognosis group,the serum CT-1 and ANGPTL3 levels of the poor progno-sis group were increased(P＜0.05).Logistic regression model analysis showed that smoking,diabetes,lesion vessel number ≥3,irregular medication outside the hospital,serum CT-1 and ANGPTL3 levels were the influencing factors of poor prognosis in patients with CHD complicated with HF(P＜0.05).ROC curve analysis showed that the sensitivity and area under the curve(AUC)of combined serum CT-1 and ANGPTL3 levels for predicting poor prognosis of patients with CHD complicated with HF were higher than those of either marker alone,while the specificity was basically similar to that of sin-gle-marker prediction.Conclusion Serum CT-1 and ANGPTL3 levels are abnormally elevated in patients with CHD complicated with HF after PCI,and are closely related to the cardiac function and prognosis.

Objective:To construct a classification management model on the basis of Kraljic matrix for electrocardiogram(ECG)monitoring equipment in emergency intensive care unit(ICU),so as to explore its application value in the management for ECG monitoring equipment in emergency ICU.Methods:The classification management model on the basis of index for ECG monitoring equipment in emergency ICU was constructed.According to two classification dimensions included the market supply risk and the self-value,an indicator system of classification management,which aimed at strategic materials with high value and high risk,leverage materials with high value and low risk,bottleneck materials with low value and high risk,and conventional materials with low value and low risk,was constructed.A total of fifty-one ECG monitoring equipment in the emergency ICU of The People's Hospital of Longhua of Shenzhen from January to December 2023 were selected,and they were managed respectively by conventional management mode(25 sets)and classification management mode(26 sets)according to different management modes.The standardization level of operation management for equipment,the occurrence of safety risk and the level of management for equipment of the two management modes were compared,and the satisfaction of 30 relative personnel,who used and managed these equipment,for classification management of equipment also were compared.Results:The average values of the percentage of standardization level of normality of equipment operation,disinfection and sterilization,maintenance and fault repair of using classification management mode were respectively(91.58±4.33)%,(92.1±3.28)%,(91.49±3.54)%and(92.58±3.32)%,all of which were higher than those of conventional management mode,and the differences were statistically significant(t=12.537,15.706,14.196,18.946,P<0.05),repsectively.The average incidences of the risk of pressure injury,electrical injury and body fluid extravasation of adopting classification management mode were respectively(2.54±0.87)%,(3.02±0.82)%and(1.29±0.65)%,all of which were lower than those of adopting conventional management mode,and the differences were statistically significant(t=22.825,17.453,24.424,P<0.05),respectively.The satisfaction scores of 30 relative management personnel,who used equipment on the process rationality,system standardization and quality effectiveness,of adopting classification management mode were respectively(94.26±3.54),(92.57±4.36)and(91.87±3.69),all of which were higher than those of conventional management mode,and the differences were statistically significant(t=14.052,13.991,13.551,P<0.05),respectively.The reasonable placement rate,recording rate of standardization,and intact rate of equipment in the 26 equipment by adopting classification management mode were respectively 92.31%,92.31%and 88.46%,all of which were significantly higher than those by adopting conventional management mode,and the differences were statistical significant(x2=12.052,10.398,11.338,P<0.05).Conclusion:The classification management model of ECG monitoring equipment in emergency ICU can increase the management efficiency for the equipment in operating room of hospital,and improve the operation quality of equipment,and enhance the safety of equipment in clinical use,and the standardization of operation management for equipment.