Purpose To analyze the sonographic features of incarcerated gravid uterus and evaluate the diagnostic value of ultrasonography.Materials and Methods Clinical data of eight patients diagnosed with incarcerated gravid uterus at Sichuan Provincial Maternity and Child Health Care Hospital from January 2018 to December 2023 were retrospectively analyzed.Clinical manifestations,sonographic characteristics,management approaches and pregnancy outcomes were evaluated.Results Among the eight confirmed cases,seven presented with initial symptoms of dysuria and urinary retention,while one reported irregular lower abdominal pain.Ultrasonography consistently demonstrated:retroverted and retroflexed uterine position with the uterine body posterior to the cervix.Elongated cervix(range:4.0-8.6 cm)displaced anteriorly.Overdistended,elongated and superiorly displaced bladder in seven cases.Management included successful manual reduction via knee-chest position after catheterization in seven patients.One patient was managed conservatively with close monitoring and delivered by cesarean section at term.All eight patients achieved successful term deliveries with favorable maternal and neonatal outcomes.Conclusion Prenatal ultrasonography plays a crucial role in diagnosing and managing incarcerated gravid uterus.Early recognition of characteristic sonographic features facilitates prompt diagnosis and intervention,thereby mitigating risks of adverse pregnancy outcomes.

Purpose To analyze the sonographic features of incarcerated gravid uterus and evaluate the diagnostic value of ultrasonography.Materials and Methods Clinical data of eight patients diagnosed with incarcerated gravid uterus at Sichuan Provincial Maternity and Child Health Care Hospital from January 2018 to December 2023 were retrospectively analyzed.Clinical manifestations,sonographic characteristics,management approaches and pregnancy outcomes were evaluated.Results Among the eight confirmed cases,seven presented with initial symptoms of dysuria and urinary retention,while one reported irregular lower abdominal pain.Ultrasonography consistently demonstrated:retroverted and retroflexed uterine position with the uterine body posterior to the cervix.Elongated cervix(range:4.0-8.6 cm)displaced anteriorly.Overdistended,elongated and superiorly displaced bladder in seven cases.Management included successful manual reduction via knee-chest position after catheterization in seven patients.One patient was managed conservatively with close monitoring and delivered by cesarean section at term.All eight patients achieved successful term deliveries with favorable maternal and neonatal outcomes.Conclusion Prenatal ultrasonography plays a crucial role in diagnosing and managing incarcerated gravid uterus.Early recognition of characteristic sonographic features facilitates prompt diagnosis and intervention,thereby mitigating risks of adverse pregnancy outcomes.

Objective:To investigate the efficacy of radiotherapy in patients with advanced esophageal cancer receiving first-line chemoimmunotherapy.Methods:A retrospective analysis was conducted on the data of 137 patients with Stage Ⅳ esophageal squamous cell carcinoma (ESCC) treated at our hospital from January 2018 to May 2023. These patients were divided into two groups: a group treated with first-line chemoimmunotherapy combined with radiotherapy (chemoimmunotherapy + radiotherapy group, n = 43) and a group treated with only chemoimmunotherapy ( n = 94). Inverse probability of treatment weighting (IPTW) was applied to balance baseline characteristics between the groups. With overall survival (OS) and progression-free survival (PFS) as study endpoints, the survival data were analyzed using the Kaplan-Meier method, the log-rank test, and the Cox regression method. Results:Before calibration, the chemoimmunotherapy + radiotherapy group significantly outperformed the sole chemoimmunotherapy group in median PFS (13.6 months vs. 7.0 months; HR: 0.501, 95% CI: 0.309-0.811, P = 0.005). After calibration using the COX proportional-hazards model for age, gender, Eastern Cooperative Oncology Group (ECOG) performance status, smoking history, T/N/M stage, and tumor location, the chemoimmunotherapy + radiotherapy group still had significant advantages in PFS (14.7 months vs. 7.0 months; HR: 0.441, 95% CI: 0.261-0.745, P = 0.002). IPTW analysis further confirmed this trend (13.9 months vs. 7.0 months; HR: 0.492, 95% CI: 0.304-0.795, P < 0.001). Specifically, the median OS of the chemoimmunotherapy + radiotherapy group demonstrated significant improvement in all analyses: pre-calibration (29.5 months vs. 18.0 months; HR: 0.507, 95% CI: 0.297-0.867, P = 0.013), after calibration using the Cox model (27.5 months vs. 16.7 months; HR: 0.470, 95% CI: 0.266-0.830, P = 0.009), and after calibration using IPTW (29.5 months vs. 16.9 months; HR: 0.448, 95% CI: 0.262-0.764, P < 0.001). Conclusions:The combination of radiotherapy and first-line chemoimmunotherapy can significantly improve survival outcomes of patients with advanced ESCC, suggesting its potential as a standard treatment strategy.

Aplastic anemia is a rare and life-threatening bone marrow failure that is becoming more common and tends to affect younger individuals.Traditional Chinese medicine has a long history of preventing and treating asthenia and blood syndrome.Its treatment of aplastic anemia involves coordinated regulation through multiple components,targets,and channels.The article classifies and elaborates on the therapeutic effects of traditional Chinese medicine compounds and their components on aplastic anemia.As well as the expression of related factors from three aspects:hematopoietic stem/progenitor cells,the immune system,and bone marrow microenvironmental abnormalities.It also analyzes the frequency and meridian of commonly used drugs in traditional Chinese medicine compounds.Deficiency tonifying drugs were found to be the most frequently used treatment for aplastic anemia,which is consistent with the deficiency-based nature of the disease.The related organs affected are the liver,spleen,and kidney.This paper reviews the mechanism of aplastic anemia and the preventive and therapeutic effects of traditional Chinese medicine.The study is of great significance for the follow-up research on traditional Chinese medicine in improving aplastic anemia.

Background When discussing the new concept of"pancreas spleen integration"in the early stage,we proposed that dampness heat stagnation in the spleen and deficiency due to stagnation are the traditional Chinese medicine(TCM)pathogenesis elements of pancreatitis-induced pancreatic ductal adenocarcinoma,among which dampness heat is the soil of pancreatitis deteriorates into pancreatic cancer.Objective Based on the TCM pathogenesis elements of pancreatitis to cancer with"damp heat"as the main factor,data mining technology was used to analyze the properties,channel conversion and active ingredients of heat-clearing Chinese medicines with anti-inflammatory and anti-tumor effects,and to summarize the drug characteristics of these Chinese medicines.To prospectively predict the use of drugs in the transformation process of pancreatitis to pancreatic cancer.Methods Taking Traditional Chinese Medicine(10th Edition of China Traditional Chinese Medicine Press)as the drug data source,66 heat-clearing herbs were searched in the literature database of CNKI and PubMed of inflammation * TCM or(inflammation+tumor)* TCM.The active ingredients were analyzed in the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP).Results Among the 66 heat-clearing drugs(excluding adjunct drugs),58 herbs had anti-inflammatory effects,53 herbs had anti-tumor effects,and 48 herbs had both anti-inflammatory and anti-tumor effects.The three groups of drugs were mainly bitter,sweet and pungent in five flavors,and were mainly liver,stomach,lung,heart and large intestine in meridian affinity.Five flavors and meridian affinity were highly similar.In the TCMSP,the"five principles of drug class"were used to screen the active ingredients of anti-inflammatory and anti-tumor drugs.A total of 1041 active ingredient data were screened,and 798 active ingredient data were screened after duplicate items were deleted.Top three active ingredients were Luteolin,Kaempferol and Acacetin.Conclusion Based on the analysis of five flavors,meridian affinity and active ingredients of heat-clearing medicine,this study found that the anti-inflammatory and anti-tumor effects of these Chinese herbs are highly overlapping,it has important guiding significance for the drug research and clinical prescription of pancreatitis-induced pancreatic ductal adenocarcinoma.

OBJECTIVE:This study comprehensively and quantitatively evaluates the effect of low-volume high-intensity interval training (LV-HIIT) on the prevention of cardiovascular disease in obese or overweight people through a meta-analysis,and further verifies the feasibility of LV-HIIT application in special populations such as obese people. METHODS:Literature addressing randomized controlled trials of LV-HIIT-related studies was searched in CNKI,PubMed,Web of Science,Cochrane library,and EBSCO-SPORTD Exercise Science full-text database from database inception to February 2024. Screening,quality assessment and data extraction of included studies were performed by two researchers,and Meta-analyses of outcome indicators,including combined effect sizes,subgroup analyses,Leave-One-Out sensitivity analyses,as well as the publication of Egger's test and the plotting of funnel plots,were performed using the software Review Manager 5.4 and the software Stata 17.0. The protocol was registered with the International Prospective Registry for Systematic Reviews (CRD42024534409). RESULTS:(1) Finally,13 randomized controlled trials,including 349 subjects,were eligible and included,and the overall quality of the included literature was high. (2) LV-HIIT intervention significantly improved cardiorespiratory fitness[standardized mean difference (SMD)=-0.65,95％ confidence interval (CI):-0.87 to-0.43,P<0.05],systolic blood pressure (SMD=0.38,95％ CI:0.11-0.65,P<0.05),diastolic blood pressure (SMD=0.42,95％ CI:0.15-0.68,P<0.05),and body fat percentage (SMD=0.25,95％ CI:0.02-0.49,P<0.05). (3) LV-HIIT and moderate-intensity continuous training (MICT) had similar interventional effects on cardiorespiratory fitness,systolic blood pressure,diastolic blood pressure,body fat percentage,standardized body weight,body mass index,high-density lipoprotein,low-density lipoprotein,and total cholesterol in people with overweight or obesity (P>0.05),but MICT was better than LV-HIIT in improving triglyceride level (SMD=-0.30,95％ CI:-0.57 to-0.02,P<0.05). (4) The results of subgroup analyses further showed that LV-HIIT and MICT interventions showed similar improvements in each index. CONCLUSION:Current evidence suggests that LV-HIIT can effectively enhance cardiopulmonary adaptive capacity and promote fat loss and blood pressure regulation in overweight or obese people,and the improvements are similar to those of MICT. Short-term LV-HIIT is more time-effective than long-term MICT. Future studies are recommended to determine the optimal LV-HIIT exercise prescription for overweight or obese populations.

Objective To investigate the predictive value of serum microRNA(miRNA)-143-3p and miR-188-5p levels for poor prognosis in patients with acute cerebral infarction(ACI)after thrombolysis.Methods From February 2022 to February 2024,121 patients with acute cerebral infarction(ACI)who visited the hospital(all treated with thrombolysis)were selected as the study group.They were assigned into mild and moderate to severe groups based on the severity of their condition.They were into good prognosis group and poor prognosis group based on their postoperative condition.In addition,another 121 healthy individuals who underwent physical check ups during the same period were as the control group.The qRT-PCR method was applied to detect the expression levels of miR-143-3p and miR-188-5p.Pearson correlation was applied to analyze the correlation between serum miR-143-3p,miR-188-5p and NIHSS score.The influencing factors of poor prognosis in ACI patients after throm-bolysis were analyzed using multiple logistic regression.ROC curve was plotted to analyze the predictive value of serum miR-143-3p and miR-188-5p for poor prognosis after thrombolysis in ACI patients.Results The serum miR-143-3p level in the study group was higher than that in the control group(P<0.05),and the miR-188-5p level was lower than that in the control group(P<0.05);The serum miR-143-3p and NIHSS score in the mild,moderate and severe groups were increased in turn,and the level of miR-188-5p was decreased in turn(P<0.05);Serum miR-143-3p was negatively correlated with miR-188-5p(P<0.05);Diabetes,time from onset to throm-bolysis,NIHSS score at admission,miR-143-3p and miR-143-3p were the influencing factors of poor prognosis in ACI patients after thrombolysis;The AUC of the joint of serum miR-143-3p and miR-188-5p in predicting poor prognosis after thrombolysis in ACI patients was 0.871,and the joint of the two was better than their individual predictions(Z=2.683,2.703,P<0.05).Conclusions The level of serum miR-143-3p in ACI patients is significantly increased,and the level of serum miR-188-5p is significantly decreased,which is a poor prognostic factor for ACI patients after thrombolysis.The combination of the two has higher diagnostic value.

Objective: To investigate the influencing factors for vaccination willingness of herpes zoster vaccine (HZV) among the elderly, so as to provide the basis for improving the HZV vaccination strategy for the elderly. Methods: From July 2023 to June 2024, permanent residents aged ≥60 years in Yangzhou City, Jiangsu Province were selected using the multistage random sampling method and probability proportionate to size sampling method. Basic information, disease history, awareness of herpes zoster (HZ) and HZV, vaccination history, and vaccination willingness of HZV were collected through questionnaire surveys. Multivariable logistic regression model was used to analyze the influencing factors for vaccination willingness of HZV among the elderly. Results: Totally 1 209 valid questionnaires were recovered, with an effective recovery rate of 95.95%. The respondents included 657 males (54.34%) and 552 females (45.66%). Among them, 626 (51.78%) individuals were aged 60 -<70 years. There were 113 individuals had vaccination willingness of HZV, with a vaccination willingness rate of 9.35%. The multivariable logistic regression analysis showed that female (OR=2.872, 95%CI: 1.624-5.080), urban (OR=4.909, 95%CI: 2.732-8.818), individual monthly income of 1 000-<2 000 yuan (OR=3.085, 95%CI: 1.602-5.940), accessibility of vaccination clinics (OR=5.717, 95%CI: 1.109-29.462), presence of chronic diseases (OR=2.423, 95%CI: 1.325-4.431), history of varicella infection (OR=2.114, 95%CI: 1.213-3.684), awareness of HZ (OR=2.194, 95%CI: 1.096-4.394), awareness of HZV (OR=3.562, 95%CI: 2.005-6.330), history of influenza vaccine vaccination (OR=7.833, 95%CI: 4.189-14.645), and history of 23-valent pneumococcal vaccine vaccination (OR=2.955, 95%CI: 1.603-5.449) were promoting factors for vaccination willingness of HZV. Conclusion The vaccination willingness rate of HZV among the elderly is relatively low, which is mainly affected by factors such as gender, residence, individual monthly income, accessibility of vaccination clinics, presence of chronic diseases, history of varicella infection, awareness of HZ and HZV, and history of influenza vaccine and 23-valent pneumococcal vaccine vaccination.

Objective:To establish the reference intervals (RIs) of systemic immune inflammatory index (SII), platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR) and monocyte to lymphocyte ratio (MLR) in healthy pregnant women in Henan province, China.Methods:A retrospective analysis was conducted on the data of the healthy pregnant women without a history of adverse pregnancy events who participated in health check-ups from August 2016 to February 2019. A total of 4 016 healthy pregnant women were selected for establishing RIs. Data from healthy adult control group were derived from the healthy adult cohort in Henan established earlier by our team, and the Propensity Score Matching analysis was used and 3 595 healthy adult women and 3 595 healthy pregnant women to compare the indicators between the two groups. The RIs of the above indicators were established using the indirect method with a 95% confidence interval. The Tukey Rule was used to identify and remove outliers. The RIs were stratified and grouped based on the differences in each indicator during the pregnancy: SII: 3 929 cases, including 712 in the first trimester, 1 947 in the second trimester, and 1, 270 in the third trimester; PLR: 3 927 cases, no grouping; NLR: 3 925 cases, including 712 in the first trimester and 3 213 in the second and third trimesters; LMR: 3 925 cases, including 723 in the first trimester, 1 942 in the second trimester, and 1 260 in the third trimester; MLR: 3 904 cases, including 721 in the first trimester, 1 928 in the second trimester, and 1 255 in the third trimester. After the RIs were established, another 396 healthy pregnant women without a history of adverse pregnancy events who participated in health check-ups from February to April 2019 were selected for the validation of the RIs.Results:SII, NLR, LMR, MLR, and PLR differ significantly between healthy adult women and healthy pregnant women. There were significant differences in SII, LMR, and MLR among the three trimesters ( P<0.05). NLR in the first trimester was significantly lower than that in the second and third trimesters ( P<0.05), while there was no significant difference between the second and third trimester ( P=0.124). PLR only showed significant differences between the second and third trimester ( P<0.05), while no significant differences were found among the other groups. Based on the above results, the stratified RIs of each index in healthy pregnant population were established and verified. SII: first trimester (341-1 426)×10 9/L, second trimester (437-1 680)×10 9/L, third trimester (379-1 580)×10 9/L; PLR: 73-215; NLR: first trimester 1.78-5.60, second and third trimester 2.21-6.74; LMR: first trimester 2.20-6.61, second trimester 1.85-5.42, third trimester 1.63-4.82; MLR: first trimester 0.14-0.42, second trimester 0.17-0.49, third trimester 0.18-0.55. The rejection rate of 396 cases was less than 10%. Conclusions:The RIs of SII, NLR, LMR, MLR and PLR for healthy pregnant women in Hernan province of China were established and validated, and4 could be used in clinical practice.

Objective:To investigate the efficacy of radiotherapy in patients with advanced esophageal cancer receiving first-line chemoimmunotherapy.Methods:A retrospective analysis was conducted on the data of 137 patients with Stage Ⅳ esophageal squamous cell carcinoma (ESCC) treated at our hospital from January 2018 to May 2023. These patients were divided into two groups: a group treated with first-line chemoimmunotherapy combined with radiotherapy (chemoimmunotherapy + radiotherapy group, n = 43) and a group treated with only chemoimmunotherapy ( n = 94). Inverse probability of treatment weighting (IPTW) was applied to balance baseline characteristics between the groups. With overall survival (OS) and progression-free survival (PFS) as study endpoints, the survival data were analyzed using the Kaplan-Meier method, the log-rank test, and the Cox regression method. Results:Before calibration, the chemoimmunotherapy + radiotherapy group significantly outperformed the sole chemoimmunotherapy group in median PFS (13.6 months vs. 7.0 months; HR: 0.501, 95% CI: 0.309-0.811, P = 0.005). After calibration using the COX proportional-hazards model for age, gender, Eastern Cooperative Oncology Group (ECOG) performance status, smoking history, T/N/M stage, and tumor location, the chemoimmunotherapy + radiotherapy group still had significant advantages in PFS (14.7 months vs. 7.0 months; HR: 0.441, 95% CI: 0.261-0.745, P = 0.002). IPTW analysis further confirmed this trend (13.9 months vs. 7.0 months; HR: 0.492, 95% CI: 0.304-0.795, P < 0.001). Specifically, the median OS of the chemoimmunotherapy + radiotherapy group demonstrated significant improvement in all analyses: pre-calibration (29.5 months vs. 18.0 months; HR: 0.507, 95% CI: 0.297-0.867, P = 0.013), after calibration using the Cox model (27.5 months vs. 16.7 months; HR: 0.470, 95% CI: 0.266-0.830, P = 0.009), and after calibration using IPTW (29.5 months vs. 16.9 months; HR: 0.448, 95% CI: 0.262-0.764, P < 0.001). Conclusions:The combination of radiotherapy and first-line chemoimmunotherapy can significantly improve survival outcomes of patients with advanced ESCC, suggesting its potential as a standard treatment strategy.