OBJECTIVE To explore the efficacy of platelet-rich plasma （PRP） intrauterine infusion combined with Gushen antai pills in the treatment of recurrent abortion （RSA） and its impacts on endometrial receptivity and hormone levels in patients. METHODS A total of 108 patients with RSA treated in our hospital from January 2021 to January 2024 were selected and evenly divided into control group and study group using the random number table method， with 54 cases in each group. On the basis of conventional treatment， patients in the control group were administered with Gushen antai pills， while patients in the study group received PRP intrauterine infusion combined with Gushen antai pills. The clinical efficacy， TCM syndrome scores before and after treatment， endometrial receptivity [endometrial thickness （EST）， spiral artery resistance index （RI）， and pulsatility index （PI）]， hormone [progesterone （P）， estradiol （E2）， and human chorionic gonadotropin （HCG）] levels， as well as pregnancy outcomes， were compared between the two groups. Additionally， the occurrence of adverse reactions in both groups was recorded. RESULTS The total effective rate （91.44% vs. 81.48%） and infant live birth rate （96.30% vs. 83.33%） of the study group were significantly higher than those of the control group （P＜0.05）. Following treatment， various TCM syndrome scores and total score， spiral artery RI and PI levels in both groups were markedly lower than those in the same groups before treatment， with the study group showing significantly lower levels than the control group（P＜0.05）. Conversely， the P， E2， HCG and EST levels in both groups were significantly higher than those in the same groups before treatment， and the study group exhibited notably higher levels than the control group （P＜0.05）. There was no statistically significant difference in the total incidence of adverse reactions between the two groups （P＞0.05）. CONCLUSIONS PRP intrauterine infusion combined with Gushen antai pills has good clinical efficacy in the treatment of RSA. It can improve TCM syndromes， enhance endometrial receptivity， regulate hormone levels and improve pregnancy outcomes， and it is highly safe.

Objective To investigate the effects of aerobic respiratory training on cardiopulmonary function and hemorheology in patients with chronic pulmonary heart disease(CPHD).Methods A total of 92 CPHD patients treated at our hospital from January 2022 to June 2024 were enrolled as study subjects.They were randomly divided into a control group and a study group using a random number table method,with 46 patients in each group.The control group was treated with conventional therapy,while the study group under-went a standardized aerobic respiratory training program on top of the control group's treatment.Cardiac function indicators,pulmonary function parameters,clinical symptom scores,hemorheological indexes,quality of life,adverse reactions,and treatment efficacy were compared between the two groups.Results After treat-ment,the study group exhibited significantly lower left ventricular end-diastolic dimension(LVEDD),left ventricular end-systolic dimension(LVESD),clinical symptom scores,hematocrit,fibrinogen,high-shear whole blood viscosity,and low-shear whole blood viscosity compared to the control group(P<0.05).Con-versely,left ventricular ejection fraction(LVEF),6-minute walk distance(6MWD),maximal voluntary venti-lation(MVV),forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC),scores on the ge-neric quality of life inventory-74(GQOLI-74),and overall treatment efficacy were significantly higher in the study group(P<0.05).No statistically significant differences were observed in the incidence of adverse reac-tions between the two groups(P>0.05).Conclusion Aerobic respiratory training effectively improves car-diopulmonary function,clinical symptoms,hemorheological profiles,and quality of life in patients with CPHD.

Objective·To systematically integrate relevant influencing factors of advanced cancer patients'engagement behavior in advance care planning(ACP).Methods·The systematic search of Chinese and English literature on factors influencing ACP engagement behavior in advanced cancer patients from inception to December 2022 in China National Knowledge Infrastructure(CNKI),Wanfang,China Biomedical Literature Database(Sinomed),PubMed,Cochrane Library,Embase,CINAHL,and PsycINFO was conducted.After the literature quality evaluation,content extraction and summary were conducted by two researchers,and the data of quantitative research and qualitative research were extracted and integrated respectively.The final influencing factors of ACP engagement behavior of advanced cancer patients were obtained.With the help of the theoretical domain,they were mapped to the capability,opportunity,motivation-behavior(COM-B)model step by step.Results·A total of 21 studies were included and 27 factors were summarized,including 9 theoretical domains.Mapping to the COM-B model included 9 capability factors(knowledge of ACP,education level,accurate knowledge of prognosis,knowledge of the time of disease diagnosis,prior experience,subjective life expectancy,age,cancer site,and disease symptom burden),13 opportunity factors(gender,marital status,race/ethnicity,religious belief,dependent children,family economic condition,place of living,housing type,family support,social support,doctor-patient relationship,acculturation,and whether or not to establish a hospice service center)and 5 motivational factors(ACP attitude,ACP belief,ACP motivation,anxiety and depression,and death attitude).Among them,doctor-patient relationship,religious belief,ACP attitude,educational level,marital status,family support,knowledge of ACP,accurate knowledge of prognosis,age,place of living,attitude toward death,prior experience,and race/ethnicity were more influential factors on ACP engagement behavior.Conclusion·Based on the COM-B model,the influencing factors of ACP engagement behavior in advanced cancer patients can be comprehensively summarized.Future studies can use the above factors as an entry point to design continuous,multifaceted,and comprehensive interventions based on the COM-B model to promote the practice of ACP engagement behavior in advanced cancer patients.

Objective:To analyze the clinical outcome of vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) in infertile patients with polycystic ovary syndrome (PCOS) combined with insulin resistance (IR) .Methods:A total of 257 PCOS infertile patients undergoing IVF/ICSI-ET from Jan. 2018 to Dec. 2020 were included and retrospectively analyzed. The patients were divided into IR group (HOMA-IR≥2.5, 130 cases) and non-IR group (HOMA-IR<2.5, 127 cases) according to the level (median 2.5) of homeostasis model assessment of insulin resistance index (HOMA-IR) . The levels of basic sex hormones [follicular stimulating hormone (FSH) , luteinizing hormone (LH) , estradiol (E2) , testosterone (T) , progestational hormone (P) , anti-mullerian hormone (AMH) ] and numbers of basic sinus follicles, levels of blood glucose and insulin at 30min, 60min and 120min after glucose administration and fasting and proconceptive pregnancy outcome indicators[gonadotropin (Gn) use time and dose, number of eggs obtained, fertilization rate, high-quality embryonic rate, occurrence rate of ovarian hyperstimulation syndrome (OHSS) , implantation rate, clinical pregnancy rate, biochemical pregnancy rate, abortion rate, live birth rate and pregnancy complications] were compared between the two groups. The influencing factors of clinical outcomes were analyzed by Logistic regression.Results:The levels of basic LH [ (8.86±1.60) mIU/ml vs (6.54±1.12) mIU/ml], T[ (63.20±7.47) ng/dl vs (52.11±5.69) ng/dl] in IR group was significantly higher than those in non-IR group ( P<0.05) . At different time-point, the levels of blood glucose and insulin in IR group were significantly higher than those in non-IR group ( P<0.05) . The Gn dose [ (1947.35±129.13) IU vs (1522.70±88.41) IU] and abortion rate [32.69% (17/52) vs 13.70% (10/73) ] in IR group was significantly higher than those in non-IR group ( P<0.05) , and the clinical pregnancy rate [40.00% (52/130) vs 57.48% (73/127) ] and live birth rate [51.92% (27/52) vs 72.60% (53/73) ] was significantly lower than those in non-IR group ( P<0.05) . Logistic regression analysis showed that age, BMI, basic LH, basic T and HOMA-IR was independent risk factors for clinical outcome of IVF/ICSI-ET in infertility patients with PCOS ( P<0.05) , and basic AMH and Gn dose were protective factors for clinical outcome ( P<0.05) . Conclusion:IR negatively affects the clinical outcome of IVF/ICSI-ET in infertile patients with PCOS, HOMA-IR is a risk factor for clinical outcomes, and IR should be evaluated in time for infertile patients with PCOS.

Objective:To construct a systematic standardization system of combined medical care and elderly nursing service in general hospital-nursing home-community-family, so as to provide reference for the development of different forms of combined medical care and elderly nursing services.Methods:Delphi expert consultation method was used in the study. The expert consultation form of the standardized system of combined medical care and elderly nursing service in general hospital-nursing home-community-family was designed by discussing through the research group meeting on the basis of literature review from January to June 2020. A total of 15 experts who are engaged in geriatric nursing and management, geriatric nursing education, and geriatrics were selected to conduct two rounds of expert consultation.Results:The effective recovery rate of the questionnaires in the two rounds of expert consultation was 100.00%, and the expert authority coefficients were 0.875 and 0.848, and the expert opinions tended to be consistent. The standardized system of combined medical care and elderly nursing service was divided into 4 first-level indicators, 19 second-level indicators, 95 third-level indicators for general hospitals, 4 first-level indicators, 25 second-level indicators, and 96 third-level indicators for nursing homes, 4 first-level indicators, 16 second-level indicators and 88 third-level indicators for communities, 4 first-level indicators, 16 second-level indicators and 88 third-level indicators for families.Conclusions:The research method of the standardized system of combined medical care and elderly nursing service in general hospital-nursing home-community-family constructed in this study is scientific, reasonable and feasible, and the content is targeted, which can provide a reference for the development of different forms of combined medical care and elderly nursing services in the future.

OBJECTIVE：To evaluate th e eff ects of infusion sequence regulation on the promotion of intravenous rational drug use. METHODS ：The intelligent control of infusion sequence was realized with Markov chain machine learning method on the basis of intelligent reminder manual labeling infusion sequence. Selected from Binhu Hospital of Hefei during Jan. to Sept. 2017， 164 800 inpatients’medication orders were collected as data before intelligent control of infusion sequence ，and 264 600 inpatients’ medication orders were collected as data after intelligent control of infusion sequence. The correct rate of incompatibility ，storage time limit ，administration frequency ，chronopharmacology，preventive drugs ，drug interaction ，auxiliary drugs and infusion sequence for intravenous irritant drugs were compared before and after regulation ；the times of flushing tube ，the cost of flushing tube infusion and the change of liquid property in the infusion tube were compared before and after regulation. RESULTS ：The correct rate of incompatibility ，storage time limit ，administration frequency ，chronopharmacology，drug interaction and infusion sequence for auxiliary drugs after regulation were significantly higher than before regulation ；the correct rate of infusion sequence for preventive drugs and intravenous irritant drugs ，the times of flushing tube ，the cost of flushing tube infusion and the case number of the liquid change （proportion） in infusion tube were significantly lower than before regulation （P＜0.001）. CONCLUSIONS：Intelligent regulation of infusion sequence can improve the rationality of intravenous medication sequence to a certain extend.

OBJECTIVE：To design and upgrade the finished infusion label in P IVAS of Hefei Binhu hospital ，so as to improve the safety and effectiveness of intravenous medication. METHODS ：By investigating the experience and suggestions about the use of infusion labels by pharmacists and clinical nurses in PIVAS ，taking clear ，concise，focused，rational layout ，comprehensive information as improving principle ，the infusion label was designed and upgraded. The effect of upgrading were evaluated by the recognition rate of label scanning ，scanning time and rate on label （94 701，113 759 groups，respectively），and the correct rate ， time and rate of drug delivery checking in 30 days before and after upgrading ，as well as satisfaction degree ，which made among PIVAS pharmacists （30），nurses（50）and patients （49）. RESULTS ：The upgraded label simplified part of the content and optimized the layout structure ，removed redundant content ，focused on the patient safety information that nurses needed to pay attention to when checking ，and added the marking of infusion sequence and precautions. By changing the barcode into two-dimensional code and adding hidden display function ，more information about drugs and rational drug use related to the infusion of patients was provided. Compared with original label ，after upgrading ，the recognition rate of new label scanning increased from 99.27％ to 99.96％，the scanning time reduced from 3 518.75 s/d to 2 110.10 s/d，and the scanning rate increased from 0.57 group/s to 0.95 group/s；the correct rate of drug delivery checking increased from 99.73％ to 99.91％，the time of drug delivery checking decreased from 5 423.55 s/d to 4 818.85 s/d，and the speed of drug delivery checking increased from 0.36 group/s to 0.41 group/s. The satisfaction degree of pharmacists ，nurses and patients were increased from 70.00％ to 93.33％，from 62.00％ to 90.00％，from 20.40％ to 89.80％，respectively. CONCLUSIONS：The design and upgrading of infusion labels can improve the working efficiency of staff ，and improve the quality of pharmaceutical care and nursing care ， and satisfaction， promote the improvement on the safety and effectiveness of intravenous medication for patients.

Objective: To understand the level of compassion satisfaction of medical oncology nurses and to explore the mediating effect of resilience in the relationship between empathy ability and compassion satisfaction of medical oncology nurses, and to investigate the moderating effect of social support in this mediating role. Methods: A total of 291 medical oncology nurses from 7 general hospitals in Dalian were measured with self-made general questionnaire, professional quality of life scale, Chinese version of Jefferson empathy scale, perceived social support scale and Ego-Resiliency Scale. Results: The scores of compassion satisfaction of medical oncology nurses was (34.79±5.87).Pearson correlation analysis showed that there was a significant positive correlation between empathy, resilience, social support and compassion satisfaction (r=0.222-0.402, P<0.01). Resilience partially mediated the relationship between empathy ability and compassion satisfaction, the value of mediating effect was 23.1% of the total effect. The effect of resilience and compassion satisfaction among medical oncology nurses was also moderated by social support, that is, social support regulates the latter half of the process of empathy, resilience and compassion satisfaction. The higher the level of social support, the stronger the mediating effect of empathy through resilience on compassion satisfaction. Conclusions The level of compassion satisfaction of medical oncology nurses in Dalian is low and needs to be improved. The are close relationships among empathy ability, resilience, social support and compassion satisfaction. It is a moderated mediating effect model. It is suggested that managers should pay attention to the role of psychological resilience and provide high-level social support to improve the level of compassion satisfaction of medical oncology nurses.

Objective To analyze the clinical manifestations, imaging features, histopathology and genes of cerebrotendinous xanthomatosis (CTX) to improve the understanding of clinical workers on the disease. Methods The imaging examination, histopathological and gene detection methods were synthetically applied, and the disease characteristics of two patients with CTX, admitted to our hospital in March 2018 , were analyzed. Results (1) Patient one was a 52-year-old male, with typical neurological symptoms: weakness of both lower limbs, damage of pyramidal tract and extrapyramidal system, cognitive impairment, and ataxia; non-neurological symptoms included cataract, arch foot, and Achilles tendon mass; cranial MR imaging indicated symmetrical abnormal signal of cerebellar dentate nucleus, low signal on T1WI, and slightly high and low signal intensity on T2WI/FLAIR; achilles tendon biopsy showed fibrous connective tissues with multiple xanthoma cells and multinucleated giant cells aggregation, accompanied by cholesterol crystallization. (2) Another 16-year-old male presented with cerebellar ataxia, recurrent seizures, mental and motor retardation, and congenital cataract; two heterozygous mutations of CYP27A1 gene were detected by gene detection; and the mutations were c.373-379 delCCAGTAC and c.1420C>T. Conclusion The clinical manifestations of CTX are varied; early imaging examination lacks specificity; it can be clearly diagnosed by histopathology and CYP27A1 gene detection.

Effects of traditional Chinese medicine salvianolate combined with alprostadil and reduced glutathione on delay of progression in patients with acute kidney injury has been confirmed, but the role of this combination therapy on the progression of chronic renal failure is uncertain.