Objective:To search, evaluate, and summarize the best evidence for postpartum contraceptive health guidance, providing evidence-based support for clinical healthcare providers in implementing standardized contraceptive counseling and management.Methods:A systematic search was conducted across guideline repositories, professional association websites, and databases for literature related to postpartum contraception guidance, including guidelines, best practices, expert consensus, and systematic reviews, with a search timeframe from database inception to December 2023. Four researchers independently evaluated the quality of the included studies, extracted relevant data, and synthesized evidence from eligible literature.Results:According to the inclusion and exclusion criteria, 18 documents were included, comprising 5 guidelines, 2 clinical decision-making documents, 1 best practice document, 4 expert consensus statements, and 6 meta-analyses or systematic reviews. Totally 46 pieces of best evidence were summarized from 9 aspects, including health educators, health education recipients, assessment, planning, mode and content of health education, available contraceptive methods, evaluation index of health education, and considerations.Conclusion:This study systematically synthesizes the best available evidence on postpartum contraceptive health guidance. It emphasizes strengthening the competencies of clinical practitioners, supported by structured assessments and standardized guidance, to improve the feasibility and accessibility of contraceptive services. It further highlights the importance of ensuring the long-term sustainability of contraceptive plans and integrating digital tools to enhance the precision and coverage of guidance, ultimately reducing unintended and short-interval pregnancies and safeguarding women's reproductive health.

AIM:To observe the effects of Huangqi-Danggui mixture(HQDG)on the pyroptosis of brain tis-sues in rats with middle cerebral artery occlusion/reperfusion(MCAO/R),and to explore the mechanism of neuroprotec-tion provided by HQDG.METHODS:Sixty-four SD rats were randomly divided into 4 groups:sham group,model group,HQDG group,and Xuesaitong(XST)group.The infarct volume of brain tissues was observed by 2,3,5-triphenyl-tetrazolium chloride staining,while hematoxylin-eosin staining was used to observe the pathological changes of brain tis-sues.Immunofluorescence was employed to assess the expression of nucleotide-binding oligomerization domain-like recep-tor protein 3(NLRP3),cleaved caspase-1 and gasdermin D(GSDMD)in the ischemic penumbra of brain tissues.The se-rum levels of interleukin-1β(IL-1β)and IL-18 were measured using ELISA.Western blot was used to detect NLRP3,cleaved caspase-1,apoptosis-associated speck-like protein containing a caspase recruitment domain(ASC),IL-1β and IL-18 in brain tissues.RESULTS:Compared with sham group,the neurological deficit scores of the rats in model group were significantly increased(P<0.01),while those in HQDG and XST groups were significantly reduced compared with model group(P<0.01).The cerebral infarct volume ratio was significantly reduced in HQDG and XST groups compared with model group(P<0.01).The pathological damage of brain tissue in HQDG and XST groups was significantly reduced compared with model group.The positive rates of NLRP3,cleaved caspase-1 and GSDMD in the ischemic penumbra of brain tissues were significantly decreased in HQDG group compared with model group(P<0.01).The expression of pyrop-tosis-related proteins,NLRP3,cleaved caspase-1 and ASC,in the ischemic penumbra of brain tissues was significantly el-evated in model group compared with sham group(P<0.01),and significantly decreased in HQDG group compared with model group(P<0.01).The serum levels of IL-1β and IL-18 were significantly increased in model group compared with sham group(P<0.01),and significantly reduced in HQDG group compared with model group(P<0.01).CONCLU-SION:The HQDG effectively attenuates brain tissue injury in rats with MCAO/R,and its mechanism may be related to the inhibition of neural cell pyroptosis.

Objective:To search, evaluate, and summarize the best evidence for postpartum contraceptive health guidance, providing evidence-based support for clinical healthcare providers in implementing standardized contraceptive counseling and management.Methods:A systematic search was conducted across guideline repositories, professional association websites, and databases for literature related to postpartum contraception guidance, including guidelines, best practices, expert consensus, and systematic reviews, with a search timeframe from database inception to December 2023. Four researchers independently evaluated the quality of the included studies, extracted relevant data, and synthesized evidence from eligible literature.Results:According to the inclusion and exclusion criteria, 18 documents were included, comprising 5 guidelines, 2 clinical decision-making documents, 1 best practice document, 4 expert consensus statements, and 6 meta-analyses or systematic reviews. Totally 46 pieces of best evidence were summarized from 9 aspects, including health educators, health education recipients, assessment, planning, mode and content of health education, available contraceptive methods, evaluation index of health education, and considerations.Conclusion:This study systematically synthesizes the best available evidence on postpartum contraceptive health guidance. It emphasizes strengthening the competencies of clinical practitioners, supported by structured assessments and standardized guidance, to improve the feasibility and accessibility of contraceptive services. It further highlights the importance of ensuring the long-term sustainability of contraceptive plans and integrating digital tools to enhance the precision and coverage of guidance, ultimately reducing unintended and short-interval pregnancies and safeguarding women's reproductive health.

AIM:To observe the effects of Huangqi-Danggui mixture(HQDG)on the pyroptosis of brain tis-sues in rats with middle cerebral artery occlusion/reperfusion(MCAO/R),and to explore the mechanism of neuroprotec-tion provided by HQDG.METHODS:Sixty-four SD rats were randomly divided into 4 groups:sham group,model group,HQDG group,and Xuesaitong(XST)group.The infarct volume of brain tissues was observed by 2,3,5-triphenyl-tetrazolium chloride staining,while hematoxylin-eosin staining was used to observe the pathological changes of brain tis-sues.Immunofluorescence was employed to assess the expression of nucleotide-binding oligomerization domain-like recep-tor protein 3(NLRP3),cleaved caspase-1 and gasdermin D(GSDMD)in the ischemic penumbra of brain tissues.The se-rum levels of interleukin-1β(IL-1β)and IL-18 were measured using ELISA.Western blot was used to detect NLRP3,cleaved caspase-1,apoptosis-associated speck-like protein containing a caspase recruitment domain(ASC),IL-1β and IL-18 in brain tissues.RESULTS:Compared with sham group,the neurological deficit scores of the rats in model group were significantly increased(P<0.01),while those in HQDG and XST groups were significantly reduced compared with model group(P<0.01).The cerebral infarct volume ratio was significantly reduced in HQDG and XST groups compared with model group(P<0.01).The pathological damage of brain tissue in HQDG and XST groups was significantly reduced compared with model group.The positive rates of NLRP3,cleaved caspase-1 and GSDMD in the ischemic penumbra of brain tissues were significantly decreased in HQDG group compared with model group(P<0.01).The expression of pyrop-tosis-related proteins,NLRP3,cleaved caspase-1 and ASC,in the ischemic penumbra of brain tissues was significantly el-evated in model group compared with sham group(P<0.01),and significantly decreased in HQDG group compared with model group(P<0.01).The serum levels of IL-1β and IL-18 were significantly increased in model group compared with sham group(P<0.01),and significantly reduced in HQDG group compared with model group(P<0.01).CONCLU-SION:The HQDG effectively attenuates brain tissue injury in rats with MCAO/R,and its mechanism may be related to the inhibition of neural cell pyroptosis.

Objective:In order to accurately evaluate the postoperative rehabilitation of gynecological robotic surgery, a prediction model for evaluating postanesthesia care unit (PACU) extubation time and hospital stay in gynecological robotic surgery was established.Methods:The clinical data of gynecological patients who underwent robotic surgery in Xiangya Third Hospital of Central South University from October 2015 to May 2017 were retrospectively analyzed, and the data were screened to evaluate the postoperative recovery of patients from two aspects: PACU extubation time and postoperative hospital stay. Binary logistic regression was used to screen out the factors affecting PACU extubation time and postoperative hospital stay, and the prediction model was preliminarily established and verified.Results:Finally, there were 456 patients and 30 variables analyzed in the binary logistics regression. According to these variables, the prediction model of the postoperative recovery evaluation after gynecological robotic surgical procedures was established. Among them, age, intraoperative amount of atracurium and midazolam were independent risk factors affecting PACU extubation time (all P<0.05). American Society of Anesthesiologists (ASA) grade, intraoperative amount of midazolam, intraoperative bleeding and operation time were independent risk factors affecting postoperative hospital stay (all P<0.05). All models passed Hosmer lemeshow test (all P>0.05); The areas under the receiver operating characteristic curve (ROC) were 0.647 and 0.806, respectively. Conclusions:The prediction model of PACU extubation time and the postoperative hospitalization time has been established.

OBJECTIVE:To observe clinical efficacy of Guipu shenqing capsules combined with Levofloxacin tablets in the treatment of urinary tract infection. METHODS:A total of 100 patients with urinary tract infection were randomly divided into ob-servation group (55 cases) and control group (45 cases). Observation group was given Levofloxacin tablet 0.1 g orally,twice a day+Guipu shenqing capsule 1.4 g orally,3 times a day;4 days later,they were given Guipu shenqing capsule alone for 3 d. Con-trol group was given Levofloxacin tablet 0.1 g orally,twice a day,same medication time as observation group+Placebo capsule 1.4 g orally,3 times a day. Both groups received treatment for 7 d. The infection efficiency,the change of frequent urination,urgent urination,dysuria,yellowish urine,integral,etiology efficacy and the occurrence of ADR were observed and compared between 2 groups. RESULTS:The response rate of injection(92.7%vs. 77.8%)and etiology(72.7%vs. 53.3%)in observation group were sig-nificantly higher than control group,with statistical significance(P<0.05). Before treatment,there was no statistical significance in the proportion of patients with dysuria,urgent urination,frequent urination or yellowish urine between 2 groups(P>0.05). After treatment,the proportion of patients in the item of zero point was significantly higher than before treatment,and the observation group was significantly higher than the control group;the proportion of patients in the item of six points was significantly higher than before treatment,and the observation group was significantly lower than the control group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups during treatment. CONCLUSIONS:For urinary tract infection,Guipu shenqing cap-sules combined with Levofloxacin tablet can improve the anti-infection effect and relieve urinary irritation symptom with good safety.

Objective To evaluate the effect of electrical stimulation of the pelvic floor muscles combined with bladder training on urinary dysfunctionafter incomplete spinal cord injury.Methods Sixty-two incomplete spinal cord injury patients who had received an operation between November 2009 and December 2014 were enrolled and divided randomly into a control group (n=32) and a treatment group (n =30).Both groups were treated with conventional intermittent catheterization,while the treatment group was additionally given electrical stimulation of the pelvic floor muscles combined with bladder training.The residual urine volume was recorded before and after the treatment.Uurodynamic examinations were conducted,and the rate of successful catheter extraction and of urinary tract infection on the 15th and 30th day of treatment,were recorded and analyzed.Results All of the patients were followed-up for an average of 18.5 months.Significant improvement was observed in the residual urine volume,the maximum or average urinary flow rate,and the detrusor pressure at peak flow of both groups.However,at the end of follow-up the treatment group recorded significantly better results on all these measures than the control group.The successful catheter extraction rate of the treatment group (96.7％) was significantly higher than that of the control group and their average number of catheterization days was significantly fewer.The urinary tract infection rates on the 15th and 30th day of treatment were 16.7％ and 6.7％ in the treatment group,significantly lower than in the control group.Conclusions Electrical stimulation of the pelvic floor combined with bladder training significantly improves urination function after an operation for incomplete spinal cord injury,decreases the days of catheterization and lowers the rate of urinary tract infection.Such combined therapy is worth promoting in clinical practice.

Objective To investigate the influence of +Gz acceleration on saliva a-amylase (SAA) of pilots,so as to assess the feasibility of taking SAA as an indicator of +Gz stress on pilots.Methods Saliva was collected from 47 pilots before and after + 6.5 Gz,+ 7.0 Gz and + 8.0 Gz centrifuge exposures.The SAA was measured by a-amylase kit (dynamic monitoring method) and chemiluminescnet immunoassay.Results ①The SAA and cortisol levels significantly changed by different +Gz exposures (F＝ 17.712,3.427,P＜0.01 or P＜0.05).Compared with that before exposures,the SAA levels measured after +6.5 Gz,+ 7.0 Gz and +8.0 Gz exposures were significantly higher (P＜0.01).The cortisol levels after +7.0 Gz and +8.0 Gz exposures were significantly higher than the baseline (P＜0.05 or 0.01).The cortisol level obtained after +8.0 Gz exposure was significantly higher than that before + 6.5 Gz,+ 7.0 Gz and + 8.0 Gz centrifuge exposures (P＜0.05).②Multivariate analysis showed that the aircraft type,pilot's age and flying hours had no influence on SAA and cortisol levels obtained after +Gz exposures.③ Pilots' cortisol levels were negatively correlated to the age and aircraft type of (r＝-0.328,-0.694,P＜0.05) but positively correlated to flying hours and +Gz level (r＝0.466,0.141,P＜0.05).SAA was positively correlated to +Gz level (r＝0.354,P＜0.01).④The levels of cortisol and SAA had less correlation either before or after +Gz exposure.Conclusions SAA elevates sensitivity with +Gz stress increase and quickly returns to baseline.So we can conclude that SAA could be a valid indicator of +Gz stress.

Objective To investigate the influence of +Gz acceleration on saliva a-amylase (SAA) of pilots,so as to assess the feasibility of taking SAA as an indicator of +Gz stress on pilots.Methods Saliva was collected from 47 pilots before and after + 6.5 Gz,+ 7.0 Gz and + 8.0 Gz centrifuge exposures.The SAA was measured by a-amylase kit (dynamic monitoring method) and chemiluminescnet immunoassay.Results ①The SAA and cortisol levels significantly changed by different +Gz exposures (F＝ 17.712,3.427,P＜0.01 or P＜0.05).Compared with that before exposures,the SAA levels measured after +6.5 Gz,+ 7.0 Gz and +8.0 Gz exposures were significantly higher (P＜0.01).The cortisol levels after +7.0 Gz and +8.0 Gz exposures were significantly higher than the baseline (P＜0.05 or 0.01).The cortisol level obtained after +8.0 Gz exposure was significantly higher than that before + 6.5 Gz,+ 7.0 Gz and + 8.0 Gz centrifuge exposures (P＜0.05).②Multivariate analysis showed that the aircraft type,pilot's age and flying hours had no influence on SAA and cortisol levels obtained after +Gz exposures.③ Pilots' cortisol levels were negatively correlated to the age and aircraft type of (r＝-0.328,-0.694,P＜0.05) but positively correlated to flying hours and +Gz level (r＝0.466,0.141,P＜0.05).SAA was positively correlated to +Gz level (r＝0.354,P＜0.01).④The levels of cortisol and SAA had less correlation either before or after +Gz exposure.Conclusions SAA elevates sensitivity with +Gz stress increase and quickly returns to baseline.So we can conclude that SAA could be a valid indicator of +Gz stress.

Objective To evaluate the accuracy of thoracic pedicle screw placement using the "funnel technique" and investigate its consistency in experimental study and clinical application.Methods The clinical data of three human cadavers and 11 patients with the installation of at least one thoracic pedicle screw at T1 -T12 from August 2006 to July 2008 were retrospectively analyzed. One junior spine surgeon lack of experience were responsible for placing these screws with the "funnel technique".The accuracy of screw placement and the complications related to the use of thoracic pedicle screws were analyzed by assessing postoperative CT scans. Results The mean follow-up time was 23.1 months,which showed no vascular or visceral complications, or iatrogenic neurological injury. The rate of unintended cortex perforations was 14% (10/72) in cadavers and 15% (8/55) in patients, respectively.The critical perforation occurred in two screws (3%) in cadavers and one screw (2%) in patients. There was no statistical difference between the percentage of cortex perforations in cadavers and patients. Of all the 11 patients, screw violation occurred laterally in six ( 11% ), medially in one ( 2% ) and superiorly in one (2%). No violations occurred inferiorly or anteriorly. For all patients, only one screw needed revision. The perforations made by the junior spine surgeon occurred in six screws in the first cadaver, three in the second cadaver and one in the third cadaver. Conclusions The "funnel technique" is a simple,safe, accurate and cost-effective technique for pedicle screw placement. The result of the experimental study is consistent with that of the clinical application. "funnel technique" is helpful for junior spine surgeons to master the technique of thoracic pedicle screw placement.