Objective:To identify the risk factors for postoperative pain and construct a risk prediction model and validate it in the patients with mixed hemorrhoids.Methods:In this case-control study, 231 mixed haemorrhoid patients at Suzhou Hospital affiliated to Nanjing University Shool of Medicine from October 2022 to February 2024 were selected as the study subjects and divided into model group( n=161) and validation group( n=70)in a ratio of 7∶3, and the patients in model group were divided into pain group( n=40)and non-pain group( n=121)based on their pain scores at 24 h postoperatively. Univariate analysis and binary logistic regression analysis were used to identify the risk factors for postoperative pain in the patients with mixed haemorrhoids, and a column-line diagram prediction model was plotted, the differentiation and consistency of the column-line diagram model were validated using receiver operating characteristic (ROC) curves and calibration curves, and the clinical benefit of the model was evaluated using the decision curve analysis. Results:The results of logistic regression analysis showed that male, preoperative anxiety score≥50, self-efficacy score <80, and external peeling and internal ligation were independent risk factors for postoperative pain in patients with mixed haemorrhoids ( P<0.05). The area under the ROC curve in model group was 0.745, Hosmer-Lemeshow test χ2=1.912, P=0.752; in validation group, the area under the ROC curve was 0.729, Hosmer-Lemeshow test χ2=1.635, P=0.651, and the calibration curve was in good agreement with the actual curve, with good model consistency; the results of the decision curve analysis showed that, when interventions were conducted within the probability range of 0.1 to 0.9 for predicting postoperative pain in patients with mixed hemorrhoids, the clinical benefit was increased. Conclusions:Male, preoperative anxiety score≥50, self-efficacy score <80, and external peeling and internal ligation are independent risk factors for postoperative pain in patients with mixed haemorrhoids, and the column-line graph prediction model of postoperative pain constructed has good differentiation and consistency and high clinical benefit.

Objective:To identify the risk factors for postoperative pain and construct a risk prediction model and validate it in the patients with mixed hemorrhoids.Methods:In this case-control study, 231 mixed haemorrhoid patients at Suzhou Hospital affiliated to Nanjing University Shool of Medicine from October 2022 to February 2024 were selected as the study subjects and divided into model group( n=161) and validation group( n=70)in a ratio of 7∶3, and the patients in model group were divided into pain group( n=40)and non-pain group( n=121)based on their pain scores at 24 h postoperatively. Univariate analysis and binary logistic regression analysis were used to identify the risk factors for postoperative pain in the patients with mixed haemorrhoids, and a column-line diagram prediction model was plotted, the differentiation and consistency of the column-line diagram model were validated using receiver operating characteristic (ROC) curves and calibration curves, and the clinical benefit of the model was evaluated using the decision curve analysis. Results:The results of logistic regression analysis showed that male, preoperative anxiety score≥50, self-efficacy score <80, and external peeling and internal ligation were independent risk factors for postoperative pain in patients with mixed haemorrhoids ( P<0.05). The area under the ROC curve in model group was 0.745, Hosmer-Lemeshow test χ2=1.912, P=0.752; in validation group, the area under the ROC curve was 0.729, Hosmer-Lemeshow test χ2=1.635, P=0.651, and the calibration curve was in good agreement with the actual curve, with good model consistency; the results of the decision curve analysis showed that, when interventions were conducted within the probability range of 0.1 to 0.9 for predicting postoperative pain in patients with mixed hemorrhoids, the clinical benefit was increased. Conclusions:Male, preoperative anxiety score≥50, self-efficacy score <80, and external peeling and internal ligation are independent risk factors for postoperative pain in patients with mixed haemorrhoids, and the column-line graph prediction model of postoperative pain constructed has good differentiation and consistency and high clinical benefit.

The United States is one of the pioneers in the world to introduce a heath strategy, making its practice highly significant for other countries. The paper described the four health strategies developed by the US government in succession, including the goals, focused areas and key health indicators of the strategies in different stages. In addition, it analyzed the patterns of evolution and key features of the strategy, offering references for the development and implementation of the "Health China by the Year 2020".

8 oocytes) according to the number of oocytes collected in one ovary. On day of human chorionic gonadotrophin injection, PSV, EDV, PI, RI, S/D of ovarian stromal artery in the ovarian were detected and perifollicular vascularity were graded with color Doppler ultrasonography. Results Not only PSV and EDV of stromal artery but also perifollicular vascularity in low-response group was significantly lower than that of normal-response and high-response groups. PSV and EDV of ovarian stromal artery and perifollicular vascularity were highly interrelated with ovarian response. Conclusions The increase of PSV and EDV of ovarian stromal artery and perifollicular vascilarity indicate the improvement of perfusion in ovary and ovarian response.