Objective To construct and evaluate an evaluation index system for the training effect of cardiac surgery specialist nurses and provide a reference for the quality evaluation of cardiac surgery specialist nurse training.Methods Based on the Kirkpatrick Model,the preliminary draft of the evaluation index system for the training effect of cardiac surgery specialist nurses was formed through literature review and semi-structured interviews.The Delphi method was used to conduct the expert consultation with 24 experts nationwide in September 2024,and the weight of each index was determined by the analytic hierarchy process.In February 2025,60 cardiac surgery nurses from 3 tertiary A hospitals in Nanjing were selected as the survey subjects,and a satisfaction questionnaire on the evaluation index system for the training effect of cardiac surgery nurses was used for the survey.Results The effective recovery rates of the 2 rounds of expert questionnaires were 96％and 100％,respectively.The expert authority coefficient was 0.913,and the Kendall harmony coefficient was 0.127-0.212 and 0.152-0.176,respectively(both P＜0.05).The final evaluation index system for the training effect of cardiac surgery specialist nurses included 4 primary indexes,14 secondary indexes and 59 tertiary indicators.The satisfaction questionnaire score of the evaluation index system for the training effect of cardiac surgery nurses was(18.75±2.21).Conclusion The evaluation index system for the training effect of cardiac surgery specialist nurses was scientific and reliable,and can guide significance for the subsequent training,assessment and evaluation of cardiac surgery specialist nurses.

Acute symptomatic osteoporotic thoracolumbar compression fracture (ASOTLF) can lead to chronic low back pain, kyphosis deformity, pulmonary dysfunction, loss of mobility, and even life-threatening complications. Vertebral augmentation is currently the mainstream treatment method for this condition. In 2019, the Editorial Board of Chinese Journal of Trauma and the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association collaboratively led the development of Clinical guideline for vertebral augmentation for acute symptomatic osteoporotic thoracolumbar compression fractures. Six years later, with advances in clinical diagnosis and treatment techniques as well as accumulating evidence in related fields, the 2019 guideline requires updating. To this end, the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association, the Spinal Health Professional Committee of China Human Health Science and Technology Promotion Association, and the Minimally Invasive Orthopedics Professional Committee of Shaanxi Medical Doctor Association have organized experts in the field to develop the Clinical guideline for vertebral augmentation of acute symptomatic osteoporotic thoracolumbar compression fractures ( version 2025) , based on the latest evidence-based medical researches. This guideline incorporates 3 recommendations retained from the 2019 version with updated strength of evidence, along with 12 new recommendations. It provides recommendations from six aspects of diagnosis, pain management, treatment option selection, prevention of postoperative complications, anti-osteoporosis therapy, and postoperative rehabilitation, aiming to provide a reference for standard treatment of vertebral augmentation for ASOTLF in hospitals at all levels.

Objective:To investigate whether hysteroscopic transcervical resection of septum (TCRS) prior to in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) can improve cumulative live birth rates in patients with uterine septum. Methods:A retrospective cohort study was conducted to analyze data from 244 patients with partial uterine septum who underwent IVF/ICSI at the Reproductive Medicine Center of the Third Affiliated Hospital of Zhengzhou University between January 2016 and August 2022. The patients were divided into a surgical group ( n=171) and a non-surgical group ( n=73) based on whether TCRS was performed prior to IVF/ICSI. The clinical outcomes of IVF/ICSI in the two groups were analyzed, with the primary observation indicator being the cumulative live birth rate. Cox regression analysis was employed to identify determinants. Results:The age of patients in the operated group [(31.20±3.80) years] was younger than that in the non-operated group [(32.92±5.34) years, P=0.005], and the basal antral follicle count [17.0 (11.0, 24.0)] was higher than that in the non-operated group [14.0 (8.0, 21.5), P=0.039]. There were no significant differences in other baseline data (all P>0.05). The cumulative pregnancy rate [79.53% (136/171)] and the cumulative live birth rate [60.23% (103/171)] in the operated group during the 24-month follow-up period were significantly higher than those in the non-operated group [65.75% (48/73), P=0.022; 45.21% (33/73), P=0.030]. Compared with the operated group [296.0 (260.0, 430.0) d], the duration from the start of ovarian stimulation to the first live birth was significantly prolonged in the non-operated group [379.0 (329.5, 471.5) d, P<0.001]. Adjusted Cox-regression analysis showed that whether or not surgery was performed ( HR=1.683, 95% CI: 1.116-2.539, P=0.013) and the basal antral follicle count ( HR=1.032, 95% CI: 1.000-1.065, P=0.048) were independent factors affecting cumulative live birth rate. Conclusion:Performing TCRS before IVF/ICSI can improve cumulative live birth rates of patients with uterine septum.

Objective:To investigate whether hysteroscopic transcervical resection of septum (TCRS) prior to in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) can improve cumulative live birth rates in patients with uterine septum. Methods:A retrospective cohort study was conducted to analyze data from 244 patients with partial uterine septum who underwent IVF/ICSI at the Reproductive Medicine Center of the Third Affiliated Hospital of Zhengzhou University between January 2016 and August 2022. The patients were divided into a surgical group ( n=171) and a non-surgical group ( n=73) based on whether TCRS was performed prior to IVF/ICSI. The clinical outcomes of IVF/ICSI in the two groups were analyzed, with the primary observation indicator being the cumulative live birth rate. Cox regression analysis was employed to identify determinants. Results:The age of patients in the operated group [(31.20±3.80) years] was younger than that in the non-operated group [(32.92±5.34) years, P=0.005], and the basal antral follicle count [17.0 (11.0, 24.0)] was higher than that in the non-operated group [14.0 (8.0, 21.5), P=0.039]. There were no significant differences in other baseline data (all P>0.05). The cumulative pregnancy rate [79.53% (136/171)] and the cumulative live birth rate [60.23% (103/171)] in the operated group during the 24-month follow-up period were significantly higher than those in the non-operated group [65.75% (48/73), P=0.022; 45.21% (33/73), P=0.030]. Compared with the operated group [296.0 (260.0, 430.0) d], the duration from the start of ovarian stimulation to the first live birth was significantly prolonged in the non-operated group [379.0 (329.5, 471.5) d, P<0.001]. Adjusted Cox-regression analysis showed that whether or not surgery was performed ( HR=1.683, 95% CI: 1.116-2.539, P=0.013) and the basal antral follicle count ( HR=1.032, 95% CI: 1.000-1.065, P=0.048) were independent factors affecting cumulative live birth rate. Conclusion:Performing TCRS before IVF/ICSI can improve cumulative live birth rates of patients with uterine septum.

Objective To construct and evaluate an evaluation index system for the training effect of cardiac surgery specialist nurses and provide a reference for the quality evaluation of cardiac surgery specialist nurse training.Methods Based on the Kirkpatrick Model,the preliminary draft of the evaluation index system for the training effect of cardiac surgery specialist nurses was formed through literature review and semi-structured interviews.The Delphi method was used to conduct the expert consultation with 24 experts nationwide in September 2024,and the weight of each index was determined by the analytic hierarchy process.In February 2025,60 cardiac surgery nurses from 3 tertiary A hospitals in Nanjing were selected as the survey subjects,and a satisfaction questionnaire on the evaluation index system for the training effect of cardiac surgery nurses was used for the survey.Results The effective recovery rates of the 2 rounds of expert questionnaires were 96％and 100％,respectively.The expert authority coefficient was 0.913,and the Kendall harmony coefficient was 0.127-0.212 and 0.152-0.176,respectively(both P＜0.05).The final evaluation index system for the training effect of cardiac surgery specialist nurses included 4 primary indexes,14 secondary indexes and 59 tertiary indicators.The satisfaction questionnaire score of the evaluation index system for the training effect of cardiac surgery nurses was(18.75±2.21).Conclusion The evaluation index system for the training effect of cardiac surgery specialist nurses was scientific and reliable,and can guide significance for the subsequent training,assessment and evaluation of cardiac surgery specialist nurses.

Acute symptomatic osteoporotic thoracolumbar compression fracture (ASOTLF) can lead to chronic low back pain, kyphosis deformity, pulmonary dysfunction, loss of mobility, and even life-threatening complications. Vertebral augmentation is currently the mainstream treatment method for this condition. In 2019, the Editorial Board of Chinese Journal of Trauma and the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association collaboratively led the development of Clinical guideline for vertebral augmentation for acute symptomatic osteoporotic thoracolumbar compression fractures. Six years later, with advances in clinical diagnosis and treatment techniques as well as accumulating evidence in related fields, the 2019 guideline requires updating. To this end, the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association, the Spinal Health Professional Committee of China Human Health Science and Technology Promotion Association, and the Minimally Invasive Orthopedics Professional Committee of Shaanxi Medical Doctor Association have organized experts in the field to develop the Clinical guideline for vertebral augmentation of acute symptomatic osteoporotic thoracolumbar compression fractures ( version 2025) , based on the latest evidence-based medical researches. This guideline incorporates 3 recommendations retained from the 2019 version with updated strength of evidence, along with 12 new recommendations. It provides recommendations from six aspects of diagnosis, pain management, treatment option selection, prevention of postoperative complications, anti-osteoporosis therapy, and postoperative rehabilitation, aiming to provide a reference for standard treatment of vertebral augmentation for ASOTLF in hospitals at all levels.

Objective:To explore the effect of body fat percent (BFP) on assisted reproductive outcomes in infertile women undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) and fresh embryo transfer. Methods:We analyzed clinical data on infertile women in a retrospective cohort study, who underwent IVF/ICSI and embryo transfer at the Reproductive Health Hospital of the Third Affiliated Hospital of Zhengzhou University from March 2022 to October 2023. The study subjects were divided into non-obese group (BFP<35%, 800 cases) and obese group (BFP≥35%, 742 cases) according to BFP. The baseline data, ovulation induction outcomes and clinical pregnancy outcomes were compared between the two groups.Results:1) The body mass index [BMI, 25.85 (24.22, 28.04) kg/m 2], basal testosterone [0.80 (0.45, 1.12) nmol/L], triglyceride [1.29 (1.03, 1.59) mmol/L], serum total cholesterol [4.55 (4.29, 4.81) mmol/L], low-density lipoprotein cholesterol [3.17 (2.90, 3.40) mmol/L], fasting glucose [5.40 (5.10, 5.75) mmol/L], fasting insulin [12.99 (9.01, 18.31) mU/L], homeostasis model assessment-insulin resistance [3.09 (2.14, 4.50)], antral follicle count [16.00 (11.00, 22.00)], the patients combined with polycystic ovary syndrome [9.4% (70/742)] in obese group were significantly higher than those in non-obese group [21.94 (20.32, 23.51) kg/m 2, P<0.001; 0.69 (0.43, 0.98) nmol/L, P<0.001; 1.00 (0.79, 1.21) mmol/L, P<0.001; 4.42 (4.19, 4.66) mmol/L, P<0.001; 2.91 (2.67, 3.15) mmol/L, P<0.001; 5.22 (5.00, 5.45) mmol/L, P<0.001; 11.30 (8.33, 14.82) mU/L, P<0.001; 2.61 (1.86, 3.48), P<0.001; 14.00 (10.00, 20.00) mmol/L, P<0.001; 4.8% (38/800), P<0.001]. Basal follicle-stimulating hormone [6.58 (5.64, 7.73) U/L], basal estradiol [133.01 (102.35, 171.56) pmol/L], basal luteinizing hormone [4.80 (3.62, 6.53) U/L] and high-density lipoprotein cholesterol [1.29 (1.17, 1.39) mmol/L] in obese group were significantly lower than those in non-obese group [6.91 (5.86, 8.33) U/L, P<0.001; 145.52 (105.23, 187.95) pmol/L, P=0.001; 5.16 (3.82, 6.94) U/L, P=0.022; 1.45 (1.36, 1.55) mmol/L, P<0.001]. 2) The initiated dosage of gonadotropin (Gn) used [187.50 (150.00, 225.00) U] and the total dosage of Gn used [2 481.25 (1 856.25, 3 225.00) U] in obese group were significantly higher than those in non-obese group [225.00 (175.00, 250.00) U, P<0.001; 2 925.00 (2 250.00, 3 675.00) U, P<0.001]. Serum estradiol level on the day of human chorionic gonadotropin (hCG) injection [8 984.00 (6 087.75, 11 978.25) pmol/L], luteinizing hormone level on the day of hCG injection [1.23 (0.87, 1.79) U/L], the rate of blastocyst formation [55.56% (33.33%, 75.00%)] in obese group were significantly lower than those in non-obese group [9 378.50 (6 528.50, 12 624.50) pmol/L, P=0.016; 1.37 (0.94, 2.01) U/L, P=0.001; 60.00% (37.86%, 80.00%), P=0.014]. 3) Sustained pregnancy rate in obese group [41.5% (308/742)] was lower than that in non-obese group [47.6% (381/800), P=0.016]. The number of embryo transfer, embryo transfer type, implantation rate, clinical pregnancy rate, abortion rate and live birth rate were not statistically significant between the two groups (all P>0.05). 4) BFP was not an independent factor of clinical pregnancy rate and live birth rate (all P>0.05). 5) The area under the curve (AUC) of BMI and BFP to predict clinical pregnancy was 0.509 and 0.518, and there was no significant difference between them (AUC difference=0.009, 95% CI: -0.010-0.028, P=0.376). The AUC of BMI and BFP for predicting live birth was 0.501 and 0.513, with no statistically significant difference (AUC difference=0.012, 95% CI: -0.007-0.030, P=0.221). Conclusion:High BFP can increase total dosage of Gn used, decrease blastocyst formation rate and continuous pregnancy rate.

Objective:To investigate the factors influencing patients' willingness to have a second child after obtaining their first singleton live birth by in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). Methods:The data of patients who achieved their first single live birth via IVF/ICSI at the Reproductive Health Hospital of the Third Affiliated Hospital of Zhengzhou University were collected between July 2016 and July 2021 in a retrospective cohort study. Until July 2023, the patients were divided into the returning group ( n=1 809) and the non-returning group ( n=5 824) according to whether they returned again to receive assisted reproduction treatment for the birth of a second child. The clinical data of the two groups were compared, and the factors affecting patients' willingness to have a second child were analyzed. Results:The characteristics of the two groups of patients were compared. Variables that were statistically significant after being included in the univariate analysis were employed to construct a multivariate logistic regression equation. The results indicated that the age of the female ( OR=0.93, 95% CI: 0.91-0.94, P<0.001), the duration of infertility ( OR=0.96, 95% CI: 0.93-0.98, P=0.002), male+female factors of infertility factor ( OR=0.82, 95% CI: 0.70-0.97, P=0.023) the previous reproductive history ( OR=0.33, 95% CI: 0.27-0.42, P<0.001), the method of assisted pregnancy ( OR=1.31, 95% CI: 1.11-1.55, P=0.001), the transplantation plan ( OR=0.83, 95% CI: 0.74-0.93, P=0.002), the mode of delivery ( OR=0.63, 95% CI: 0.55-0.71, P<0.001), pregnancy complications ( OR=0.70, 95% CI: 0.60-0.82, P<0.001), the presence or absence of remaining embryos ( OR=2.67, 95% CI: 2.24-3.19, P<0.001), the gender of the first live birth ( OR=0.40, 95% CI: 0.36-0.45, P<0.001), the degree of education ( OR=0.74, 95% CI: 0.64-0.85, P<0.001), and the type of household registration ( OR=0.74, 95% CI: 0.65-0.84, P<0.001) were the influencing factors of the second-child fertility intention of patients after obtaining the first singleton live birth through IVF/ICSI. Conclusion:The age of the female, the duration of infertility, the factors of infertility, the previous reproductive history, frozen-thawed embryo transfer, cesarean section, having pregnancy complications, the gender of the first live birth being a boy, having a high school education or above, and urban household registration are negatively correlated with the patients' return visits. ICSI-assisted pregnancy and having remaining embryos are positively correlated with the patients' return visits.

Objective:To explore the effect of body fat percent (BFP) on assisted reproductive outcomes in infertile women undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) and fresh embryo transfer. Methods:We analyzed clinical data on infertile women in a retrospective cohort study, who underwent IVF/ICSI and embryo transfer at the Reproductive Health Hospital of the Third Affiliated Hospital of Zhengzhou University from March 2022 to October 2023. The study subjects were divided into non-obese group (BFP<35%, 800 cases) and obese group (BFP≥35%, 742 cases) according to BFP. The baseline data, ovulation induction outcomes and clinical pregnancy outcomes were compared between the two groups.Results:1) The body mass index [BMI, 25.85 (24.22, 28.04) kg/m 2], basal testosterone [0.80 (0.45, 1.12) nmol/L], triglyceride [1.29 (1.03, 1.59) mmol/L], serum total cholesterol [4.55 (4.29, 4.81) mmol/L], low-density lipoprotein cholesterol [3.17 (2.90, 3.40) mmol/L], fasting glucose [5.40 (5.10, 5.75) mmol/L], fasting insulin [12.99 (9.01, 18.31) mU/L], homeostasis model assessment-insulin resistance [3.09 (2.14, 4.50)], antral follicle count [16.00 (11.00, 22.00)], the patients combined with polycystic ovary syndrome [9.4% (70/742)] in obese group were significantly higher than those in non-obese group [21.94 (20.32, 23.51) kg/m 2, P<0.001; 0.69 (0.43, 0.98) nmol/L, P<0.001; 1.00 (0.79, 1.21) mmol/L, P<0.001; 4.42 (4.19, 4.66) mmol/L, P<0.001; 2.91 (2.67, 3.15) mmol/L, P<0.001; 5.22 (5.00, 5.45) mmol/L, P<0.001; 11.30 (8.33, 14.82) mU/L, P<0.001; 2.61 (1.86, 3.48), P<0.001; 14.00 (10.00, 20.00) mmol/L, P<0.001; 4.8% (38/800), P<0.001]. Basal follicle-stimulating hormone [6.58 (5.64, 7.73) U/L], basal estradiol [133.01 (102.35, 171.56) pmol/L], basal luteinizing hormone [4.80 (3.62, 6.53) U/L] and high-density lipoprotein cholesterol [1.29 (1.17, 1.39) mmol/L] in obese group were significantly lower than those in non-obese group [6.91 (5.86, 8.33) U/L, P<0.001; 145.52 (105.23, 187.95) pmol/L, P=0.001; 5.16 (3.82, 6.94) U/L, P=0.022; 1.45 (1.36, 1.55) mmol/L, P<0.001]. 2) The initiated dosage of gonadotropin (Gn) used [187.50 (150.00, 225.00) U] and the total dosage of Gn used [2 481.25 (1 856.25, 3 225.00) U] in obese group were significantly higher than those in non-obese group [225.00 (175.00, 250.00) U, P<0.001; 2 925.00 (2 250.00, 3 675.00) U, P<0.001]. Serum estradiol level on the day of human chorionic gonadotropin (hCG) injection [8 984.00 (6 087.75, 11 978.25) pmol/L], luteinizing hormone level on the day of hCG injection [1.23 (0.87, 1.79) U/L], the rate of blastocyst formation [55.56% (33.33%, 75.00%)] in obese group were significantly lower than those in non-obese group [9 378.50 (6 528.50, 12 624.50) pmol/L, P=0.016; 1.37 (0.94, 2.01) U/L, P=0.001; 60.00% (37.86%, 80.00%), P=0.014]. 3) Sustained pregnancy rate in obese group [41.5% (308/742)] was lower than that in non-obese group [47.6% (381/800), P=0.016]. The number of embryo transfer, embryo transfer type, implantation rate, clinical pregnancy rate, abortion rate and live birth rate were not statistically significant between the two groups (all P>0.05). 4) BFP was not an independent factor of clinical pregnancy rate and live birth rate (all P>0.05). 5) The area under the curve (AUC) of BMI and BFP to predict clinical pregnancy was 0.509 and 0.518, and there was no significant difference between them (AUC difference=0.009, 95% CI: -0.010-0.028, P=0.376). The AUC of BMI and BFP for predicting live birth was 0.501 and 0.513, with no statistically significant difference (AUC difference=0.012, 95% CI: -0.007-0.030, P=0.221). Conclusion:High BFP can increase total dosage of Gn used, decrease blastocyst formation rate and continuous pregnancy rate.

Objective:To investigate the factors influencing patients' willingness to have a second child after obtaining their first singleton live birth by in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). Methods:The data of patients who achieved their first single live birth via IVF/ICSI at the Reproductive Health Hospital of the Third Affiliated Hospital of Zhengzhou University were collected between July 2016 and July 2021 in a retrospective cohort study. Until July 2023, the patients were divided into the returning group ( n=1 809) and the non-returning group ( n=5 824) according to whether they returned again to receive assisted reproduction treatment for the birth of a second child. The clinical data of the two groups were compared, and the factors affecting patients' willingness to have a second child were analyzed. Results:The characteristics of the two groups of patients were compared. Variables that were statistically significant after being included in the univariate analysis were employed to construct a multivariate logistic regression equation. The results indicated that the age of the female ( OR=0.93, 95% CI: 0.91-0.94, P<0.001), the duration of infertility ( OR=0.96, 95% CI: 0.93-0.98, P=0.002), male+female factors of infertility factor ( OR=0.82, 95% CI: 0.70-0.97, P=0.023) the previous reproductive history ( OR=0.33, 95% CI: 0.27-0.42, P<0.001), the method of assisted pregnancy ( OR=1.31, 95% CI: 1.11-1.55, P=0.001), the transplantation plan ( OR=0.83, 95% CI: 0.74-0.93, P=0.002), the mode of delivery ( OR=0.63, 95% CI: 0.55-0.71, P<0.001), pregnancy complications ( OR=0.70, 95% CI: 0.60-0.82, P<0.001), the presence or absence of remaining embryos ( OR=2.67, 95% CI: 2.24-3.19, P<0.001), the gender of the first live birth ( OR=0.40, 95% CI: 0.36-0.45, P<0.001), the degree of education ( OR=0.74, 95% CI: 0.64-0.85, P<0.001), and the type of household registration ( OR=0.74, 95% CI: 0.65-0.84, P<0.001) were the influencing factors of the second-child fertility intention of patients after obtaining the first singleton live birth through IVF/ICSI. Conclusion:The age of the female, the duration of infertility, the factors of infertility, the previous reproductive history, frozen-thawed embryo transfer, cesarean section, having pregnancy complications, the gender of the first live birth being a boy, having a high school education or above, and urban household registration are negatively correlated with the patients' return visits. ICSI-assisted pregnancy and having remaining embryos are positively correlated with the patients' return visits.