Objective To analyze the influencing factors of ovulation induction therapy in patients with polycystic ovary syndrome (PCOS), and to construct a predictive model for the efficacy of ovulation induction therapy in PCOS patients. Methods A total of 200 infertile PCOS patients suitable for ovulation induction therapy were selected as the study subjects.All patients underwent ovulation induction with letrozole or letrozole combined with urinary gonadotropins. They were divided into effective group (n=160) and ineffective group (n=40) based on the efficacy of ovulation induction. The clinical data of the two groups were retrospectively collected and analyzed. Logistic regression analysis was used to analyze the influencing factors of ovulation induction therapy in PCOS patients, and a nomogram prediction model for the efficacy of ovulation induction was constructed. The predictive performance of the nomogram model for ovulation induction therapy in PCOS patients was evaluated. Results The number of ovulations and mature follicles, proportion of ovulation patients and endometrial thickness in the effective group were significantly higher, and the androgen level in the effective group was significantly lower than that in the ineffective group (P<0.05). Logistic regression analysis showed that androgen level, ovulation count, the number of mature follicles and endometrial thickness were influencing factors for the efficacy of ovulation induction in PCOS patients (OR<1, P<0.05). Receiver operating characteristic (ROC) curve analysis revealed that the area under the curve (AUC) values for ovulation count, the number of mature follicles, endometrial thickness and androgen level in assessing the efficacy of ovulation induction therapy in PCOS patients were greater than 0.60. The verification results of the nomogram prediction model showed that the consistency index value of the calibration curve was 0.984. Conclusions Androgen level, ovulation count, the number of mature follicles and endometrial thickness areinfluencing factors for the efficacy of ovulation induction therapy in PCOS patients. The evaluation performance of the nomogram prediction model based on the above factors is good.

A 49-year-old male patient received long-term use of warfarin 5 mg once daily orally after the operation of aortic mechanical valve replacement, and the international normalized ratio (INR) was maintained at 1.80~2.50. The patient was treated with amiodarone due to atrial tachycardia, and developed nasal bleeding 1 week later. Laboratory tests showed prothrombin time (PT) 79.7 s, INR 10.17, serum creatinine (Scr) 1 032 μmol/L, and blood urea nitrogen (BUN) 29.4 mmol/L; urine routine examination showed urinary occult blood (+) and urinary protein (±). Considering that it was warfarin-related nephropathy caused by the combination of amiodarone, which can enhance the anticoagulant effect of warfarin, leading to excessive anticoagulation. Warfarin was discontinued and the treatments such as local hemostasis, vitamin K 1, tranexamic acid, Bailing capsules (百令胶囊), lanthanum carbonate chewable tablets, and continuous hemodialysis were given. Five days of drug withdrawal, warfarin was restored. Two weeks later, laboratory tests showed PT 21.0 s, INR 1.82, Scr 179 μmol/L, and BUN 19.0 mmol/L. Renal function indicators were within the reference range at 2 and 6 months of follow-up.

A 49-year-old male patient received long-term use of warfarin 5 mg once daily orally after the operation of aortic mechanical valve replacement, and the international normalized ratio (INR) was maintained at 1.80~2.50. The patient was treated with amiodarone due to atrial tachycardia, and developed nasal bleeding 1 week later. Laboratory tests showed prothrombin time (PT) 79.7 s, INR 10.17, serum creatinine (Scr) 1 032 μmol/L, and blood urea nitrogen (BUN) 29.4 mmol/L; urine routine examination showed urinary occult blood (+) and urinary protein (±). Considering that it was warfarin-related nephropathy caused by the combination of amiodarone, which can enhance the anticoagulant effect of warfarin, leading to excessive anticoagulation. Warfarin was discontinued and the treatments such as local hemostasis, vitamin K 1, tranexamic acid, Bailing capsules (百令胶囊), lanthanum carbonate chewable tablets, and continuous hemodialysis were given. Five days of drug withdrawal, warfarin was restored. Two weeks later, laboratory tests showed PT 21.0 s, INR 1.82, Scr 179 μmol/L, and BUN 19.0 mmol/L. Renal function indicators were within the reference range at 2 and 6 months of follow-up.

Hip fractures are among the most common fractures in the elderly, presenting to be a leading cause of disability and mortality. Surgical treatment is currently the main treatment method for hip fractures. The incidence of perioperative malnutrition is increased after hip fractures in the elderly due to the comorbidities, decreased basal metabolic rate, accelerated protein breakdown, weakened anabolism and surgical stress. However, malnutrition not only increases the incidence of postoperative complications, but also leads to increased mortality, indicating an important role of perioperative nursing management of nutrition for the elderly patients with hip fractures. At present, there still lacks scientific guidance and application standards on perioperative nursing management of nutrition for the elderly patients with hip fractures. Therefore, the Orthopedic Nursing Committee of Chinese Nursing Association and the Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures ( version 2023) according to evidence-based medical evidences and their clinical experiences. Fourteen recommendations were made from aspects of nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention and nutrition monitoring to provide guidance for perioperative nursing management of nutrition in elderly patients with hip fractures.

Objective:To investigate the expression levels of silent information regulator 1 (SIRT1), hypoxia-inducible factor-1α (HIF-1α) and mutant P53 proteins in colorectal adenocarcinoma tissues and their clinical significances.Methods:The data of 68 cases of colorectal adenocarcinoma confirmed by pathology in Shanxi Traditional Chinese Medical Hospital from March 2015 to October 2021 were collected. The expressions of SIRT1, HIF-1α and mutant P53 proteins in colorectal adenocarcinoma tissues and paracancerous tissues were determined by immunohistochemistry. The correlation among SIRT1, HIF-1α and mutant P53 proteins and their relationship with clinicopathological features of patients were analyzed.Results:Among 68 colorectal adenocarcinoma tissues and paracancerous tissues, SIRT1 protein was positive in 38 cases (55.88%) and 11 cases (16.18%) ( χ2 = 23.25, P < 0.001), HIF-1α protein was positive in 47 cases (69.12%) and 5 cases (7.35%) ( χ2 =54.92, P < 0.001), and mutant P53 protein was positive in 41 cases (60.29%) and 0 cases (0) ( P < 0.001). The positive expression rate of SIRT1 protein was high in patients with high clinical stage and lymph node metastasis (both P < 0.05); the positive expression rate of HIF-1α protein was high in patients with poor differentiation ( P < 0.05); the positive expression rate of mutant P53 protein was high in patients with poor differentiation and lymph node metastasis (both P < 0.05). There was a negative correlation between expressions of SIRT1 and mutant P53 proteins ( rs = -0.38, P = 0.001); there was a positive correlation between expressions of HIF-1α and mutant P53 proteins ( rs = 0.56, P < 0.001); there was a negative correlation between expressions of SIRT1 and HIF-1α proteins ( rs = -0.40, P = 0.001). Conclusions:SIRT1, HIF-1α and mutant P53 proteins are highly expressed in colorectal adenocarcinoma and are correlated with clinicopathological features suggesting poor prognosis. Combined detection of the three proteins may be used for the diagnosis and prognosis of colorectal adenocarcinoma and serve as a new target for treatment.

Objective:To explore the correlation of c-MET and CXCR4 proteins and microvessel density (MVD) with liver metastasis in colorectal cancer tissues.Methods:A total of 40 colorectal cancer tissue samples and 10 paracancerous (5 cm from the edge of the tumor) normal colorectal tissue samples were collected from March 2015 to December 2020 in Shanxi Traditional Chinese Medical Hospital. Among 40 patients with colorectal cancer, 15 patients had liver metastasis. Immunohistochemistry was used to detect c-MET protein, CXCR4 protein and CD34-labeled MVD in various tissues, and the relationships between them and liver metastasis and between the three were analyzed.Results:The positive rates of c-MET protein [72.5% (29/40) vs. 30.0% (3/10)], CXCR4 protein [47.5% (19/40) vs. 10.0% (1/10)] and MVD (20.1±5.2 vs. 11.5±4.3) in colorectal cancer tissues were higher than those in paracancerous tissues, and the differences were statistically significant (all P < 0.05). The positive rates of c-MET protein [86.7% (13/15) vs. 64.0% (16/25)] and CXCR4 protein [66.7% (10/15) vs. 36.0% (9/25)] in colorectal cancer liver metastasis group were significantly higher than those in non-liver metastasis group, and the differences were statistically significant (both P < 0.05). MVD in colorectal cancer liver metastasis group was significantly higher than that in non-liver metastasis group (21.5±5.3 vs. 12.4±5.7), and the difference was statistically significant ( P < 0.05). In colorectal cancer tissues, c-MET protein expression was positively correlated with CXCR4 protein expression ( r = 0.568, P < 0.05), and MVD in c-MET-positive patients or CXCR4-positive patients was higher than that in negative ones (both P < 0.05). Conclusions:The c-MET protein, CXCR4 protein and MVD may play important roles in the liver metastasis of colorectal cancer. The three indicators can provide a certain reference for the early diagnosis and prognosis prediction of liver metastasis of colorectal cancer.

Objective To observe the clinical efficacy of HE’s needling method (three ways for unblocking) in treating mild simple obesity due to dampness from spleen deficiency.Method Forty eligible subjects with mild simple obesity due to dampness from spleen deficiency were randomized into group A and group B, 20 cases in each group. Group A was intervened by mild unblocking method plus intensive unblocking method from HE’s needling method, and group B was by mild unblocking method plus warm unblocking method. The obesity-related indexes were observed before and after treatment, and the clinical efficacies were compared.Result The body weight and Body Mass Index (BMI) were significantly changed after intervention in the treatment group (P<0.05). The body weight was significantly changed after treatment in the control group (P<0.05). After treatment, there were no significant differences in comparing the obesity-related indexes (body weight, BMI, waist circumference, hip circumference, and waist-hip ratio) between the two groups (P>0.05). The total effective rate was 55.0% in the treatment group versus 10.0% in the control group, and the difference was statistically significant (P<0.01).Conclusion HE’s needling method is effective in treating mild simple obesity due to dampness from spleen deficiency, and mild unblocking method plus intensive unblocking method can produce a more significant efficacy compared to mild unblocking method plus warm unblocking method.

Objective To evaluate the clinical features of osteoarticular damage of patients with brucellosis,and to enhance the knowledge of clinical doctors.Methods The demographic characteristics,clinical presentations,accessory examination of 265 patients with brucellosis admitted from January 2011 to April 2014 in Ji'nan Infectious Diseases Hospital were retrospectively analyzed.Patients were classified into two groups:Patients with osteoarticular complications and patients without osteoarticular complications.Results Of the 265 patients,forty-six patients (17.36％) had osteoarticular complications.Spondylitis was the most common complication [50.00％ (23/46)],followed by sacroiliitis [41.30％ (19/46)] and peripheral arthritis [26.09％ (12/46)].Sacroiliitis was more common than other types of osteoarticular damage in females [21.74％ (10/46)],whereas in males spondylitis was more common [36.96％ (17/46)].Peripheral arthritis was more common in individuals under the age of 17 years old [4.35％ (2/46)],and sacroiliitis were more common in the ages of 18-60 years old group [23.91％(11/46)] and spondylitis were more common in over 60-year age group [30.43％ (14/46)].Patients with osteoarticular complications showed longer duration of illness from the onset of the symptoms to its diagnosis (median 45 days),compared to those non-osteoarticular brucellosis (median 30 days,Z =5.74,P ＜ 0.05).Conclusion Due to diversity of osteoarticular damage in patients with brucellosis,in case of a patient with long-term fever and osteoarticular symptoms,medical and epidemiological history should be inquired so as to strengthen early diagnosis and treatment of the disease based on combination with radiological findings.

Objective We sought to evaluate the effect of structured health education on quality of life and the end point of patients with coronary disease with evidence-based method.Methods The Cochrane Library,Cochrane Database of Systematic Reviews (CDSR),Medline (OVID),Pubmed and Web of Science were searched to collect the randomized controlled trials (RCT) which mentioned the structured health education to CHD patients,the quality of the RCTs was evaluated by Jadad Score,then effective data were extracted and analyzed by Meta-analysis with RevMan 5.2 software.Results A total of 12 eligible studies of RCT were included in the study with Jadad Score evaluations at B level or above.There were 20 476 cases in the intervention group,14 522 cases in the control group.Meta-analysis showed that the quality of life scores of the intervention group were significantly higher than those of the control group,weighted mean difference was 3.29,95％ CI (0.49-6.09).No significant difference was found in cardiac morbidity outcomes,re-hospitalization and the mortality rate,relative risk,95％ confidence interval were respectively 0.72(0.50-1.04),0.98(0.86-1.11),0.77(0.58-1.03).Conclusions The structured health education can improve the quality of life of patients with coronary disease,but has no obvious effect on the cardiac morbidity outcomes,re-hospitalization and mortality rate.We suggest transitional care to be carried out in future research to decrease the incidence rates of them.

Objective To investigate the relationship of nerve growth factor (NGF) between serum and follicular fluid in patients with polycystic ovary syndrome (PCOS), and its effect on pregnancy outcomes. Methods From December 2011 to November 2012, 65 PCOS patients suffered with in vitro fertilization-embryo transfer (IVF-ET) were included in PCOS group and 31 non-PCOS patients with IVF-ET were used as control group. The expressions of NGF in serum and follicular fluid were detected by ELISA on the injection day of chorionic gonadotropin (HCG). The expression levels of NGF in serum and follicular fluid were compared between PCOS group and control group. Results The NGF levels in serum[(14.38±0.42) ng/L] and follicular fluid[(9.61±0.49)ng/L] were significantly higher in PCOS group than those of control group[(11.39±0.38) ng/L and (7.55 ± 0.40)ng/L]. In PCOS group, NGF levels in serum [(14.22 ± 0.35)ng/L] and follicular fluid [(9.30 ± 0.31)ng/L] were significantly lower in pregnant group than those of non-pregnant group[(14.51±0.43)ng/L, (9.86±0.46)ng/L, P<0.01]. Conclusion The increased levels of NGF in serum and follicular fluid of PCOS patients contribute to the pathogenesis of PCOS. The high expression of NGF in serum and follicular fluid may be harmful to pregnancy in PCOS patients.