The number of women entering pregnancy with chronic liver disease is rising， and gestational liver disorders affect 3% of the pregnant population. Both can be associated with significant maternal and fetal morbidity and mortality. An international panel of experts with extensive experience in managing liver disease during pregnancy from various continents contributed to the formulation of these guidelines. This edition of the International Federation of Gynecology and Obstetrics guidelines on liver disease and pregnancy systematically addresses the most common diseases of gestational liver disorders and pregnancy comorbid with acute and chronic liver diseases and summarizes evidence-based clinical guidance and management recommendations， in order to enhance the clinical management of this patient population.

Pelvic organ prolapse (POP), whose etiology is influenced by genetic and clinical risk factors, considerably impacts women's quality of life. However, the genetic underpinnings in non-European populations and comprehensive risk models integrating genetic and clinical factors remain underexplored. This study constructed the first polygenic risk score (PRS) for POP in the Chinese population by utilizing 20 disease-associated variants from the largest existing genome-wide association study. We analyzed a discovery cohort of 576 cases and 623 controls and a validation cohort of 264 cases and 200 controls. Results showed that the case group exhibited a significantly higher PRS than the control group. Moreover, the odds ratio of the top 10% risk group was 2.6 times higher than that of the bottom 10%. A high PRS was significantly correlated with POP occurrence in women older than 50 years old and in those with one or no childbirths. As far as we know, the integrated prediction model, which combined PRS and clinical risk factors, demonstrated better predictive accuracy than other existing PRS models. This combined risk assessment model serves as a robust tool for POP risk prediction and stratification, thereby offering insights into individualized preventive measures and treatment strategies in future clinical practice.
Humans ; Female ; Pelvic Organ Prolapse/epidemiology* ; Middle Aged ; Risk Assessment/methods* ; China/epidemiology* ; Multifactorial Inheritance ; Aged ; Risk Factors ; Genome-Wide Association Study ; Genetic Predisposition to Disease ; Case-Control Studies ; Adult ; Polymorphism, Single Nucleotide ; Genetic Risk Score ; East Asian People

Objective To investigate the mechanism and protective effect of Humanin(HN)on rotenone(Rot)-induced toxic damage for dopamine neurons.Methods The Rot-poisened PC12 cell model was constructed,and the control group,the Rot poisening group,the HN pretreated Rot poisening group,and the HN treatment group were set up.ELISA was used to detect the content of HN inside and outside of Rot-infected cells,CCK-8 assay was used to detect cell viability,and ATP detection kit was used to detect the intracellular ATP content.Dichloro-dihydro-fluorescein diacetate(DCFH-DA)assay was used to detect the level of reactive oxygen species(ROS)in cells.Western blotting was performed to detect the expression level of mitochondrial autophagy regulatory proteins Pink1,Parkin,p62,LC3,mitochondrial biogenesis regulatory protein PGC1α,division/fusion regulatory proteins OPA1,MFN2,DRP1,p-DRP1 and antioxidant stress regulatory proteins Keap1 and Nrf2.HBAD-mcherry-EGFP-LC3 adenovirus transfected cells was used to observed the number of autophagosomes and autophagolysosomes.Results The results showed that the intracellular concentration of HN in PC12 in the Rot poisening group was significantly higher than that in the control group(P＜0.05);Compared with the control group,the Rot poisening group had significantly decreased activity of PC12 cells,decreased ATP content and increased production of ROS.After the poisen of Rot in PC12 cells,the expression of Pink1 and p-Parkin,the ratio of LC3Ⅱ/LC3Ⅰ and the expression of p-DRP1 in mitochondrial fusion protein was increased,while the expression of p62,the expression of mitochondrial biogenesis protein PGC1 α,mitochondrial fusion proteins MFN2 and OPA1,and antioxidant stress proteins Keap1 and Nrf2 were decreased(all P＜0.05).The number of autophagosomes and autophagolysosomes in PC12 cells in the Rot poisening group was higher than that in the control group(P＜0.05),and HN pretreatment(20 μmol/L)could significantly improve the changes mentioned above caused by Rot poisening(P＜0.05).Conclusion HN ameliorates Rot-induced toxic damage for dopamine neurons by inhibiting mitophagy and mitochondrial division and promoting mitochondrial biogenesis and fusion,and anti-oxidative stress.

Radiotherapy combined with immunotherapy for the treatment of cancer can induce stronger abscopal effect (AE) and inhibit the growth of tumors outside of radiation field, but the occurrence of AE is distinctly uncommon and unpredictable in clinical practice. The complex molecular mechanism underlying AE remains to be in-depth understood. It has been reported that some new factors are involved in the regulation of AE induced by radiation, but the molecular mechanism has not been fully unravelled. In this article, the roles of macrophages, tumor draining lymph node, p53 and exosomes in the new mechanisms of AE were reviewed, aiming to provide a theoretical basis for the development of more effective cancer therapeutics.

Adult ; Antibodies, Viral/isolation & purification* ; COVID-19/virology* ; Feces/chemistry* ; Female ; Humans ; Intestines/virology* ; Male ; RNA, Ribosomal, 16S/genetics* ; RNA, Viral/isolation & purification* ; SARS-CoV-2/pathogenicity*

Objective:To evaluate the application of SBAR mode handover card in transferring patients with mechanical ventilation for hyperbaric oxygen therapy.Methods:A total of 200 patients with mechanical ventilation, who were admitted to Zhejiang Mingzhou Rehabilitation Hospital and needed hyperbaric oxygen therapy from March 2019 to March 2020, were randomized into observation group and control group with 100 subjects in each group. When transferring the patients from ward to hyperbaric oxygen therapy center, the observation group used our self-designed SBAR mode handover card, while the control group used the conventional handover card. The incidence of nursing adverse events, some medical record missing during handover, nurses’ satisfaction rate on the transferring, and average transferring time were compared between the two groups.Results:There were 8 nursing adverse events and 2 cases of some medical record missing during handover in the observation group, which were less than the 21 events and the 11 cases in the control group. The nurses’ satisfaction rate was 96.0% in the observation group, which was significantly higher than that (83.0%) in the control group, with a statistically significance difference ( P<0.05). The average handover time of the observation group [(9.95±1.23) min] was shorter than that of the control group [(22.46±1.38) min], with a statistically significance difference ( P<0.05). Conclusion:SBAR mode handover card can standardize the handover of patients with mechanical ventilation for transferring to hyperbaric oxygen therapy, effectively reduce the occurrence of nursing adverse event and some medical record missing during handover, improve the handover efficiency, and the satisfaction rate of the nurses, so as to ensure the safety of transferring the patients in critical condition.

Objective:To evaluate the application of SBAR mode handover card in transferring patients with mechanical ventilation for hyperbaric oxygen therapy.Methods:A total of 200 patients with mechanical ventilation, who were admitted to Zhejiang Mingzhou Rehabilitation Hospital and needed hyperbaric oxygen therapy from March 2019 to March 2020, were randomized into observation group and control group with 100 subjects in each group. When transferring the patients from ward to hyperbaric oxygen therapy center, the observation group used our self-designed SBAR mode handover card, while the control group used the conventional handover card. The incidence of nursing adverse events, some medical record missing during handover, nurses’ satisfaction rate on the transferring, and average transferring time were compared between the two groups.Results:There were 8 nursing adverse events and 2 cases of some medical record missing during handover in the observation group, which were less than the 21 events and the 11 cases in the control group. The nurses’ satisfaction rate was 96.0% in the observation group, which was significantly higher than that (83.0%) in the control group, with a statistically significance difference ( P<0.05). The average handover time of the observation group [(9.95±1.23) min] was shorter than that of the control group [(22.46±1.38) min], with a statistically significance difference ( P<0.05). Conclusion:SBAR mode handover card can standardize the handover of patients with mechanical ventilation for transferring to hyperbaric oxygen therapy, effectively reduce the occurrence of nursing adverse event and some medical record missing during handover, improve the handover efficiency, and the satisfaction rate of the nurses, so as to ensure the safety of transferring the patients in critical condition.

OBJECTIVE：To introduce the development and application of automatic dosing and mixing system of intravenous infusion in PIVAS of our hospital. METHODS ：Based on the bar code management system in PIVAS ，combined with automatic mixing equipment ，our hospital developed and designed automatic dosing and mixing system of intravenous infusion which could realize real-time scanning and charging of drugs ，setting parameters of mixed dispensing and automatic dosing and mixed dispensing of intravenous infusion. Compared with manual dispensing model ，work efficiency of 5 staff who dispensed Coenzyme complex for injection and Carbazochrome sodium s ulfonate for injection 300 bags each as well as the amount of drug residues in empty bottle were investigated to evaluate the effects of the system. RESULTS ：The system realized automatic mixing of intravenous infusion. In manual dispensing model and automatic dispensing model ，the mixing efficiency of Coenzyme complex for injection were （96.6±10.0）and（195.2±10.7）bag/h（P＜0.001）；mixing efficiency of Carbazochrome sodium sulfonate for injection were （83.8±12.9）and（118.8±6.7）bag/h（P＜0.001）. The amount of residual liquid in Coenzyme complex for injection empty bottle were （0.09±0.02）and（0.11±0.01）mL；Carbazochrome sodium sulfonate for injection empty bottle were （0.08± 0.02）and（0.12±0.01）mL，which were all lower than the internal control requirements that injected solvent volume was no more than 5％ （0.15 mL）. CONCLUSIONS ：The automatic dosing and mixing system of intravenous infusion could improve the efficiency of intravenous infusion dispensing and reduce the labor intensity of the staff .

Objective To study the clinical, laboratorial, histopathological, imaging features of two cases of hypothyroid myopathy. Method Clinical manifestations, thyroid function, electromyography, muscle MRI, muscle biopsy and follow-up results were collected, and analyzed with the literature. Result These two patients were middle-age to old age and the onset of disease was insidious. Their common clinical manifestations included subacute progressive weakness in the proximal muscles,myalgia after sports and reduction in tendon reflex.The blood test showed an increase in serum concentration of CK and TSH, and a decrease in FT3 and FT4. The electromyography showed suspicious myogenic damage.Muscle histopathological findings were largely nonspecific,such as type I fiber predominance and type 2 atrophy. The MRI revealed extensive muscular dystrophy and fatty filtration in the posterior group of thighs. Treatment of replacement therapy with L-T4 relieved the myopathic symptoms quickly. Conclusion When a patient presents with a subacute progressive weakness in the proximal muscles, the hypothyroidism should be consideration. Muscle histopathological findings may be nonspecific. The muscle MRI have a value of differential diagnosis and lesion assessment.