ObjectiveTo understand the utilization of preconception healthcare services and the influencing factors among the women expecting additional childbirth in Jiading District， Shanghai， and to provide references for promoting the utilization of preconception healthcare services under the new population policy. MethodsA questionnaire survey on the utilization of preconception healthcare services and related influencing factors was carried out among 682 women expecting additional childbirth across six subdistricts in Jiading District， Shanghai. The results were statistically analyzed. ResultsThe average age of the women was （31.7±4.5） years， 30.2% of whom were ≥35 years old. The proportion of women having their third or subsequent children was low， at 16.4%. A significant majority， 92.4%， were found to have various risk factors during initial pregnancy screening. The utilization rate of preconception healthcare services among women seeking additional childbirth was relatively low at 26.7%. Awareness of the free preconception check-up program in Jiading District was also low at 28.6%， and the utilization rate for these services was even lower at 7.69%. Unplanned pregnancies were the primary reason for not utilizing preconception healthcare services， accounting for 63.6%. The results of multifactorial binary logistic regression analysis showed that the utilization rate of preconception healthcare services before the current pregnancy was higher for women aged between 35 and 39 compared to women aged ≤29 years old （OR=1.789， 95%CI： 1.033‒3.099）. Women with planned pregnancies had a higher utilization of preconception healthcare services prior to this pregnancy （OR=4.164， 95%CI： 2.627‒6.602）. Women who had received preconception care prior to their first birth had a higher utilization rate of preconception care prior to the current pregnancy （OR=7.534， 95%CI： 4.954‒11.456）. Women without a family history of chronic diseases had a higher utilization rate of preconception healthcare services （OR=1.903， 95%CI： 1.083‒3.345）. ConclusionUnder the context of three-child policy， the proportion of women seeking three or more children in Jiading District is low. Most of these women have risk factors identified during initial pregnancy screenings. The utilization rate of preconception healthcare services and the awareness of the free preconception screening program in Jiading District are both low. Unplanned pregnancies remain the primary reason for failing to receive timely preconception healthcare services. Age， whether the pregnancy was planned， whether the women had received preconception healthcare services before their first baby and family history of chronic diseases are the main factors affecting the utilization of preconception healthcare services. Relevant departments should enhance the promotion of preconception healthcare service programs， especially for women of childbearing age who have not yet given birth， so as to improve the utilization rate of preconception health care services.

Objective:To discuss the clinical features and prognostic factors of adrenal metastases.Methods:The clinical data of 37 patients with adrenal metastases admitted to the First Affiliated Hospital of Guangxi Medical University from May 2015 to August 2022 were retrospectively analyzed. There were 30 males and 7 females. The median age was 54 (43, 62) years old, including 13 cases aged ≥60 years old and 24 cases aged < 60 years old. There were 22 cases of right metastasis, 12 cases of left metastasis and 3 cases of bilateral metastasis. The maximum diameter of metastatic carcinoma was <3 cm in 10 cases, 3-6 cm in 18 cases, and >6 cm in 9 cases. There were 20 cases of synchronous metastasis (diagnosed with adrenal metastasis at the same time as the primary tumor) and 17 cases of metachronous metastasis (found after the diagnosis of primary tumor). There were 20 cases of adrenal metastasis alone and 17 cases of adrenal metastasis combined with other distant metastasis. 16 cases underwent adrenalectomy, 15 cases underwent adrenalectomy combined with other organ resection, and 6 cases underwent ultrasound-guided needle biopsy. 18 patients were treated with surgery alone, and 19 patients were treated with combined treatment (surgery, chemotherapy, radiotherapy, immunotherapy, targeted therapy, interventional therapy and seed implantation). There were 12 cases of hepatocellular carcinoma, 8 cases of renal clear cell carcinoma, 5 cases of lung adenocarcinoma, 2 cases of colon adenocarcinoma, 2 cases of neuroblastoma, 1 case of renal pelvis carcinoma, 1 case of gastric adenocarcinoma, 1 case of cholangiocarcinoma, 1 case of renal papillary cell carcinoma, 1 case of colon adenosquamous carcinoma, 1 case of thymic small cell carcinoma, 1 case of endometrial carcinoma, and 1 case of diffuse large B-cell lymphoma. The Kaplan-Meier method was used to draw the survival curve, the log-rank test was used to analyze the relationship between the clinical characteristics of patients and overall survival (OS) and progression-free survival (PFS), and the Cox proportional hazards regression model was used to analyze the factors affecting OS.Results:The median follow-up time of the 37 patients was 10 (4, 18.5) months.The overall survival rates at 6 months, 1 year and 2 years were 59.5% (22/37), 43.2% (16/37) and 32.4% (12/37), respectively. The 6-month, 1-year and 2-year overall survival rates of 18 patients who underwent surgery alone were 66.7% (12/18), 44.4% (8/18) and 27.8% (5/18), respectively. The 6 months, 1 year and 2 years overall survival rates of 19 patients with comprehensive treatment were 52.6% (10/19), 42.1% (8/19) and 36.8% (7/19), respectively. There was no significant difference in overall survival rate between the two groups ( P=0.773). Kaplan-Meier survival curve analysis showed that the side of metastatic cancer was a risk factor for OS ( P=0.012) and PFS ( P=0.013), and the time of diagnosis of metastatic cancer was a risk factor for OS ( P=0.021). Univariate Cox regression analysis showed that, time to diagnosis of metastases ( HR=2.5, 95% CI 1.1-5.4, P=0.021), side of metastases ( HR=3.6, 95% CI 1.5-8.5, P=0.004), pulmonary metastases ( HR=3.6, 95% CI 1.1-11.0, P=0.032) and adenocarcinoma of the primary tumor ( HR=3.2, 95% CI 1.2-8.8, P=0.025) were risk factors for OS. Multivariate Cox regression analysis showed that simultaneous presence of metastases ( HR=2.6, 95% CI 1.1-6.2, P=0.033) and metastases located on the left side ( HR=3.6, 95% CI 1.5-8.6, P=0.005) were independent risk factors for OS. Conclusions:Hepatocellular carcinoma is the most common pathological type of adrenal metastases in this study. Patients may benefit from combined therapy based on surgery. The time of diagnosis, side, tumor origin and pathological type of primary tumor are the prognostic factors of adrenal metastases. Simultaneous presence of metastases and left-sided metastases are independent risk factors for OS in patients with adrenal metastases.

Objective:To analyze the health system appeal orders from Beijing 12345 citizen service hotline, for references for further promoting the efficient implementation of swift response to publis complaints in Beijing.Methods:12345 citizen service hotline orders received by Beijing health system from 2021 to 2023 were collected. The spatial and temporal distribution of orders and its appeal text were analyzed. Unit root test and cointegration test were used to determine the correlation between the number of effective appeal orders and the number of notifable disease cases in Beijing. Pearson correlation analysis was used to analyze the correlation between the number of effective appeal orders received by tertiary hospitals and their medical service volume.Results:From 2021 to 2023, there were 252.6 thousand valid orders with an increasing trend year by year; There was a time series correlation( P<0.001) between the number of orders and the number of notifable disease cases. There were 231.8 thousand effective appeal orders for tertiary hospitals, which were densely distributed in Xicheng District, and their quantity was positively correlated with the medical service volume of tertiary hospitals( P<0.001). The most common type of work order was medical service management(215.5 thousand items), and the number of orders related to patient experience and performance evaluation of tertiary hospitals had been increasing year by year. Conclusions:The number of work orders in the health system from the 12345 citizen service hotline in Beijing had been increasing year by year, and the number of orders were effected by the volume of public health emergencies and medical services provided by tertiary hospitals; The classification of demands in existing work orders was not detailed enough. It was recommended to strengthen departmental linkage, establish early warning and response mechanisms, formulate refined classification standards for orders, and accurately assess potential demands. Moreover, it was necessary to focus on the patient, move the gate of " Handling Complaints Immediately" forward, truly realize the handling complaints before they are filed and proactive governance, and promote high-quality development of health field.

Objective:To analyze the health system appeal orders from Beijing 12345 citizen service hotline, for references for further promoting the efficient implementation of swift response to publis complaints in Beijing.Methods:12345 citizen service hotline orders received by Beijing health system from 2021 to 2023 were collected. The spatial and temporal distribution of orders and its appeal text were analyzed. Unit root test and cointegration test were used to determine the correlation between the number of effective appeal orders and the number of notifable disease cases in Beijing. Pearson correlation analysis was used to analyze the correlation between the number of effective appeal orders received by tertiary hospitals and their medical service volume.Results:From 2021 to 2023, there were 252.6 thousand valid orders with an increasing trend year by year; There was a time series correlation( P<0.001) between the number of orders and the number of notifable disease cases. There were 231.8 thousand effective appeal orders for tertiary hospitals, which were densely distributed in Xicheng District, and their quantity was positively correlated with the medical service volume of tertiary hospitals( P<0.001). The most common type of work order was medical service management(215.5 thousand items), and the number of orders related to patient experience and performance evaluation of tertiary hospitals had been increasing year by year. Conclusions:The number of work orders in the health system from the 12345 citizen service hotline in Beijing had been increasing year by year, and the number of orders were effected by the volume of public health emergencies and medical services provided by tertiary hospitals; The classification of demands in existing work orders was not detailed enough. It was recommended to strengthen departmental linkage, establish early warning and response mechanisms, formulate refined classification standards for orders, and accurately assess potential demands. Moreover, it was necessary to focus on the patient, move the gate of " Handling Complaints Immediately" forward, truly realize the handling complaints before they are filed and proactive governance, and promote high-quality development of health field.

Objective:To establish a predictive model of moderate to severe pain in patients with hepatocellular carcinoma (HCC) undergoing transcatheter arterial chemoembolization (TACE).Methods:264 patients with HCC who underwent TACE operation in Southern Medical University from January 2017 to April 2018 were selected as the modeling set. The pain was assessed by numeric rating scales. The patients were divided into pain group ( n=96) and non-pain group ( n=168) according to whether moderate to severe pain occurred within 24 hours after the operation. Binary Logistic regression analysis were performed for variables that were statistically significant in the univariate analyses. The predictive nomogram was constructed and the internal validation was performed. In addition, 87 patients with HCC who underwent TACE operation from January 2020 to June 2020 were selected as the validation set for external validation. Results:In the modeling set, 96 patients (36.36%) had moderate to severe pain within 24 hours after TACE operation in 264 patients with HCC, and the dosage of morphine intramuscularly injected within 24 hours was 1015 mg, with an average of 10.57 mg per patient. Multivariate Logistic regression analysis showed that preoperative pain, the distance between the tumor and capsule ≤2 cm, high prothrombin activity, dosage of lipiodol>10 ml, and several thromboembolic tumors were independent risk factors for moderate to severe pain after TACE ( P<0.05). Age>50 was the protective factor of moderate to severe pain after TACE ( P<0.05). The area under ROC curve was 0.799 (95% CI: 0.745-0.853) in the modeling set. The area under Roc curve for internal validation and external validation were 0.780 and 0.788, respectively. The calibration curves showed satisfactory agreements between the model predicted probability and the actually observed probability. Conclusion:The predictive model of moderate to severe pain after TACE was established in this study has good differentiation and accuracy, it has certain guiding significance for predicting the high-risk group of moderate to severe pain after TACE operation and formulating the targeted prevention strategy.

Objective:To determine the effect of hypoxic stress on glioma cell XBP1 expression, the relationship between XBP1 expres-sion and sugar metabolism, the influence of XBP1 repression on the survival rate of glioma cells under normoxia and hypoxia, and the influence of XBP1 on glioma cell glycolysis. Methods:We tested XBP1 activation in human glioma cell lines cultured under normoxia and hypoxia. XBP1 expression was repressed with siRNA technology. Cells were treated with oxidative phosphorylation inhibitor. We then detected the variation in cell apoptosis, sugar metabolism mode, and cell apoptosis and glycolysis products under normoxia and hypoxia. Results:XBP1 activation increased under hypoxia. Silencing XBP1 expression reduced glioma cell survival level, ATP and lactic acid production, and glucose consumption under hypoxia. After inhibiting cell oxidative phosphorylation, XBP1 repression significantly reduced the survival level of glioma cells. Conclusion:Hypoxia can activate XBP1 in glioma cells. Under hypoxia, XBP1 silencing de-presses cell activity and glycolysis. Glycolysis of glioma cells under hypoxia depends on XBP1 activation.

Children are special groups who grow rapidly,the characteristics of physical growth are discontinuous,and individual in different stages.Growth level,growth velocity and proportion of body need in consideration for a proper assessment and explanation of growth status in children.

BACKGROUND: Basic fibroblast growth factor (BFGF) widely in human tissue participates in trauma repair of various tissues and is one of wound healing factors in the body. OBJECTIVE: To summarize the progress of BFGF in the fracture healing. RETRIEVAL STRATEGY: A computer-based online search of Pubmed Database was undertaken to identify the relevant articles on BFGF in the fracture healing published from January 2000 to December 2007 with the Keywords of "fibroblast growth factor 2 (basic fibroblast growth factor), fracture healing, regulation, signal transduction" in English. At the same time, Chinese relevant articles were searched in China Journal Full-text Database (CJFD) and Wanfang Database published between January 2000 and December 2007 with the same key words in Chinese. Exclusive criteria included articles with repetitive research and non-original study. LITERATURE EVALUATION: A total of 33 articles were collected about the distribution (3 articles), biological characteristics (3 articles) and the effect on the healing of bone fracture (27 articles) of BFGF. DATA SYNTHESIS: Bone healing is the process of regeneration after bone injury and the process of bone formation. BFGF can promote the cell migration by its chemotaxis and accelerate the healing by aggregating mesenchymal stem cells, macrophage and fibroblasts towards trauma region. Present animal studies on BFGF are deep and reports on clinical application are a few. Thus, the effect of BFGF is available. BGFG can affect bone formation by adjusting cell prolifeation and differentiation and changing the synthesis of cell products. BGFG not only can promote the bone growth, but also enhance the adhesion of osteoblasts and scaffold. CONCLUSION: The distribution and biological characteristics of BGFG have been recognized primarily. The further study on modulatory mechanism in the fracture healing of BFGF is carrying through. The bone restoration compounded by BFGF and its carriers is in the experiment and needs to be studied further.