Objective To construction of discharge readiness assessment index for patients with percutaneous transhepatic biliary drainage.Methods Based on the framework of the Meleis's transitions theory,the relevant literature was consulted,the semi-structured interview and group discussion were implemented,and the framework of the assessment index system for discharge readiness of patients with percutaneous transhepatic biliary drainage was initially constructed.Then,two rounds of Delphi expert consultations were conducted.The weight of each indicator was set by Analytic Hierarchy Process.Results The effective recovery of 2 rounds of expert consultations were both 100％.The authority coefficients were 0.964 and 0.972,The Kendall harmony coefficients were 0.240 and 0.228(P＜0.001).The final discharge readiness assessment index system for patients with percutaneous transhepatic biliary drainage was established,including 4 first-level indicators and 35 second-level indicators.Conclusion The discharge readiness assessment index system for patients with percutaneous transhepatic biliary drainage was scientific and reliable,which can provide references for the evaluation of discharge readiness for patients with percutaneous transhepatic biliary drainage.

Objective:To analyze the effects of exposure to life events and social support levels during different stages of pregnancy on low birth weight in offspring.Methods:From 2021 to 2023, pregnant women in early pregnancy who were registered with health cards in Linping District, Hangzhou City, were recruited and followed up. The Life Events Scale for Pregnant Women (LESPW) and Social Support Rating Scale (SSRS) were used to evaluate the exposure to life events and social support levels of pregnant women in early, middle and late pregnancy, respectively. A generalized linear model was used to analyze the impact and critical period of exposure to prenatal life events and social support levels on the risk of low birth weight in offspring.Results:A total of 3 663 pregnant women with ages M ( Q1, Q3) of 29.18 (26.59, 32.21) years were included in this study. 116 cases (3.17%) of infants with low birth weight were delivered. Generalized linear model analysis showed no correlation between the level of social support in early, middle and late pregnancy and low birth weight in offspring (all P>0.05). The risk of low birth weight in offspring of pregnant women with high exposure to early pregnancy life events was 1.78 times higher than that of the low exposure group ( RR=1.78, 95% CI: 1.13-2.73, P=0.010), and there was no association in the middle and late stages of pregnancy (both P>0.05). Pregnant women with high exposure to early life events and low levels of social support had a 2.08-fold higher risk of low birth weight in their offspring compared to the low exposure group ( RR=2.08, 95% CI: 1.17-6.78, P=0.010), while this situation was not associated with high social support stratification. Conclusion:Exposure to life events during pregnancy has an early window effect on birth weight. Increased exposure to life events during early pregnancy is associated with a higher risk of low birth weight in offspring. This association is more pronounced in pregnant women with low social support.

Objective:To analyze the effects of exposure to life events and social support levels during different stages of pregnancy on low birth weight in offspring.Methods:From 2021 to 2023, pregnant women in early pregnancy who were registered with health cards in Linping District, Hangzhou City, were recruited and followed up. The Life Events Scale for Pregnant Women (LESPW) and Social Support Rating Scale (SSRS) were used to evaluate the exposure to life events and social support levels of pregnant women in early, middle and late pregnancy, respectively. A generalized linear model was used to analyze the impact and critical period of exposure to prenatal life events and social support levels on the risk of low birth weight in offspring.Results:A total of 3 663 pregnant women with ages M ( Q1, Q3) of 29.18 (26.59, 32.21) years were included in this study. 116 cases (3.17%) of infants with low birth weight were delivered. Generalized linear model analysis showed no correlation between the level of social support in early, middle and late pregnancy and low birth weight in offspring (all P>0.05). The risk of low birth weight in offspring of pregnant women with high exposure to early pregnancy life events was 1.78 times higher than that of the low exposure group ( RR=1.78, 95% CI: 1.13-2.73, P=0.010), and there was no association in the middle and late stages of pregnancy (both P>0.05). Pregnant women with high exposure to early life events and low levels of social support had a 2.08-fold higher risk of low birth weight in their offspring compared to the low exposure group ( RR=2.08, 95% CI: 1.17-6.78, P=0.010), while this situation was not associated with high social support stratification. Conclusion:Exposure to life events during pregnancy has an early window effect on birth weight. Increased exposure to life events during early pregnancy is associated with a higher risk of low birth weight in offspring. This association is more pronounced in pregnant women with low social support.

Objective To explore the value of mammogram texture analysis in prediction of metastasis of axillary lymph nodes for breast carcinoma.Methods Mammograms and clinical data of 171 patients with breast carcinoma confirmed by pathology were retrospectively analyzed,and all patients underwent axillary lymph node dissection (ALND).Then the patients were divided into axillary lymph node metastasis group and non-metastasis group according to the result of ALND.The texture features of these lesions were statistically analyzed,including gray-level histogram texture parameters (mean value,standard deviation,skewness,kurtosis and variance) and gray-level co-occurrence matrix texture parameters (energy,entropy,correlation,inertia,inverse difference moment and contrast).Results In all of 171 breast cancer patients,96patients had axillary lymph node metastasis,while 75 patients had no metastasis.Mammograms showed negative axillary lymph nodes in 119 patients and positive axillary lymph nodes in 52 patients,and the sensitivity and specificity of mammograms in the diagnosis of positive axillary lymph nodes was 48.96％ (47/96) and 93.33％ (70/75),respectively.Mammogram texture analysis showed the values of energy,entropy,inverse difference moment and correlation in axillary lymph node metastasis group were higher than those in non-metastasis group,while the values of inertia and contrast in the axillary lymph node metastasis group were lower than those in non-metastasis group (all P＜0.05).The rest texture parameters had no significant differences between two groups (all P＞0.05).Area under curve (AUC) for texture parameters of energy,entropy,inertia,inverse difference moment,correlation and contrast was 0.610,0.610,0.374,0.599,0.612 and 0.421 (all P＜0.05),respectively.AUC of mammography,mammogram texture features,and the combination of mammography and texture features was 0.711,0.676 and 0.787 (all P＜0.05),respectively.The sensitivity and specificity of mammogram texture features,the combination of mammography and texture features in diagnosis of axillary lymph nodes metastasis was 62.5％ and 64.6％,66.7％ and 82.7％,respectively.Conclusion Mammogram texture parameters are helpful for predicting axillary lymph node metastasis,and the combination of mammography and texture features can improve diagnostic efficiency of axillary lymph node metastasis.