Objective:To investigate the status of allostatic load (AL) in patients with polycystic ovary syndrome (PCOS) and its influence on the clinical outcomes of in vitro fertilization-embryo transfer.Methods:This was a prospective study. By using convenient sampling method, 421 patients with PCOS (PCOS group) and 372 control infertility patients (control group) in the Reproductive Center of the First Affiliated Hospital of Anhui Medical University from April 2022 to January 2024 were investigated for basic information, physical examination, laboratory examination and follow-up of clinical outcomes. The total score of AL was calculated using 16 related indicators of cardiovascular system, metabolic system and immune system, and AL>3 was used as the judgment criteria for the high level AL group and the low level AL group. The differences in general data, embryo development and clinical outcomes between the groups were compared.Results:There were 222 cases (52.7%, 222/421) in PCOS low level AL group and 199 cases (47.3%, 199/421) in PCOS high level AL group. There were 214 patients (57.5%, 214/372) in the control low level AL group and 158 patients (42.5%, 158/372) in the control high level AL group. Embryo development outcomes: number of oocytes retrieved (median: 12, 12, 19, 14, respectively; P<0.001), number of two pronuclei (median: 8, 7, 11, 8, respectively; P<0.001), number of fertilization (median: 9, 9, 13, 10, respectively; P<0.001), number of metaphase of meiosis Ⅱ oocytes (median: 9, 8, 13, 10, respectively; P<0.001), number of transferable embryos (median: 5, 5, 7, 6, respectively; P<0.001), number of high-quality embryos (median: 4, 3, 6, 5, respectively; P<0.001), gonadotropin(Gn) starting dosage (median: 150, 200, 150, 200 U, respectively; P<0.001), total dosage of Gn (median: 1 800, 2 075, 1 575, 2 025 U, respectively; P<0.001), duration of Gn used (median: 10, 10, 10, 10 days, respectively; P=0.027) in the control low level AL group, control high level AL group, PCOS low level AL group and PCOS high level AL group were significantly different. Pairings between groups showed that number of oocytes retrieved, number of two pronuclei, number of fertilization, number of metaphase of meiosis Ⅱ oocytes and number of transferable embryos in PCOS high level AL group were lower than those in PCOS low level AL group (all P<0.05); Gn starting dosage and total dosage of Gn in PCOS low level AL group were lower than those in the other three groups (all P<0.05); duration of Gn used in PCOS high level AL group was higher than that PCOS low level AL group ( P<0.05). Clinical outcomes: the control low level AL group, control high level AL group, PCOS low level AL group and PCOS high level AL group underwent fresh transplantation [27.4% (57/208), 24.4% (38/156), 15.1% (32/212), 17.1% (33/193), respectively; P=0.006] and the proportion of transplanted day 5 embryos [82.7% (172/208), 77.6% (121/156), 91.0% (193/212), 86.5% (167/193), respectively; P=0.018] were statistically significant. There were no significant differences in fertilization rate, biochemical pregnancy rate, clinical pregnancy rate, multiple pregnancy rate and early abortion rate among the four groups (all P>0.05). Conclusion:The high level of AL in PCOS patients may affect the outcomes of embryo development, and more attention should be paid to AL in PCOS patients to reduce stress.

Objective To explore the integrating modeling strategy of prognosis prediction models,and provide support for the methodological selection of establishing effective clinical prediction models.Methods Based on the SEER liver cancer clinical follow-up data,the predictive performance and estimation accuracy of the classical Cox proportional hazard regression model,frequentist model averaging,and Bayesian model averaging methods were compared,and the applicability of model averaging methods was explored.Simulated studies were used to investigate the predictive performance of the models.Results Results of simulation analysis:the C index obtained by Bayesian model averaging was slightly higher than the Cox regression and frequentist model averaging.The 95%confidence interval of the C index tended to become narrower as the sample size increased.For variables with larger effect sizes,the Bayesian model averaging method obtained the smallest deviation of regression coefficients and the largest 95%interval coverage.Results of the case study:the validation set C index obtained by Cox regression,Bayesian model averaging and frequentist model averaging were 0.7845(95%CI:0.7613～0.8076),0.7851(95%CI:0.7619～0.8083)and 0.7845(95%CI:0.7613～0.8076),respectively.Conclusion Bayesian model averaging method can improve the ability of predicting prognosis when the sample size is small and the predictor variables are correlated.

Objective To develop and evaluate dietary and exercise intervention program for over-weight/obese patients with polycystic ovary syndrome(PCOS).Methods Seventy patients with over-weight/obese PCOS were prospectively selected as research subjects and divided into intervention group(n=35)and control group(n=35)according to random number table method.According to the completion of the intervention plan,29 cases were finally included in the intervention group and 28 cases in the control group.The control group was given conventional nursing intervention,while the intervention group was applied with the diet and exercise intervention program for overweight/obese patients with PCOS.Both groups were intervened for 3 months.The physical indicators,PCOS sign scores,natural pregnancy rate,degree of self-body image distress(Multidimensional Self-body Im-age Relationship Questionnaire-Appearance Subscale)and self-efficacy level(Self-efficacy Scale)before and after the intervention were compared between the two groups.The occurrence of adverse reactions during the intervention period between the two groups were compared.Results After 1 month and 3 months of intervention,the body mass index(BMI)and PC OS sign score of the pa-tients in the intervention group were significantly lower than those in the control group(P＜0.05).The natural conception rate of the intervention group was 34.48％(10/29),which was significantly higher than 10.71％(3/28)of the control group(P＜0.05).After 1 month and 3 months of inter-vention,the scores of the self-body image relationship-appearance subscale of the patients in the inter-vention group were significantly higher than those in the control group(P＜0.001).After 3 months of intervention,the score of the Self-efficacy Scale of patients in the intervention group was significantly higher than that in the control group(P＜0.001).During the intervention period,no adverse reac-tions caused by diet and exercise intervention occurred in either group.Conclusion Implementing a diet and exercise intervention program for overweight/obese patients with PCOS is beneficial for re-ducing patients' BMI,increasing the natural pregnancy rate,improving self-body image disorders,and enhancing self-efficacy.

Objective:To investigate the short-term and long-term effects of competency-oriented BOPPPS combined with scenario simulation teaching model on team emergency rescue skills training for healthcare professionals in Xizang.Methods:Forty-four healthcare professionals who participated in team emergency rescue training at Bianba People's Hospital from May 2022 to May 2023 were selected as study subjects. The BOPPPS combined with scenario simulation teaching model was applied in the clinical teaching of acute myocardial infarction. Before the training, the post competency was assessed using the Self-Directed Learning Instrument. The short-term teaching effects were evaluated using skill assessment and questionnaire after the training, and the long-term teaching effects were evaluated using the same questionnaire after six months.Results:Post-training skill assessment scores of the trainees were (50.45±6.68) for skill operation, (7.80±0.97) for humanistic communication, and (16.28±1.52) for team cooperation, which were significantly higher than pre-training scores ( P<0.05). Among self-directed learning abilities, "I enjoy finding answers to questions" was positively correlated with the humanistic communication scores, and "I can connect new knowledge with my personal experiences" was negatively correlated with skill operation scores ( P<0.05). The score of long-term emergency rescue skill improvement (4.27) was significantly higher than that after the training in the short term (3.98) ( P<0.05), while there were no significant decreases in career confidence and team collaboration ability ( P>0.05). Conclusions:The post competency-oriented BOPPPS combined with scenario simulation teaching model contributes to improving the team emergency rescue skills of healthcare professionals in Xizang, stabilizing their career confidence, and stimulating their self-learning ability. It is suitable to promote this teaching model in the clinical skills training of healthcare professionals in Xizang.

Polycystic ovary syndrome (PCOS) is a common chronic disease in women of childbearing age, which mainly threatens women's reproductive health and metabolism. Globally, 5%-20% of women of childbearing age are affected, depending on the diagnostic criteria. There is currently no effective treatment, so early and long-term management is crucial. International evidence-based guidelines for the assessment and management of PCOS recommend lifestyle interventions, such as exercise alone or a variety of diets combined with exercise and behavioral strategies, as first-line management options for women with PCOS to improve metabolic health. This review summarizes the new progress in the application of lifestyle interventions in PCOS patients from different dietary patterns, exercise interventions and action management in order to improve the attention of medical staff in China to the female population of PCOS and provide technical reference for the future application in the health management practice of PCOS patients.

Viral myocarditis is a myocardial disease resulting from various viral infections.Due to the com-plexity of its pathogenesis,effective prevention and treatment options are currently lacking.Establishing appropriate ex-perimental models is crucial for studying the pathogenic mechanisms,disease progression,early diagnosis,and the devel-opment of new drugs and therapies for viral myocarditis.This article reviews the construction methods,research advance-ments,and applications of common experimental models of viral myocarditis,which range from cell models to small ani-mal models,including mice,hamsters,and rabbits,as well as larger animals such as pigs and non-human primates.Ad-ditionally,we summarize and discuss future research directions,providing a theoretical foundation and technological guid-ance for the prevention and treatment of viral myocarditis in clinical settings.

Polycystic ovary syndrome (PCOS) is a common chronic disease in women of childbearing age, which mainly threatens women's reproductive health and metabolism. Globally, 5%-20% of women of childbearing age are affected, depending on the diagnostic criteria. There is currently no effective treatment, so early and long-term management is crucial. International evidence-based guidelines for the assessment and management of PCOS recommend lifestyle interventions, such as exercise alone or a variety of diets combined with exercise and behavioral strategies, as first-line management options for women with PCOS to improve metabolic health. This review summarizes the new progress in the application of lifestyle interventions in PCOS patients from different dietary patterns, exercise interventions and action management in order to improve the attention of medical staff in China to the female population of PCOS and provide technical reference for the future application in the health management practice of PCOS patients.

Objective To explore the integrating modeling strategy of prognosis prediction models,and provide support for the methodological selection of establishing effective clinical prediction models.Methods Based on the SEER liver cancer clinical follow-up data,the predictive performance and estimation accuracy of the classical Cox proportional hazard regression model,frequentist model averaging,and Bayesian model averaging methods were compared,and the applicability of model averaging methods was explored.Simulated studies were used to investigate the predictive performance of the models.Results Results of simulation analysis:the C index obtained by Bayesian model averaging was slightly higher than the Cox regression and frequentist model averaging.The 95%confidence interval of the C index tended to become narrower as the sample size increased.For variables with larger effect sizes,the Bayesian model averaging method obtained the smallest deviation of regression coefficients and the largest 95%interval coverage.Results of the case study:the validation set C index obtained by Cox regression,Bayesian model averaging and frequentist model averaging were 0.7845(95%CI:0.7613～0.8076),0.7851(95%CI:0.7619～0.8083)and 0.7845(95%CI:0.7613～0.8076),respectively.Conclusion Bayesian model averaging method can improve the ability of predicting prognosis when the sample size is small and the predictor variables are correlated.

Objective:To investigate the status of allostatic load (AL) in patients with polycystic ovary syndrome (PCOS) and its influence on the clinical outcomes of in vitro fertilization-embryo transfer.Methods:This was a prospective study. By using convenient sampling method, 421 patients with PCOS (PCOS group) and 372 control infertility patients (control group) in the Reproductive Center of the First Affiliated Hospital of Anhui Medical University from April 2022 to January 2024 were investigated for basic information, physical examination, laboratory examination and follow-up of clinical outcomes. The total score of AL was calculated using 16 related indicators of cardiovascular system, metabolic system and immune system, and AL>3 was used as the judgment criteria for the high level AL group and the low level AL group. The differences in general data, embryo development and clinical outcomes between the groups were compared.Results:There were 222 cases (52.7%, 222/421) in PCOS low level AL group and 199 cases (47.3%, 199/421) in PCOS high level AL group. There were 214 patients (57.5%, 214/372) in the control low level AL group and 158 patients (42.5%, 158/372) in the control high level AL group. Embryo development outcomes: number of oocytes retrieved (median: 12, 12, 19, 14, respectively; P<0.001), number of two pronuclei (median: 8, 7, 11, 8, respectively; P<0.001), number of fertilization (median: 9, 9, 13, 10, respectively; P<0.001), number of metaphase of meiosis Ⅱ oocytes (median: 9, 8, 13, 10, respectively; P<0.001), number of transferable embryos (median: 5, 5, 7, 6, respectively; P<0.001), number of high-quality embryos (median: 4, 3, 6, 5, respectively; P<0.001), gonadotropin(Gn) starting dosage (median: 150, 200, 150, 200 U, respectively; P<0.001), total dosage of Gn (median: 1 800, 2 075, 1 575, 2 025 U, respectively; P<0.001), duration of Gn used (median: 10, 10, 10, 10 days, respectively; P=0.027) in the control low level AL group, control high level AL group, PCOS low level AL group and PCOS high level AL group were significantly different. Pairings between groups showed that number of oocytes retrieved, number of two pronuclei, number of fertilization, number of metaphase of meiosis Ⅱ oocytes and number of transferable embryos in PCOS high level AL group were lower than those in PCOS low level AL group (all P<0.05); Gn starting dosage and total dosage of Gn in PCOS low level AL group were lower than those in the other three groups (all P<0.05); duration of Gn used in PCOS high level AL group was higher than that PCOS low level AL group ( P<0.05). Clinical outcomes: the control low level AL group, control high level AL group, PCOS low level AL group and PCOS high level AL group underwent fresh transplantation [27.4% (57/208), 24.4% (38/156), 15.1% (32/212), 17.1% (33/193), respectively; P=0.006] and the proportion of transplanted day 5 embryos [82.7% (172/208), 77.6% (121/156), 91.0% (193/212), 86.5% (167/193), respectively; P=0.018] were statistically significant. There were no significant differences in fertilization rate, biochemical pregnancy rate, clinical pregnancy rate, multiple pregnancy rate and early abortion rate among the four groups (all P>0.05). Conclusion:The high level of AL in PCOS patients may affect the outcomes of embryo development, and more attention should be paid to AL in PCOS patients to reduce stress.

Objective:To investigate the short-term and long-term effects of competency-oriented BOPPPS combined with scenario simulation teaching model on team emergency rescue skills training for healthcare professionals in Xizang.Methods:Forty-four healthcare professionals who participated in team emergency rescue training at Bianba People's Hospital from May 2022 to May 2023 were selected as study subjects. The BOPPPS combined with scenario simulation teaching model was applied in the clinical teaching of acute myocardial infarction. Before the training, the post competency was assessed using the Self-Directed Learning Instrument. The short-term teaching effects were evaluated using skill assessment and questionnaire after the training, and the long-term teaching effects were evaluated using the same questionnaire after six months.Results:Post-training skill assessment scores of the trainees were (50.45±6.68) for skill operation, (7.80±0.97) for humanistic communication, and (16.28±1.52) for team cooperation, which were significantly higher than pre-training scores ( P<0.05). Among self-directed learning abilities, "I enjoy finding answers to questions" was positively correlated with the humanistic communication scores, and "I can connect new knowledge with my personal experiences" was negatively correlated with skill operation scores ( P<0.05). The score of long-term emergency rescue skill improvement (4.27) was significantly higher than that after the training in the short term (3.98) ( P<0.05), while there were no significant decreases in career confidence and team collaboration ability ( P>0.05). Conclusions:The post competency-oriented BOPPPS combined with scenario simulation teaching model contributes to improving the team emergency rescue skills of healthcare professionals in Xizang, stabilizing their career confidence, and stimulating their self-learning ability. It is suitable to promote this teaching model in the clinical skills training of healthcare professionals in Xizang.