Objective: Hundreds of countries have implemented lockdown policies to slow the spread of coronavirus disease-2019 (COVID-19), but the impact of these measures on maternal mental health is not well understood. Methods: This study integrated a stress-process model to examine the pathways from lockdown-related stressors to prenatal psychological outcomes, with COVID-19 coping strategies (COP) and self-efficacy in managing negative affect (NEG) as mediators and lockdown duration, hours on pandemic-related information, and number of pregnancies as moderators. Pregnant women in Shanghai completed the Regulatory Emotional Self-Efficacy Scale, COVID-19 Coping Scale, Depression, Anxiety, and Stress Scale-21. Structural equation modeling (SEM) was used to test and modify the hypothetical model, and moderated mediation and slope analyses were undertaken. Results: In the final SEM demonstrating satisfactory fit, three stressors—decreased household income, insufficient daily supplies, and acquired infections—showed positive direct relationships with NEG and COP. Acquired infections, NEG, and COP were identified as direct predictors of mental health outcomes. The relationship between these three stressors and mental health was mediated by NEG and COP. Additionally, the number of pregnancies moderated the mediating effect of COP; this effect was more pronounced among first-time pregnant women than those with multiple pregnancies. Conclusion This study provides insights into how lockdown measures impact psychological outcomes in pregnant women quarantined at home. Interventions aimed at increasing coping strategies may be more effective for primiparous women during future public health emergencies.

Objective: Hundreds of countries have implemented lockdown policies to slow the spread of coronavirus disease-2019 (COVID-19), but the impact of these measures on maternal mental health is not well understood. Methods: This study integrated a stress-process model to examine the pathways from lockdown-related stressors to prenatal psychological outcomes, with COVID-19 coping strategies (COP) and self-efficacy in managing negative affect (NEG) as mediators and lockdown duration, hours on pandemic-related information, and number of pregnancies as moderators. Pregnant women in Shanghai completed the Regulatory Emotional Self-Efficacy Scale, COVID-19 Coping Scale, Depression, Anxiety, and Stress Scale-21. Structural equation modeling (SEM) was used to test and modify the hypothetical model, and moderated mediation and slope analyses were undertaken. Results: In the final SEM demonstrating satisfactory fit, three stressors—decreased household income, insufficient daily supplies, and acquired infections—showed positive direct relationships with NEG and COP. Acquired infections, NEG, and COP were identified as direct predictors of mental health outcomes. The relationship between these three stressors and mental health was mediated by NEG and COP. Additionally, the number of pregnancies moderated the mediating effect of COP; this effect was more pronounced among first-time pregnant women than those with multiple pregnancies. Conclusion This study provides insights into how lockdown measures impact psychological outcomes in pregnant women quarantined at home. Interventions aimed at increasing coping strategies may be more effective for primiparous women during future public health emergencies.

Objective: Hundreds of countries have implemented lockdown policies to slow the spread of coronavirus disease-2019 (COVID-19), but the impact of these measures on maternal mental health is not well understood. Methods: This study integrated a stress-process model to examine the pathways from lockdown-related stressors to prenatal psychological outcomes, with COVID-19 coping strategies (COP) and self-efficacy in managing negative affect (NEG) as mediators and lockdown duration, hours on pandemic-related information, and number of pregnancies as moderators. Pregnant women in Shanghai completed the Regulatory Emotional Self-Efficacy Scale, COVID-19 Coping Scale, Depression, Anxiety, and Stress Scale-21. Structural equation modeling (SEM) was used to test and modify the hypothetical model, and moderated mediation and slope analyses were undertaken. Results: In the final SEM demonstrating satisfactory fit, three stressors—decreased household income, insufficient daily supplies, and acquired infections—showed positive direct relationships with NEG and COP. Acquired infections, NEG, and COP were identified as direct predictors of mental health outcomes. The relationship between these three stressors and mental health was mediated by NEG and COP. Additionally, the number of pregnancies moderated the mediating effect of COP; this effect was more pronounced among first-time pregnant women than those with multiple pregnancies. Conclusion This study provides insights into how lockdown measures impact psychological outcomes in pregnant women quarantined at home. Interventions aimed at increasing coping strategies may be more effective for primiparous women during future public health emergencies.

Objective: Hundreds of countries have implemented lockdown policies to slow the spread of coronavirus disease-2019 (COVID-19), but the impact of these measures on maternal mental health is not well understood. Methods: This study integrated a stress-process model to examine the pathways from lockdown-related stressors to prenatal psychological outcomes, with COVID-19 coping strategies (COP) and self-efficacy in managing negative affect (NEG) as mediators and lockdown duration, hours on pandemic-related information, and number of pregnancies as moderators. Pregnant women in Shanghai completed the Regulatory Emotional Self-Efficacy Scale, COVID-19 Coping Scale, Depression, Anxiety, and Stress Scale-21. Structural equation modeling (SEM) was used to test and modify the hypothetical model, and moderated mediation and slope analyses were undertaken. Results: In the final SEM demonstrating satisfactory fit, three stressors—decreased household income, insufficient daily supplies, and acquired infections—showed positive direct relationships with NEG and COP. Acquired infections, NEG, and COP were identified as direct predictors of mental health outcomes. The relationship between these three stressors and mental health was mediated by NEG and COP. Additionally, the number of pregnancies moderated the mediating effect of COP; this effect was more pronounced among first-time pregnant women than those with multiple pregnancies. Conclusion This study provides insights into how lockdown measures impact psychological outcomes in pregnant women quarantined at home. Interventions aimed at increasing coping strategies may be more effective for primiparous women during future public health emergencies.

Objective: Hundreds of countries have implemented lockdown policies to slow the spread of coronavirus disease-2019 (COVID-19), but the impact of these measures on maternal mental health is not well understood. Methods: This study integrated a stress-process model to examine the pathways from lockdown-related stressors to prenatal psychological outcomes, with COVID-19 coping strategies (COP) and self-efficacy in managing negative affect (NEG) as mediators and lockdown duration, hours on pandemic-related information, and number of pregnancies as moderators. Pregnant women in Shanghai completed the Regulatory Emotional Self-Efficacy Scale, COVID-19 Coping Scale, Depression, Anxiety, and Stress Scale-21. Structural equation modeling (SEM) was used to test and modify the hypothetical model, and moderated mediation and slope analyses were undertaken. Results: In the final SEM demonstrating satisfactory fit, three stressors—decreased household income, insufficient daily supplies, and acquired infections—showed positive direct relationships with NEG and COP. Acquired infections, NEG, and COP were identified as direct predictors of mental health outcomes. The relationship between these three stressors and mental health was mediated by NEG and COP. Additionally, the number of pregnancies moderated the mediating effect of COP; this effect was more pronounced among first-time pregnant women than those with multiple pregnancies. Conclusion This study provides insights into how lockdown measures impact psychological outcomes in pregnant women quarantined at home. Interventions aimed at increasing coping strategies may be more effective for primiparous women during future public health emergencies.

The healing of the tendon-bone interface is a complex dynamic process involving the interaction of multiple cellular and molecular signaling pathways. Bone mesenchymal stem cells (BMSCs) have the potential to differentiate into various types of cells, including osteoblasts, chondrocytes and adipocytes, etc., and have the potential to regenerate damaged tissues. They are potential seed cells for promoting tendon-bone healing. How to precisely regulate the proliferation and differentiation of BMSCs to accelerate the process of tendon-bone healing is a current research hotspot. Monomers of traditional Chinese medicine can promote tendon-bone healing by regulating signaling pathways such as Wnt/β-catenin and BMP/Smad to induce osteogenic and chondrogenic differentiation of BMSCs. This article reviews from several aspects such as the regulatory role of related signaling pathways on tendine-bone healing, traditional Chinese medicine monomers and their mechanism of regulating BMSCs to promote tendine-bone healing in order to providing new ideas for promoting tendine-bone healing.
Mesenchymal Stem Cells/cytology* ; Humans ; Animals ; Bone Marrow Cells/cytology* ; Bone and Bones/drug effects* ; Wound Healing/drug effects* ; Medicine, Chinese Traditional ; Tendons/drug effects* ; Drugs, Chinese Herbal/pharmacology* ; Signal Transduction/drug effects* ; Cell Differentiation/drug effects*

OBJECTIVE: To investigate the short-to-medium-term clinical efficacy of total hip arthroplasty(THA) with Pinnacle ES constrained liner in the treatment of femoral neck fractures(FNF) associated with lower limb neuromuscular disorders. METHODS: A retrospective analysis was conducted on 16 patients who underwent primary THA using Pinnacle ES constrained liner for FNF with lower limb neuromuscular disorders and had complete follow-up data, treated between January 2020 and January 2023. There were 7 males and 9 females, with a mean age of (68.42±3.58) years old ranging from 61 to 75 years old. Among them, 10 cases had left-sided fractures and 6 had right-sided fractures;based on the Garden classification, 11 cases were type Ⅲ and 5 cases were type Ⅳ. The affected limbs were complicated with sequelae of poliomyelitis (2 cases), Parkinson's disease (2 cases), and sequelae of cerebral infarction (12 cases). All operations were performed via a posterolateral approach. Prosthesis position was evaluated using imaging data. Hip function was assessed by the Harris hip score(HHS) and Merle D'Aubigne hip score. During the follow-up period, the occurrence of complications such as prosthetic dislocation, loosening, and infection was recorded. RESULTS: One patient died of advanced tumor 2 years after surgery, and the remaining 15 patients were followed up for 24 to 64 months with a mean of (34.8±5.5) months. The operation time ranged from 50 to 90 minutes with a mean of (75.56±8.15) minutes, and the blood loss ranged from 150 to 200 ml with a mean of (170.32±12.56) ml. All patients achieved primary wound healing after surgery. Intraoperatively, femoral calcar splitting occurred in 2 cases, which were treated with titanium cable binding;no neurovascular injuries were observed in any case. The mean HHS increased from (18.95±2.25) preoperatively to (88.02±2.42) at the last follow-up, and the mean Merle D'Aubigne Score increased from (3.05±0.06) preoperatively to (16.65±0.93) at the last follow-up. Postoperative follow-up X-rays showed good prosthetic position, and no complications such as dislocation, prosthetic loosening, periprosthetic fracture, or deep infection occurred during the follow-up period. CONCLUSION Total hip arthroplasty with Pinnacle ES constrained liner is effective in the treatment of femoral neck fractures associated with lower limb neuromuscular disorders. It can significantly improve hip function, reduce the postoperative prosthetic dislocation rate, provide good initial stability, and achieve satisfactory short-to-medium-term clinical efficacy.
Humans ; Male ; Female ; Middle Aged ; Aged ; Arthroplasty, Replacement, Hip/methods* ; Femoral Neck Fractures/complications* ; Retrospective Studies ; Neuromuscular Diseases/surgery* ; Lower Extremity ; Treatment Outcome

Objective:To investigate the early clinical characteristics of elderly patients with severe burns and the risk factors on prognosis.Methods:This study was a retrospective case series study. Clinical data of 124 elderly patients with severe burns who met the inclusion criteria and were admitted to the 12 hospitals from January 2015 to December 2020 were collected, including 4 patients from the Fourth People's Hospital of Dalian, 5 patients from Fujian Medical University Union Hospital, 22 patients from Guangzhou Red Cross Hospital of Jinan University, 5 patients from Heilongjiang Provincial Hospital, 27 patients from the First Affiliated Hospital of Naval Medical University, 9 patients from the First Affiliated Hospital of Nanchang University, 10 patients from Affiliated Hospital of Nantong University, 9 patients from Tongren Hospital of Wuhan University & Wuhan Third Hospital, 12 patients from the 924 th Hospital of PLA, 6 patients from Zhangjiagang First People's Hospital, 4 patients from Taizhou Hospital of Zhejiang Province, and 11 patients from Zhengzhou First People's Hospital. The patients' overall clinical characteristics, such as gender, age, body mass index, total burn area, full-thickness burn area, inhalation injury, causative factors, whether combined with underlying medical diseases, and admission time after injury were recorded. According to the survival outcome within 28 days after injury, the patients were divided into survival group (89 cases) and death group (35 cases). The following data of patients were compared between the two groups, including the basic data and injuries (the same as the overall clinical characteristics ahead); the coagulation indexes within the first 24 hours of injury such as prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time, D-dimer, fibrinogen degradation product (FDP), international normalized ratio (INR), and fibrinogen; the blood routine indexes within the first 24 hours of injury such as white blood cell count, platelet count, neutrophil-to-lymphocyte ratio, monocyte count, red blood cell count, hemoglobin, and hematocrit; the organ function indexes within the first 24 hours of injury such as direct bilirubin, total bilirubin, urea, serum creatinine, aspartate aminotransferase, alanine aminotransferase, total protein, albumin, globulin, blood glucose, triglyceride, total cholesterol, alkaline phosphatase, creatine kinase, electrolyte indexes (potassium, sodium, chlorine, calcium, magnesium, and phosphorus in blood), uric acid, myoglobin, and brain natriuretic peptide; the infection and blood gas indexes within the first 24 hours of injury such as procalcitonin, C-reactive protein, pH value, oxygenation index, base excess, and lactate; treatment such as whether conducted with mechanical ventilation, whether conducted with continuous renal replacement therapy, whether conducted with anticoagulation therapy, whether applied with vasoactive drugs, and fluid resuscitation. The analysis was conducted to screen the independent risk factors for the mortality within 28 days after injury in elderly patients with severe burns. Results:Among 124 patients, there were 82 males and 42 females, aged 60-97 years, with body mass index of 23.44 (21.09, 25.95) kg/m 2, total burn area of 54.00% (42.00%, 75.00%) total body surface area (TBSA), and full-thickness burn area of 25.00% (10.00%, 40.00%) TBSA. The patients were mainly combined with moderate to severe inhalation injury and caused by flame burns. There were 43 cases with underlying medical diseases. The majority of patients were admitted to the hospital within 8 hours after injury. There were statistically significant differences between patients in the 2 groups in terms of age, total burn area, full-thickness burn area, and inhalation injury, and PT, APTT, D-dimer, FDP, INR, white blood cell count, platelet count, urea, serum creatinine, blood glucose, blood sodium, uric acid, myoglobin, and urine volume within the first 24 hours of injury (with Z values of 2.37, 5.49, 5.26, 5.97, 2.18, 1.95, 2.68, 2.68, 2.51, 2.82, 2.14, 3.40, 5.31, 3.41, 2.35, 3.81, 2.16, and -3.82, respectively, P<0.05); there were statistically significant differences between two groups of patients in whether conducted with mechanical ventilation and whether applied with vasoactive drugs (with χ2 values of 9.44 and 28.50, respectively, P<0.05). Age, total burn area, full-thickness burn area, serum creatinine within the first 24 hours of injury, and APTT within the first 24 hours of injury were the independent risk factors for the mortality within 28 days after injury in elderly patients with severe burns (with odds ratios of 1.17, 1.10, 1.10, 1.09, and 1.27, 95% confidence intervals of 1.03-1.40, 1.04-1.21, 1.05-1.19, 1.05-1.17, and 1.07-1.69, respectively, P<0.05). Conclusions:The elderly patients with severe burns had the injuries mainly from flame burns, often accompanied by moderate to severe inhalation injury and enhanced inflammatory response, elevated blood glucose levels, activated fibrinolysis, and impaired organ function in the early stage, which are associated with their prognosis. Age, total burn area, full-thickness burn area, and serum creatinine and APTT within the first 24 hours of injury are the independent risk factors for death within 28 days after injury in this population.

OBJECTIVE To systematically evaluate the risk factors for cefoperazone/sulbactam-induced coagulation dysfunction in adult patients. METHODS Retrieved from CNKI， VIP， CBM， Wanfang data， PubMed， Embase and Cochrane Library， randomized controlled trial （RCT）， case-control study or cohort study about cefoperazone/sulbactam-induced coagulation dysfunction in adult patients were collected from the inception to Apr. 30th， 2023. After literature screening， data extraction and quality evaluation， meta-analysis was carried out by using RevMan 5.3 software. RESULTS A total of 13 studies were included， among which 11 studies were case-control studies， and 2 studies were cohort studies， involving 18 387 patients in total. Meta- analysis showed that the proportion of advanced age [OR＝2.04， 95%CI （1.14， 3.64）， P＝0.02]， liver insufficiency [OR＝5.95， 95%CI （4.21， 8.40）， P＜0.000 01]， renal insufficiency [OR＝3.51， 95%CI （3.04， 4.05）， P＜0.001]， hypoproteinemia [OR＝ 1.90， 95%CI（1.37， 2.62）， P＜0.001]， poor diet [OR＝7.25， 95%CI （5.13， 10.24）， P＜0.000 01]， daily dose of cefoperazone/ sulbactam ≥9 g [OR＝3.95， 95%CI （2.45，6.37）， P＜0.001]， medication duration of cefoperazone/sulbactam ≥10 d [OR＝2.43， 95%CI （1.81， 3.28）， P＜0.001]， combined use of anticoagulant drugs [OR＝2.84， 95%CI （2.03， 3.97）， P＜0.001]， combined with malignant tumor [OR＝1.60， 95%CI （1.20， 2.15），P＜0.001] in patients with abnormal coagulation function were significantly higher than those with normal coagulation function. CONCLUSIONS Advanced age， liver insufficiency， renal insufficiency， complicated with malignant tumors and hypoalbuminemia， combined use of anticoagulant drugs， poor diet， daily dose ≥9 g， and medication duration≥10 days are risk factors for coagulation dysfunction caused by cefoperazone/sulbactam.

To solve the problems such as decentralized management of transportation needs and personnel, a tertiary hospital launched an intelligent scheduling management information system for " one-stop" transportation service in March 2022, which included the business layer, data layer, and control layer. The system used graph neural network algorithm to train multi feature transportation service data and established an artificial intelligence model for transportation service scheduling, which was used to assist the hospital transportation command center in intelligent scheduling, achieving unified application, task scheduling, process control, and personnel assessment of hospital transportation services.The coverage of transportation services had increased from 188 departments before the system online (March 2021 to February 2022) to 268 departments after the system online (March 2022 to February 2023), as well as the service types and the per capita efficiency coefficient of transportation personnel had increased from 36 categories and 4 086.53 orders/person to 52 categories and 5 839.83 orders/person, respectively. This system met the growing demand for hospital transportation services, improved the level of transportation scheduling management and user satisfaction, which could provide references for other hospitals to promote intelligent management of transportation services.