Pregnancy with chronic kidney disease (CKD), particularly in stages 4-5, carries high risks of adverse outcomes including maternal renal failure, preeclampsia/eclampsia, fetal growth restriction, and preterm birth. This report described a 26-year-old woman with congenital solitary kidney, polycystic ovaries, and uterine septum due to PAX2 gene variant, complicated by CKD stage 4. Through multidisciplinary team precision management and individualized treatment strategies, including timely initiation of dialysis, the patient successfully maintained pregnancy until 34 +1 weeks and delivered a female infant via cesarean section. This case summarizes key management experiences for end-stage renal disease in pregnancy, highlighting early risk assessment, precise nutritional management, hemodialysis protocol optimization, and the crucial role of multidisciplinary collaboration, providing valuable references for managing CKD-complicated pregnancies.

Objective:To explore the impact of a three-dimensional management based on a perinatal one-day clinic on pregnancy outcomes in overweight and obese pregnant women.Methods:It was a randomized controlled trial. A simple random sampling method was used to select 460 singleton pregnant women with a pre-pregnancy body mass index≥24 kg/m2 who had regular prenatal check-ups at the Obstetrics and Gynecology Center of the Third Affiliated Hospital of Chongqing Medical University from June 1, 2018, to December 31, 2022. The women were randomly divided into an experimental group and a control group (230 cases each) using a computer-generated random number table. The control group received regular prenatal check-ups according to the pregnancy care guidelines (once every 4 weeks during mid-pregnancy, once every 2 weeks during late pregnancy, with additional frequency as needed based on the condition). The control group also received a one-time body composition analysis and dietary guidance from a nutritionist at the time of registration. In addition to the control group′s interventions, the experimental group received three-dimensional management based on a perinatal one-day clinic. It included an intensive one-day clinic session, a traditional plus internet-based re-education model (as needed based on the condition), individualized guidance from obstetrics and clinical nutrition clinics (once every 2 weeks), a free body composition test at 24 weeks of pregnancy, and weekly WeChat group push of health care knowledge during pregnancy. A total of 55 cases dropped out, leaving 200 cases in the experimental group and 205 cases in the control group for analysis. General information, pregnancy-related, and postpartum indicators were collected in the two groups. The effect of three-dimensional management based on a perinatal one-day clinic on pregnancy outcomes in overweight and obese pregnant women was analyzed using t-tests and chi-square tests. Results:There was no significant differences in baseline age, pre-pregnancy body mass index, initial blood glucose, initial glycated hemoglobin, or initial gestational age between the two groups (all P>0.05). The experimental group showed significantly lower gestational weight gain, neonatal weight, and proportion of excessive pregnancy weight gain compared to those in the control group [(11.41±5.23) vs (13.22±4.51) kg, (3 352.1±465.3) vs (3 489.5±464.0) g, 48.00% vs 73.17%] (all P<0.05). There were no significant differences in hospitalization days, gestational age at delivery, incidence of gestational diabetes, incidence of hypertensive disorders of pregnancy, incidence of premature rupture of membranes, incidence of preterm birth, incidence of macrosomia, vaginal delivery rate and rate of neonatal transfer to the pediatric department between the two groups (all P>0.05). Conclusion:Early intervention with the three-dimensional management based on the one-day perinatal clinic can effectively control gestational weight gain and neonatal weight in overweight and obese pregnant women.

Background In recent years, the increasingly widespread application of nuclear and medical radiation technologies has resulted in a large number of occupational populations exposed to low-dose ionizing radiation (LDIR). At present, there is no consistent conclusion on the effects of long-term exposure to LDIR on the metabolic health of the occupational population. Objective To explore the association between long-term exposure to LDIR and metabolic syndrome (MetS) among medical radiologists. Methods A cross-sectional study was conducted to enroll 6431 medical radiologists who ordered occupational health checkups from January 2022 to December 2023, and basic information such as demographic characteristics, occupational characteristics, lifestyles, and dietary habits was collected through questionnaires. Physical examinations were conducted using a standardized protocol. Individual dose equivalents of occupational external exposure were monitored by dosimeters worn by medical radiologists. Logistic regression model was used for identifying influencing factors of MetS and sensitivity analysis, and restricted cubic spline model was used to explore the dose-response relationship between cumulative effective dose and MetS. Two-stage linear regression was used to evaluate threshold effect of association between cumulative effective dose and MetS. Results The positive rate of MetS was 13.6% (877/6431) among the enrolled 6431 study participants. The logistic regression showed that gender, age, monthly income, body mass index (BMI), cumulative effective dose, and smoking were influencing factors for MetS. The risk of MetS was higher in males (OR=1.511, 95%CI: 1.209, 1.888); using the < 30 years old group as reference, the risk of MetS was higher in the 30-39 years old (OR=1.509, 95%CI: 1.095, 2.079), 40-49 years old (OR=2.214, 95%CI: 1.551, 3.161), and ≥50 years old (OR=3.480, 95%CI: 2.338, 5.181) groups; using the <10000 yuan group as reference, the risk of MetS was lower in the group with a monthly income of 10000-14999 yuan (OR=0.715, 95%CI: 0.582, 0.878); the risk of MetS was higher in the BMI ≥ 24 kg·m⁻² group (OR=7.548, 95%CI: 6.223, 9.156); using the < 0.76 mSv group as reference, the risk of MetS was higher in the cumulative effective dose of 0.76-2.73 mSv group (OR=1.270, 95%CI: 1.017, 1.586); the risk of MetS was higher in the smoking group (OR=1.734, 95%CI: 1.428, 2.107). The results of restricted cubic spline showed that the cumulative effective dose was nonlinearly correlated with MetS (P _{non-linearity}=0.028), with an inflection point of 1.25 mSv. The risk of developing MetS increased by 34.1% for each unit increase in cumulative effective dose up to 1.25 mSv, whereas above 1.25 mSv, the statistical association was not significant. The sensitivity analysis results showed that after excluding the self-reported hypertensive and diabetic patients, the cumulative effective dose 0.76-2.73 mSv group still had an increased risk of developing MetS compared with the < 0.76 mSv group (P < 0.05), and the results were robust. Conclusion Among medical radiologists, male, age, BMI, and smoking are positively correlated with MetS, and monthly income is negatively correlated with MetS; cumulative effective dose is non-linearly correlated with MetS among medical radiologists.

Objective:To investigate the effects of multimodal and multisensory stimulation training on feeding-swallowing and neurological functions in stroke patients with dysphagia.Methods:Stroke patients with dysphagia treated at Henan Provincial People's Hospital from January 2023 to October 2024 were enrolled. Patients were randomly divided into three groups according to the random number table method, with 36 patients in each group. These three groups underwent different interventions for a period of 8 weeks: multisensory stimulation intervention (stimulation group), multimodal rehabilitation training intervention (rehabilitation group), and innovative multimodal and multisensory stimulation training intervention (combined group). The Kubota water swallow test and functional oral intake scale (FOIS) were used to assess the effective improvement rate of feeding function. Differences in scores of modified Mann assessment of swallowing (MMASA), swallowing quality of life (SWAL-QOL), and National Institute of Health Stroke scale (NIHSS) among the three groups were compared before intervention, and at 4 and 8 weeks post-intervention. SPSS 27.0 software was used to analyze the data by one-way ANOVA, repeated measures ANOVA, Kruskal-Wallis H test, Mann-Whitney U test and Pearson correlation analysis. Results:(1) After 8 weeks of intervention, the effective improvement rates of feeding function were 75.00%(27/36) and 72.22%(26/36) in the stimulation group and rehabilitation group, respectively, which were both lower than that in the combined group (94.44%(34/36), both P<0.05). (2) The interaction effect between time and group was significant in MMASA scores among the three groups before and after intervention ( F=2.569, P<0.05). MMASA scores at 8 weeks post-intervention were higher than those at 4 weeks post-intervention and baseline in all groups (all P<0.05), and scores at 4 weeks post-intervention were also higher than those at baseline (all P<0.05). At 4 and 8 weeks post-intervention, MMASA scores in the combined group (85.64±11.26, 92.56±10.55) were higher than those in the stimulation group (73.52±12.65, 82.97±12.84) and rehabilitation group (72.47±11.38, 84.39±12.29) (all P<0.05). (3) The interaction effect between time and group was significant in SWAL-QOL total scores among the three groups before and after intervention ( F=18.561, P<0.05). SWAL-QOL total scores at 8 weeks post-intervention were higher than those at 4 weeks post-intervention and baseline in all groups ( P<0.05), and scores at 4 weeks post-intervention were also higher than those at baseline (all P<0.05). At 4 and 8 weeks post-intervention, SWAL-QOL total scores in the combined group (115.64±9.26, 135.68±9.55) were higher than those in the stimulation group (108.42±8.65, 113.75±8.84) and rehabilitation group (108.37±8.38, 114.39±9.29) (all P<0.05). (4) The interaction effect between time and group was significant in NIHSS scores among the three groups before and after intervention ( F=7.890, P<0.05). NIHSS scores at 8 weeks post-intervention were lower than those at 4 weeks post-intervention and baseline in all groups (all P<0.05), and scores at 4 weeks post-intervention were also lower than those at baseline (all P<0.05). At 4 and 8 weeks post-intervention, NIHSS scores in the combined group (8.36±1.35, 5.22±1.05) were lower than those in the stimulation group (11.65±2.11, 8.78±1.12) and rehabilitation group (11.32±2.03, 8.36±1.17) (all P<0.05). Conclusion:Multimodal and multisensory stimulation training can improve feeding-swallowing function and neurological impairment in stroke patients with dysphagia, with intervention effects superior to those of either approach used alone.

Objective:To investigate the effects of multimodal and multisensory stimulation training on feeding-swallowing and neurological functions in stroke patients with dysphagia.Methods:Stroke patients with dysphagia treated at Henan Provincial People's Hospital from January 2023 to October 2024 were enrolled. Patients were randomly divided into three groups according to the random number table method, with 36 patients in each group. These three groups underwent different interventions for a period of 8 weeks: multisensory stimulation intervention (stimulation group), multimodal rehabilitation training intervention (rehabilitation group), and innovative multimodal and multisensory stimulation training intervention (combined group). The Kubota water swallow test and functional oral intake scale (FOIS) were used to assess the effective improvement rate of feeding function. Differences in scores of modified Mann assessment of swallowing (MMASA), swallowing quality of life (SWAL-QOL), and National Institute of Health Stroke scale (NIHSS) among the three groups were compared before intervention, and at 4 and 8 weeks post-intervention. SPSS 27.0 software was used to analyze the data by one-way ANOVA, repeated measures ANOVA, Kruskal-Wallis H test, Mann-Whitney U test and Pearson correlation analysis. Results:(1) After 8 weeks of intervention, the effective improvement rates of feeding function were 75.00%(27/36) and 72.22%(26/36) in the stimulation group and rehabilitation group, respectively, which were both lower than that in the combined group (94.44%(34/36), both P<0.05). (2) The interaction effect between time and group was significant in MMASA scores among the three groups before and after intervention ( F=2.569, P<0.05). MMASA scores at 8 weeks post-intervention were higher than those at 4 weeks post-intervention and baseline in all groups (all P<0.05), and scores at 4 weeks post-intervention were also higher than those at baseline (all P<0.05). At 4 and 8 weeks post-intervention, MMASA scores in the combined group (85.64±11.26, 92.56±10.55) were higher than those in the stimulation group (73.52±12.65, 82.97±12.84) and rehabilitation group (72.47±11.38, 84.39±12.29) (all P<0.05). (3) The interaction effect between time and group was significant in SWAL-QOL total scores among the three groups before and after intervention ( F=18.561, P<0.05). SWAL-QOL total scores at 8 weeks post-intervention were higher than those at 4 weeks post-intervention and baseline in all groups ( P<0.05), and scores at 4 weeks post-intervention were also higher than those at baseline (all P<0.05). At 4 and 8 weeks post-intervention, SWAL-QOL total scores in the combined group (115.64±9.26, 135.68±9.55) were higher than those in the stimulation group (108.42±8.65, 113.75±8.84) and rehabilitation group (108.37±8.38, 114.39±9.29) (all P<0.05). (4) The interaction effect between time and group was significant in NIHSS scores among the three groups before and after intervention ( F=7.890, P<0.05). NIHSS scores at 8 weeks post-intervention were lower than those at 4 weeks post-intervention and baseline in all groups (all P<0.05), and scores at 4 weeks post-intervention were also lower than those at baseline (all P<0.05). At 4 and 8 weeks post-intervention, NIHSS scores in the combined group (8.36±1.35, 5.22±1.05) were lower than those in the stimulation group (11.65±2.11, 8.78±1.12) and rehabilitation group (11.32±2.03, 8.36±1.17) (all P<0.05). Conclusion:Multimodal and multisensory stimulation training can improve feeding-swallowing function and neurological impairment in stroke patients with dysphagia, with intervention effects superior to those of either approach used alone.

Objective:To explore the impact of a three-dimensional management based on a perinatal one-day clinic on pregnancy outcomes in overweight and obese pregnant women.Methods:It was a randomized controlled trial. A simple random sampling method was used to select 460 singleton pregnant women with a pre-pregnancy body mass index≥24 kg/m2 who had regular prenatal check-ups at the Obstetrics and Gynecology Center of the Third Affiliated Hospital of Chongqing Medical University from June 1, 2018, to December 31, 2022. The women were randomly divided into an experimental group and a control group (230 cases each) using a computer-generated random number table. The control group received regular prenatal check-ups according to the pregnancy care guidelines (once every 4 weeks during mid-pregnancy, once every 2 weeks during late pregnancy, with additional frequency as needed based on the condition). The control group also received a one-time body composition analysis and dietary guidance from a nutritionist at the time of registration. In addition to the control group′s interventions, the experimental group received three-dimensional management based on a perinatal one-day clinic. It included an intensive one-day clinic session, a traditional plus internet-based re-education model (as needed based on the condition), individualized guidance from obstetrics and clinical nutrition clinics (once every 2 weeks), a free body composition test at 24 weeks of pregnancy, and weekly WeChat group push of health care knowledge during pregnancy. A total of 55 cases dropped out, leaving 200 cases in the experimental group and 205 cases in the control group for analysis. General information, pregnancy-related, and postpartum indicators were collected in the two groups. The effect of three-dimensional management based on a perinatal one-day clinic on pregnancy outcomes in overweight and obese pregnant women was analyzed using t-tests and chi-square tests. Results:There was no significant differences in baseline age, pre-pregnancy body mass index, initial blood glucose, initial glycated hemoglobin, or initial gestational age between the two groups (all P>0.05). The experimental group showed significantly lower gestational weight gain, neonatal weight, and proportion of excessive pregnancy weight gain compared to those in the control group [(11.41±5.23) vs (13.22±4.51) kg, (3 352.1±465.3) vs (3 489.5±464.0) g, 48.00% vs 73.17%] (all P<0.05). There were no significant differences in hospitalization days, gestational age at delivery, incidence of gestational diabetes, incidence of hypertensive disorders of pregnancy, incidence of premature rupture of membranes, incidence of preterm birth, incidence of macrosomia, vaginal delivery rate and rate of neonatal transfer to the pediatric department between the two groups (all P>0.05). Conclusion:Early intervention with the three-dimensional management based on the one-day perinatal clinic can effectively control gestational weight gain and neonatal weight in overweight and obese pregnant women.

Objective:To study and analyze radiation doses to the eye of the lens dose in interventional radiology staff of Guandong medical institutions from 2019 to 2023.Methods:Employing a convenience sampling method, the lens dose and chest dose was monitored with TLD dosimeters in 34 level A tertiary medical institutions. The monitoring data were analyzed on the basis of a summary, and the relationship between the two was explored.Results:A total of 1 033 interventional radiology staff were monitored. The ocular lens doses were in the range of (

Objective:To study and analyze radiation doses to the eye of the lens dose in interventional radiology staff of Guandong medical institutions from 2019 to 2023.Methods:Employing a convenience sampling method, the lens dose and chest dose was monitored with TLD dosimeters in 34 level A tertiary medical institutions. The monitoring data were analyzed on the basis of a summary, and the relationship between the two was explored.Results:A total of 1 033 interventional radiology staff were monitored. The ocular lens doses were in the range of (

Pregnancy with chronic kidney disease (CKD), particularly in stages 4-5, carries high risks of adverse outcomes including maternal renal failure, preeclampsia/eclampsia, fetal growth restriction, and preterm birth. This report described a 26-year-old woman with congenital solitary kidney, polycystic ovaries, and uterine septum due to PAX2 gene variant, complicated by CKD stage 4. Through multidisciplinary team precision management and individualized treatment strategies, including timely initiation of dialysis, the patient successfully maintained pregnancy until 34 +1 weeks and delivered a female infant via cesarean section. This case summarizes key management experiences for end-stage renal disease in pregnancy, highlighting early risk assessment, precise nutritional management, hemodialysis protocol optimization, and the crucial role of multidisciplinary collaboration, providing valuable references for managing CKD-complicated pregnancies.

AIM: To analyze the correlation between ocular surface status and serum lipids in patients with meibomian gland dysfunction(MGD)during pregnancy, and to provide new ideas for the management and treatment of MGD during pregnancy.METHODS: Totally 120 pregnant women(240 eyes)treated in our hospital from May 2021 to May 2022 were selected and they were divided into MGD group(60 cases, 120 eyes)and control group(60 cases, 120 eyes)according to the presence or absence of MGD. All subjects received the ocular surface disease index scores(OSDI)and underwent examinations of meibomian gland morphology and function, tear film and blood lipid.RESULTS: The scores of OSDI, the related indexes of meibomian gland, corneal fluorescein staining(FL)scores, total cholesterol(TC), triglyceride(TG)and low density lipoprotein-cholesterol(LDL-C)in the MGD group were significantly higher than those in the control group(P<0.05). The scores of fluorescein breakup time(FBUT), Schirmer Ⅰ test(SIt)and high-density lipoprotein cholesterol(HDL-C)in the MGD group were significantly lower than those in the control group(P<0.05). Correlation analysis showed that the scores of TG, TC, LDL-C were negatively correlated with the values of FBUT(rs =-0.702, -0.647, -0.710, all P<0.001).CONCLUSION: The level of blood lipids in pregnant patients with MGD is significantly increased, and the levels of TC, TG and LDL-C may be related to the stability of tear film.