Objective:To investigate the preventive effect of a subanesthetic dose of esketamine on emergence agitation (EA) in pediatric patients undergoing fracture fixation surgery under general anesthesia.Methods:This study was a randomized, double-blind, placebo-controlled trial. Eighty-two pediatric patients, aged 3-6 yr, with American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, scheduled for elective closed reduction and internal fixation of humeral fractures at the People′s Hospital of Fuyang City from March 2023 to August 2024, were divided into 2 groups ( n=41 each) using simple random sampling: esketamine group (group E) and control group (group C). Group E received an intravenous injection of esketamine at a dose of 0.3 mg/kg before anesthesia induction, while the equal volume of normal saline was given instead in group C. The induction and maintenance of general anesthesia were the same in both groups. The drug was discontinued after operation and the children were transferred to the post-anesthesia care unit. The primary outcome was the occurrence of EA assessed using the Pediatric Anesthesia Emergence Delirium scale. Secondary outcome measures included the acceptance of the facemask during anesthesia induction, the rate of propofol use during the emergence period, the Children′s Hospital of Eastern Ontario Pain Scale scores at awakening and at 2 and 6 h postoperatively, the requirement for rescue analgesia in the emergence period, and the occurrence of adverse reactions. Results:Compared with group C, the incidence of EA [38% (15/39) vs. 15% (6/40)] was significantly decreased, the usage rate of propofol during the emergence period was decreased, the degree of acceptance of the facemask during anesthesia induction was increased, and Children′s Hospital of Eastern Ontario Pain Scale scores at all time points and the rate of rescue analgesia in the emergence period were decreased in group E ( P<0.05). There was no statistically significant difference in the incidence of postoperative adverse reactions between the two groups ( P>0.05). Conclusions:Administering a subanesthetic dose of esketamine before anesthesia induction can reduce the risk of EA in pediatric patients undergoing fracture fixation surgery under general anesthesia and raise the the quality of recovery with a high safety.

Objective To analyze the current status of recurrent abortion and contraceptive con-dition among nulliparous adolescent females.Methods Data on abortion and contraception were col-lected from nulliparous adolescent females aged 15 to 24 years who had at least one history of induced or medical abortion and still requested induced or medical abortion for the current pregnancy between July 2019 and June 2024.The influencing factors of recurrent abortion were analyzed.Results The study included 3,081 cases of non-recurrent abortion(including 1,983 induced abortions,1,098 medical abortions)and 804 cases of recurrent abortion(including 475 induced abortions,329 medi-cal abortions)among nulliparous adolescent females.Statistically significant differences were ob-served between recurrent and non-recurrent abortion groups in terms of age composition,marital sta-tus,household registration,and educational level(P＜0.05).Logistic regression analysis revealed that nulliparous adolescent females aged ≤19 years(OR=1.21,95％CI,0.93 to 1.73),with high school education or below(OR=2.13,95％CI,1.77 to 2.82),unmarried(OR=1.92,95％CI,1.25 to 2.64),and non-local household registration(OR=2.68,95％CI,2.19 to 3.63)had an increased risk of recurrent abortion.Among nulliparous adolescent females,the proportion of those who did not use contraception was 62.8％(505/804)among those with a history of repeated abor-tions,which was significantly higher than that among those without a history of repeated abortions[28.1％(865/3,081),P＜0.001].Although there was no statistically significant difference in the pro-portion of those using specific contraceptive methods between the two groups(P＞0.05),the proportion of those using contraception among those with a history of repeated abortions was 37.2％(299/804),which was significantly lower than that among those without a history of repeated abortions[71.9％(2,216/3,081),P＜0.001].Only 0.3％of those with a history of repeated abortions used in-trauterine devices as a contraceptive method.Conclusion Young age,low educational level,being unmarried,and non-local household registration are high-risk factors for recurrent abortion among nulliparous adolescent females.Failure to use contraception or use of ineffective contraceptive meth-ods is the main reason for recurrent induced abortion.Strengthening post-abortion care by medical staff and promoting contraceptive knowledge education and efficient contraceptive methods among ad-olescent females are of great significance in reducing the rate of recurrent induced abortion.

Objective To investigate the correlation between G protein-coupled receptor family C group 6 member A(GPRC6A)gene polymorphisms and their expression and pulmonary infections in elderly patients with chronic heart failure(CHF).Methods 138 elderly CHF patients admitted to the Xianyang First People's Hospital from January 2021 to January 2024 were selected as the research subjects,and were divided into an infected group(n=42)and an uninfected group(n=96)based on their lung infection status.Polymerase chain reaction(PCR)was used to detect polymorphisms at the rs6901250 and rs1606365 loci of the GPRC6A gene.The allele and genotype frequency distributions of the infected and uninfected groups were compared.Logistic regression modeling was used to analyze the s6901250 and rs1606365 loci under three genetic models(co-dominant,dominant and reces-sive)and lung infections in elderly patients with CHF.Real-time fluorescence quantitative PCR(RT-qPCR)method was used to detect the expression level of GPRC6A gene.The predictive value of the mRNA expression level of the GPRC6A gene for the development of pulmonary infections in elderly patients with CHF was analyzed by applying the receiver operator characteristic(ROC)curve.Results The distribution of genotypes at loci rs6901250 and rs1606365 of the GPRC6A gene in both the infected and uninfected groups of the lungs of elderly CHF patients conformed to the Hardy-Weinberg equilibrium law(χ2=0.199～0.376,all P>0.05),which was representative of the population.Compared with the uninfected group,the frequency of allele A at locus rs6901250(57.14%vs 41.67%)was significantly higher in the infected group,Allele G(54.76%vs.37.50%)and genotype GG(14.06%vs 29.99%)frequencies were significantly higher at locus rs1606365,and the differences were statistically significant(χ2=5.628,7.114,6.849,all P<0.05).At locus rs6901250,in the co-dominant model(GG vs AA)and the dominant model(GA+AA vs GG),the elderly CHF patients with AA genotype the risk of lung infection was higher than that of GG genotype(OR=1.753,1.546,all P<0.05);.rs1606365 locus showed that the risk of lung infection was higher than that of CC genotype in el-derly CHF patients with GG genotype under all three genetic models of co-dominant model(CC vs GG),dominant model(CG+GG vs CC)and recessive model(CG+CC vs GG)(OR=1.833,1.741,0.695,all P<0.05).The mRNA expression level of GPR-C6A gene in the lung-infected group of elderly CHF patients(1.43±0.35)was significantly higher than that in the uninfected group(1.02±0.21),and the difference was statistically significant(t=8.515,P<0.001).The results of the ROC curve analysis showed that the GPRC6A gene expression level predicted lung infection in elderly CHF patients with an AUC value of 0.895,a cut-offvalue of 1.37,and sensitivity and specificity of 85.7%and 66.7%,respectively.Conclusion The AA genotype at the rs6901250 locus and the GG genotype at the rs1606365 locus of the GPRC6A gene increased the risk of developing lung infec-tions in elderly patients with CHF.MRNA expression levels of the GPRC6A gene were elevated in the infected group,and its ex-pression level could be used as a predictive indicator for the development of lung infections in elderly patients with CHF.

Objective To investigate the correlation between G protein-coupled receptor family C group 6 member A(GPRC6A)gene polymorphisms and their expression and pulmonary infections in elderly patients with chronic heart failure(CHF).Methods 138 elderly CHF patients admitted to the Xianyang First People's Hospital from January 2021 to January 2024 were selected as the research subjects,and were divided into an infected group(n=42)and an uninfected group(n=96)based on their lung infection status.Polymerase chain reaction(PCR)was used to detect polymorphisms at the rs6901250 and rs1606365 loci of the GPRC6A gene.The allele and genotype frequency distributions of the infected and uninfected groups were compared.Logistic regression modeling was used to analyze the s6901250 and rs1606365 loci under three genetic models(co-dominant,dominant and reces-sive)and lung infections in elderly patients with CHF.Real-time fluorescence quantitative PCR(RT-qPCR)method was used to detect the expression level of GPRC6A gene.The predictive value of the mRNA expression level of the GPRC6A gene for the development of pulmonary infections in elderly patients with CHF was analyzed by applying the receiver operator characteristic(ROC)curve.Results The distribution of genotypes at loci rs6901250 and rs1606365 of the GPRC6A gene in both the infected and uninfected groups of the lungs of elderly CHF patients conformed to the Hardy-Weinberg equilibrium law(χ2=0.199～0.376,all P>0.05),which was representative of the population.Compared with the uninfected group,the frequency of allele A at locus rs6901250(57.14%vs 41.67%)was significantly higher in the infected group,Allele G(54.76%vs.37.50%)and genotype GG(14.06%vs 29.99%)frequencies were significantly higher at locus rs1606365,and the differences were statistically significant(χ2=5.628,7.114,6.849,all P<0.05).At locus rs6901250,in the co-dominant model(GG vs AA)and the dominant model(GA+AA vs GG),the elderly CHF patients with AA genotype the risk of lung infection was higher than that of GG genotype(OR=1.753,1.546,all P<0.05);.rs1606365 locus showed that the risk of lung infection was higher than that of CC genotype in el-derly CHF patients with GG genotype under all three genetic models of co-dominant model(CC vs GG),dominant model(CG+GG vs CC)and recessive model(CG+CC vs GG)(OR=1.833,1.741,0.695,all P<0.05).The mRNA expression level of GPR-C6A gene in the lung-infected group of elderly CHF patients(1.43±0.35)was significantly higher than that in the uninfected group(1.02±0.21),and the difference was statistically significant(t=8.515,P<0.001).The results of the ROC curve analysis showed that the GPRC6A gene expression level predicted lung infection in elderly CHF patients with an AUC value of 0.895,a cut-offvalue of 1.37,and sensitivity and specificity of 85.7%and 66.7%,respectively.Conclusion The AA genotype at the rs6901250 locus and the GG genotype at the rs1606365 locus of the GPRC6A gene increased the risk of developing lung infec-tions in elderly patients with CHF.MRNA expression levels of the GPRC6A gene were elevated in the infected group,and its ex-pression level could be used as a predictive indicator for the development of lung infections in elderly patients with CHF.

Objective:To investigate the preventive effect of a subanesthetic dose of esketamine on emergence agitation (EA) in pediatric patients undergoing fracture fixation surgery under general anesthesia.Methods:This study was a randomized, double-blind, placebo-controlled trial. Eighty-two pediatric patients, aged 3-6 yr, with American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, scheduled for elective closed reduction and internal fixation of humeral fractures at the People′s Hospital of Fuyang City from March 2023 to August 2024, were divided into 2 groups ( n=41 each) using simple random sampling: esketamine group (group E) and control group (group C). Group E received an intravenous injection of esketamine at a dose of 0.3 mg/kg before anesthesia induction, while the equal volume of normal saline was given instead in group C. The induction and maintenance of general anesthesia were the same in both groups. The drug was discontinued after operation and the children were transferred to the post-anesthesia care unit. The primary outcome was the occurrence of EA assessed using the Pediatric Anesthesia Emergence Delirium scale. Secondary outcome measures included the acceptance of the facemask during anesthesia induction, the rate of propofol use during the emergence period, the Children′s Hospital of Eastern Ontario Pain Scale scores at awakening and at 2 and 6 h postoperatively, the requirement for rescue analgesia in the emergence period, and the occurrence of adverse reactions. Results:Compared with group C, the incidence of EA [38% (15/39) vs. 15% (6/40)] was significantly decreased, the usage rate of propofol during the emergence period was decreased, the degree of acceptance of the facemask during anesthesia induction was increased, and Children′s Hospital of Eastern Ontario Pain Scale scores at all time points and the rate of rescue analgesia in the emergence period were decreased in group E ( P<0.05). There was no statistically significant difference in the incidence of postoperative adverse reactions between the two groups ( P>0.05). Conclusions:Administering a subanesthetic dose of esketamine before anesthesia induction can reduce the risk of EA in pediatric patients undergoing fracture fixation surgery under general anesthesia and raise the the quality of recovery with a high safety.

Objective: To study serum zinc level in pregnancy and umbilical cord blood and their association with newborn birth weight. Methods: Pregnant women accepting obstetric examination in Ma'anshan Maternal and Child Care Center were recruited from May 2013 to September 2014. The follow up was conducted during their first, second and third trimesters of pregnancy and the self-designed questionnaire was used to collect information of social and demographic characteristics. Blood samples in the first, second pregnancy period and umbilical cord blood samples were collected and serum concentrations of zinc were assayed. 3 239 mother-infant entered the final analysis. We divided serum zinc level into low (<P₂₅), medium (P₂₅-P₇₅) and high (>P₇₅) groups according to their exposure concentrations at each trimesters. Non-conditional multivariate logistic regression model was conducted to evaluate the association between serum zinc level in first, second trimesters of pregnancy and umbilical cord blood with small for gestational age (SGA) and large for gestational age (LGA). Results: Serum zinc level in P₅₀ (P₂₅-P₇₅) during the first, second trimesters and cord blood were 1 016.18 (907.09-1 145.60), 813.36 (732.47-897.89) and 903.44 (808.71-1 015.64) μg/L, respectively. The prevalence of zinc deficiency during the first, second trimesters and cord blood were 1.5% (44/2 957), 15.9% (492/3 087) and 6.5% (176/2 707), respectively. The prevalence of total SGA and LGA were 9.7% (313/3 239) and 16.5% (536/3 239), respectively. Compared to high-level serum zinc group, the risk of SGA (OR (95%CI) in low-level serum zinc group during first trimesters was 1.51 (1.05-2.19)). Serum zinc level among second pregnancy period and umbilical cord blood had no statistically significant effect on SGA and LGA (both P values >0.05). Conclusion Zinc nutritional status of pregnant women in Ma'anshan city was at a good level. The low serum zinc level in first trimester increased the risk of SGA.