Objective To investigate the differences in demographic characteristics,reproductive health status,and the distribution of pregnancy-related diseases between couples conceived via assisted reproductive technology(ART)and naturally conceived couples,and to analyze the impact of ART treatment on the incidence of preterm birth(PTB)in singleton and twin and multiple pregnancies.Methods We conducted a retrospective analysis of the maternal and infant cohort data of Jing'an District from 2013 to 2020.Based on the conception method,the subjects were categorized into two groups:the ART group and the natural conception group.Chi-square test was applied to compare baseline characteristics and disease distributions differences between the two groups,and logistic regression models were used to evaluate the association between ART and the PTB risks.A causal mediation model was used to evaluate the mediating effect of twin and multiple pregnancy in the relationship between ART and PTB.Results A total of 117 717 parturients were included,6 265 in the ART group and 111 452 in the natural conception group.Compared with the natural conception group,couples in the ART group were significantly older and had a higher prevalence of reproductive system diseases.The incidences of diabetes and hypertensive disorders during pregnancy in ART parturient were 13.76%and 9.99%,respectively,which were significantly higher than 7.88%and 4.75%in the natural conception group(both P<0.001).The overall PTB rate in the ART group was 14.81%,higher than 5.35%in the natural conceptions group(P<0.001).The PTB rate in ART for singleton pregnancies in the ART group was 6.40%,higher than 4.83%in the natural conception group(P<0.001),while the PTB rate in ART for twin and multiple pregnancies in the ART group was 53.97%,lower than 60.42%in the natural conception group(P<0.05).Mediation analysis showed that 97.99%of the effect of ART on PTB was mediated by twin and multiple pregnancy,with ART increasing the PTB risk by 3.44 times through multiple pregnancy.Conclusion The overall PTB rate of ART recipients is higher than that of natural recipients,but ART does not increase the PTB risk in singleton and twin and multiple pregnancies.Twin and multiple pregnancy is the key mediating factor contributing to PTB in ART-conceived recipients.Compared with naturally conceived couples,ART conception couples own more advanced maternal age,and have higher risks of suffering gestational diabetes,gestational hypertension,and PTB.

Objective To investigate the association between cystatin C level and 6-month mortali-ty as well as re-hospitalization in elderly patients with heart failure(HF).Methods The clinical data in this study were from a retrospective cohort study,Zigong Heart Failure Study.A total of 1786 elderly HF patients admitted in Zigong Fourth People's Hospital from December 2016 to June 2019 were selected.According to the tertiles of cystatin C level,the subjected patients were divided into three groups,with the cystatin C level of 1.10±0.17(587 cases),1.60±0.17(599 ca-ses),and 2.91±0.90 mg/L(600 cases),respectively.The primary endpoint was a composite end-point of death at 6 months after discharge and readmission due to HF.Multivariate Cox propor-tional hazards regression analysis was employed to analyze the relationship of the cystatin C level with the composite endpoint of 6-month mortality and readmission due to HF.Restricted cubic spline was used to model the relationship between the cystatin C level and the composite end-point,Kaplan-Meier survival curve was plotted to analyze the differences in 6-month event free survival rates among the three groups,and ROC curve was drawn to analyze the predictive value of cystatin C level for the composite endpoint.Results Multivariate Cox proportional hazards re-gression analysis showed that the middle and upper tertiles of cystatin C level were risk factors for the composite endpoint of 6-month mortality and readmission due to HF(HR=1.170,95％CI:0.970-1.390,P=0.111;HR=1.452,95％CI:1.190-1.756,P=0.000).When taking cystatin C level as a continuous variable,the results remained consistent:for every one standard deviation increase in cystatin C level,HR=1.141,95％CI:1.060-1.226 in Model 3;For every 1 mg/L in-crease,HR=1.152,95％CI:1.057-1.250 in Model 3.Restricted cubic spline displayed a non-linear inverse J-shaped relationship between cystatin C level and the composite endpoint of 6-month mortality and readmission due to HF,with a risk inflection point of cystatin C level at 2.13 mg/L.ROC curve analysis showed that the AUC value of cystatin C level in predicting the composite endpoint,6-month death and re-admission due to HF was 0.572,0.667 and 0.554,respectively.Conclusion Elevated cystatin C level is independently associated with an increased risk of the composite endpoint of 6-month death and re-admission in elderly HF patients.

Objective To explore the mechanism of the modified Erchen Decoction in preventing and treating hyperlipidemia with phlegm-dampness syndrome based on network pharmacology and animal experiment.Methods Active components and potential targets of modified Erchen Decoction were screened using TCMSP database.Hyperlipidemia disease targets were retrieved from GeneCards,DrugBank,DisGeNET,OMIM and TTD databases,and the intersection of drugs and disease targets was taken.A protein-protein interaction network was constructed using STRING database,and GO and KEGG pathway enrichment analysis on intersecting targets was conducted using DAVID database.Cytoscape 3.9.1 software constructed a component-target-pathway network to analyze key pathways.The molecular docking between main active components and key targets was performed.A rat model of hyperlipidemia with phlegm dampness syndrome was prepared,and was intervened with modified Erchen Decoction.Liver index was calculated,lipid levels were detected,liver tissue morphology was observed by HE staining,and related protein expressions in liver tissue were detected by Western blot.Results Network pharmacology analysis showed that there were 41 targets of modified Erchen Decoction in preventing and treating hyperlipidemia,including HMGCR,SREBF1,FASN,etc.,involved in AMPK signaling pathway,lipid and atherosclerosis,chemical carcinogenesis-receptor activation,etc.The animal experiment results showed that modified Erchen Decoction could effectively regulate the blood lipid levels of model rats,reduce liver fat accumulation,significantly increase p-AMPK protein expression in liver tissue(P<0.05),and reduce HMGCR,SREBP1c and FAS protein expressions(P<0.05).Conclusion Modified Erchen Decoction may inhibit the synthesis and absorption of cholesterol and fatty acids by activating AMPK/SREBP1c signaling pathway,so as to improve hyperlipidemia.

The inclusion of"strengthening Party building in hospitals"in the Party Constitution during the 20th CPC Na-tional Congress has established fundamental guidelines for public hospital governance.As a critical component of China's health-care system,district-and county-level public hospitals'Party building quality directly influences both the implementation of hier-archical diagnosis systems and the preservation of public welfare values.Anchored in the overarching requirements of Party build-ing in the new context,this paper systematically evaluates the imperative for enhanced Party building in these hospitals.Address-ing prevalent challenges including the disconnection between Party initiatives and clinical operations,along with inadequate evalu-ation frameworks,we analyzed a successful"Five-Pillar Initiative"implemented at a Chongqing district-and county-level hospi-tal.Practical outcomes demonstrated that high-quality Party building has markedly advanced the hospital's disciplinary develop-ment,talent recruitment and cultivation,research and education,and patient satisfaction,generating a"multiplier effect"where-by Party leadership amplifies overall reform and development.The study proposes a three-dimensional development model(insti-tutionalization-standardization-branding)to establish sustainable mechanisms for deep Party-profession integration,offering repli-cable practices for grassroots healthcare institutions under the Healthy China initiative.

Objective:To observe the effect of Ba Duan Jin combined with Du Mai fumigation on improving sleep quality and negative emotions in perimenopausal insomnia patients.Methods:This study was a single-center prospective randomized controlled trial,80 perimenopausal insomnia patients who were admitted to Zhuzhou Maternal and Child Health Hospital from December 2023 to August 2024 were selected.Patients were randomly divided into control group(treated with Du Mai fumigation)and study group(treated with Ba Duan Jin combined with Du Mai fumigation)used random number table method,with 40 cases in each group.The clinical efficacy,sleep quality[Pittsburgh Sleep Quality Index(PSQI)],negative emotions[Self Rating Anxiety Scale(SAS),Self Rating Depression Scale(SDS)],clinical symptoms(Kupperman score),improvement in quality of life[the short form-36 health survey(SF-36)Score],and incidence of adverse reactions between two groups were compared before and after treatment.Results:The clinical total efficiency rate in the study group was higher than that in the control group(P＜0.05).2 weeks and 4 weeks after treatment,PSQI,SAS,SDS and Kupperman scores in the study group were lower than those in the control group,and SF-36 score was higher than that in the control group(P＜0.05).Neither group showed significant adverse reactions.Conclusion:Ba Duan Jin combined with Du Mai fumigation on improving sleep quality and negative emotions in perimenopausal insomnia patients,can effectively improve sleep quality,alleviate negative emotions,and enhance quality of life,without any significant adverse reactions.

Objective To investigate the dosimetric differences in preoperative short-course volumetric modulated arc therapy(VMAT)for rectal cancer using different fluence smoothing(FS)levels in the Monaco Treatment Planning System(Monaco TPS).Methods Twenty rectal cancer patients who received preoperative neoadjuvant short-course VMAT at some hospital from September 2021 to December 2022 were retrospectively selected.Four groups of radiotherapy plans were formulated using the Monaco TPS for each case,which were classified into an off group,a low group,a medium group and a high group based on the FS levels.Then the four groups were compared in terms of the dosimetric parameters,monitor unit and number of the segments in the planning target volume(PTV)and organ at risk(OAR).Statistical analysis was performed using SPSS 27.0 software.Results All the four groups had the doses to the target volume meeting clinical requirements,which had no significant differences in the doses to 5％(D5％)and 95％(D95％)to the target volume and the maximum dose(Dmax),minimum dose(Dmin),mean dose(Dmean)and conformity index(all P＞0.05).Statistical differences were found between the homogeneity indexes of the four groups(P＜0.05),with the medium group behaving the best.The number of the segments rose while the mornitor units decreased siginificantly with the increase of FS levels,with the differences being statistically significant(P＜0.05).There were no significant differences between the V25,V20,V15 and V10 of the small intestine,the V25 and V20 of the bladder and the V15 and V10 of the left and right femur(all P＞0.05).Conclusion In preoperative short-course VMAT for rectal cancer,clinical requirements can be met with different FS levels in the Monaco TPS,and medium-level FS results in optimal overall dose distribution in terms of treatment planning.[Chinese Medical Equipment Journal,2025,46(5):48-53]

This study was aimed at identifying the pathogenic bacteria responsible for the death of a young tiger at the Fujian Meihua Mountain South China Tiger Breeding Research Institute.Tissue samples from the lungs,liver,and intestines of the deceased tiger were collected,and the bacteria were cultured inasterile environment.The bacterial strains were characterized according to their morphological and molecular biological properties,including assessment of virulence genes and antibiotic resistance genes,mouse lethality tests,and antibiotic susceptibility evaluations.A predominant bacterial strain isolated from the liver of the deceased tiger was identified as enterotoxigenic Escherichia coli(ETEC)strain Tiger22513F.Phylogenetic analysis of the 16S rRNA gene revealed that the Tiger22513F strain exhibited close genetic similarity to the reference strain ETEC(MF919609.1),with 99.9%nucleotide similarity,and resided on the same evolutionary branch.The Tiger22513F strain contained 11 antibiotic resistance genes(tetA,sul1,sul3,cmlA,floR,blaTEM,blaSHV,blaCMY-2,qnrA,qnrS,and qnrD)along with five virulence genes(VT1,fyuA,tsh,iucD,and ST).Mouse lethality tests indicated significant pathogenicity toward mice,affecting primarily the lungs,liver,and intestines.Antibiotic susceptibility testing demonstrated that this strain exhibited resistance to various classes of beta-lactam antibiotics,as well as quinolones and aminoglycosides.This investigation successfully isolated a multi-drug resistant enterotoxigenic Escherichia coli strain with pronounced pathogenicity from the liver of a deceased tiger;thus providing valuable scientific insights for clinical diagnosis,as well as prevention and control measures,against ETEC infections in South China tigers.

Objective To investigate the dosimetric differences in preoperative short-course volumetric modulated arc therapy(VMAT)for rectal cancer using different fluence smoothing(FS)levels in the Monaco Treatment Planning System(Monaco TPS).Methods Twenty rectal cancer patients who received preoperative neoadjuvant short-course VMAT at some hospital from September 2021 to December 2022 were retrospectively selected.Four groups of radiotherapy plans were formulated using the Monaco TPS for each case,which were classified into an off group,a low group,a medium group and a high group based on the FS levels.Then the four groups were compared in terms of the dosimetric parameters,monitor unit and number of the segments in the planning target volume(PTV)and organ at risk(OAR).Statistical analysis was performed using SPSS 27.0 software.Results All the four groups had the doses to the target volume meeting clinical requirements,which had no significant differences in the doses to 5％(D5％)and 95％(D95％)to the target volume and the maximum dose(Dmax),minimum dose(Dmin),mean dose(Dmean)and conformity index(all P＞0.05).Statistical differences were found between the homogeneity indexes of the four groups(P＜0.05),with the medium group behaving the best.The number of the segments rose while the mornitor units decreased siginificantly with the increase of FS levels,with the differences being statistically significant(P＜0.05).There were no significant differences between the V25,V20,V15 and V10 of the small intestine,the V25 and V20 of the bladder and the V15 and V10 of the left and right femur(all P＞0.05).Conclusion In preoperative short-course VMAT for rectal cancer,clinical requirements can be met with different FS levels in the Monaco TPS,and medium-level FS results in optimal overall dose distribution in terms of treatment planning.[Chinese Medical Equipment Journal,2025,46(5):48-53]

This study was aimed at identifying the pathogenic bacteria responsible for the death of a young tiger at the Fujian Meihua Mountain South China Tiger Breeding Research Institute.Tissue samples from the lungs,liver,and intestines of the deceased tiger were collected,and the bacteria were cultured inasterile environment.The bacterial strains were characterized according to their morphological and molecular biological properties,including assessment of virulence genes and antibiotic resistance genes,mouse lethality tests,and antibiotic susceptibility evaluations.A predominant bacterial strain isolated from the liver of the deceased tiger was identified as enterotoxigenic Escherichia coli(ETEC)strain Tiger22513F.Phylogenetic analysis of the 16S rRNA gene revealed that the Tiger22513F strain exhibited close genetic similarity to the reference strain ETEC(MF919609.1),with 99.9%nucleotide similarity,and resided on the same evolutionary branch.The Tiger22513F strain contained 11 antibiotic resistance genes(tetA,sul1,sul3,cmlA,floR,blaTEM,blaSHV,blaCMY-2,qnrA,qnrS,and qnrD)along with five virulence genes(VT1,fyuA,tsh,iucD,and ST).Mouse lethality tests indicated significant pathogenicity toward mice,affecting primarily the lungs,liver,and intestines.Antibiotic susceptibility testing demonstrated that this strain exhibited resistance to various classes of beta-lactam antibiotics,as well as quinolones and aminoglycosides.This investigation successfully isolated a multi-drug resistant enterotoxigenic Escherichia coli strain with pronounced pathogenicity from the liver of a deceased tiger;thus providing valuable scientific insights for clinical diagnosis,as well as prevention and control measures,against ETEC infections in South China tigers.

Objective:To explore the experiences of post-traumatic growth in patients with failed assisted reproductive technology (ART), providing a basis for individualized nursing interventions.Methods:This study was a qualitative study. From November to December 2023, purposive sampling was used to select ART failed patients at Reproductive Medicine Center of Affiliated Hospital of Nantong University as participants. Data was collected through semi-structured in-depth interviews, and Colaizzi 7-step analysis method was used to summarize and analyze the data and extract themes.Results:A total of 15 ART failed patients were included, their age was (31.8±3.6) years, years of infertility was (4.7±1.7) years. After analysis, a total of four themes and nine sub-themes were extracted, namely negative emotional experiences in the early stages of trauma (anxiety and depression, psychological stress) ; diversified support systems (family support, social support) ; positive coping styles (positive binary coping between spouses, individual coping) ; post-traumatic growth experiences (mobilizing one's own positive strength, strengthening altruistic awareness, and re-planning the future) .Conclusions:Infertility patients exhibit negative emotions after experiencing ART failure, but also experience post-traumatic growth. Medical and nursing staff should provide targeted guidance based on the psychological state of ART failed patients at different stages to improve their mental health.