Background: Adrenocortical hormones, particularly 11-oxygenated androgens, are pivotal in female reproductive health and fertility. Standardized detection kits and population-specific reference intervals are lacking in China, hindering related clinical applications. Methods: A HPLC-tandem mass spectrometry (HPLC-MS/MS) pipeline was developed, rigorously validated, and applied to simultaneously quantify corticosterone, cortisone, cortisol, 18-OH cortisol, androstenedione (A4), 11β-hydroxyandrostenedione (11-OH A4), dehydroepiandrosterone, and dehydroepiandrosterone sulfate in serum samples from 455 reproductive-aged women (18–45 yrs) in Guangxi, China. Age-dependent concentration trends were analyzed, and reference intervals stratified by age (2.5th to 97.5th percentiles) were established. Correlations with body-composition metrics, ethnicity, and the menstrual cycle were investigated. Results: The HPLC-MS/MS method demonstrated high precision (intra- and inter-assay CVs < 15%), accuracy, and sensitivity. All eight hormones exhibited significant age-related declines (P < 0.001 for seven hormones; P = 0.001 for 11-OH A4). Notably, 11-OH A4 levels were significantly lower in the 35–45-yr (3.05 nmol/L) and 25–34-yr (3.09 nmol/L) age groups than in the 18–24-yr (3.57 nmol/L) age group, whereas no significant difference was observed between the 35–45-yr and 25–34-yr age groups. Weak negative correlations were observed between the body mass index and corticosterone and cortisone levels, whereas ethnicity and the menstrual cycle showed no significant associations with hormone levels. Conclusions We developed an HPLC-MS/MS-based method for simultaneously quantifying eight adrenocortical hormones, including 11-OH A4, and defined age-specific reference intervals for reproductive-aged Chinese women. These findings advance the clinical utility of adrenocortical hormones in diagnosing and managing reproductive disorders.

Objective To evaluate the methodological quality and measurement attribute quality of the evaluation tool for pediatric palliative care quality assessment tools,and to provide references for medical staff to select the best assessment tools.Methods The PubMed,Embase,Cochrane Library,Web of Science,CINAHL,Scopus,China National Knowledge Infrastructure(CNKI),Wanfang Database,VIP Database,Chinese Biomedical Literature Database,GIN,NGC,NICE,NRAO,medlive,WHO,AAHPM,WHPCA,APHN were searched from inception to March 28,2024.Data were screened and extracted independently by 2 researchers.The consensus-based standards for the selection of health measurement instruments(COSMIN)checklist and quality criteria were employed to evaluate the methodological quality and psychometric properties of the included pediatric palliative care quality assessment tools.Finally,recommendations were formulated based on these evaluations.Results A total of 13 articles were included,involving 9 pediatric palliative care quality assessment tools.Among them,the PICU-QODD,PaPEQu and QCPCI demonstrated good content validity and internal consistency,and are recommended as Grade A.The remaining assessment tools are recommended as Grade B or C.Conclusion The PICU-QODD,PaPEQu and QCPCI are recommended for use,but further validation of their psychometric properties is still needed.

Objective To evaluate the methodological quality and measurement attribute quality of the evaluation tool for pediatric palliative care quality assessment tools,and to provide references for medical staff to select the best assessment tools.Methods The PubMed,Embase,Cochrane Library,Web of Science,CINAHL,Scopus,China National Knowledge Infrastructure(CNKI),Wanfang Database,VIP Database,Chinese Biomedical Literature Database,GIN,NGC,NICE,NRAO,medlive,WHO,AAHPM,WHPCA,APHN were searched from inception to March 28,2024.Data were screened and extracted independently by 2 researchers.The consensus-based standards for the selection of health measurement instruments(COSMIN)checklist and quality criteria were employed to evaluate the methodological quality and psychometric properties of the included pediatric palliative care quality assessment tools.Finally,recommendations were formulated based on these evaluations.Results A total of 13 articles were included,involving 9 pediatric palliative care quality assessment tools.Among them,the PICU-QODD,PaPEQu and QCPCI demonstrated good content validity and internal consistency,and are recommended as Grade A.The remaining assessment tools are recommended as Grade B or C.Conclusion The PICU-QODD,PaPEQu and QCPCI are recommended for use,but further validation of their psychometric properties is still needed.

The knowledge and experience of medical practitioners in the diagnosis and treatment of diseases throughout history are mostly reflected in the description and analysis of relevant clinical events.The diagnosis and treatment thinking and cognitive reasoning process among the knowledge has dynamic and complex characteristics in time and space.However,the current exploration of ancient doctors' diagnosis and treatment experience of diseases and syndromes is mainly focuses on the academic evolution of the entire historical time line,and lacks the exploration of the concept of time and its medical relevance in ancient books.It mainly focuses on entity knowledge,and lacks the presentation of temporal dynamic cognitive logic.Moreover,the research primarily focuses on the study of specific terms in ancient Chinese medicine books,without fully covering ancient medical events.To address this issue,this research proposes to construct the evolution model of diagnosis and treatment experience based on time-series dynamic perspective:according to the time series of diagnosis and treatment events,it covers the time system module,the"coming disease"module,the"already sick"module,and the"after sick"module,which involves the dynamic risk assessment of disease occurrence by ancient medical practitioners,the grasp of the dynamic evolution of the already sick state and the treatment plan,and the dynamic health plan for the after sick state.

Objective To study the expression of PLA2G2A and its significance in vaginal wall tissue of patients with pelvic organ pro-lapse(POP).Methods Twenty-three patients without POP(control group)and 26 patients with POP(POP group)admitted to the Third Affiliated Hospital of Zhengzhou University,between June 2023 and September 2024,were selected.Histological features were observed using hematoxylin and eosin and Masson's trichrome staining.Localization of PLA2G2A was detected using immunofluorescence.The PLA2G2A expression level was assessed using immunohistochemistry,real-time PCR,and Western blotting.After transfecting fibroblasts with silenced PLA2G2A,changes in collagen Ⅰ and collagen Ⅲ were measured.Results The histological structure of the vaginal wall in the POP group was significantly different from that in the control group.PLA2G2A was expressed in fibroblasts,with protein and mRNA expression levels higher than those in the control group(P＜0.05).After silencing PLA2G2A,collagen Ⅰ and collagen Ⅲ expression were upregulated.Conclusion High expression of PLA2G2A in vaginal wall tissue of patients with POP.Increased PLA2G2A expression may be closely related to the development and presence of POP.

The knowledge and experience of medical practitioners in the diagnosis and treatment of diseases throughout history are mostly reflected in the description and analysis of relevant clinical events.The diagnosis and treatment thinking and cognitive reasoning process among the knowledge has dynamic and complex characteristics in time and space.However,the current exploration of ancient doctors' diagnosis and treatment experience of diseases and syndromes is mainly focuses on the academic evolution of the entire historical time line,and lacks the exploration of the concept of time and its medical relevance in ancient books.It mainly focuses on entity knowledge,and lacks the presentation of temporal dynamic cognitive logic.Moreover,the research primarily focuses on the study of specific terms in ancient Chinese medicine books,without fully covering ancient medical events.To address this issue,this research proposes to construct the evolution model of diagnosis and treatment experience based on time-series dynamic perspective:according to the time series of diagnosis and treatment events,it covers the time system module,the"coming disease"module,the"already sick"module,and the"after sick"module,which involves the dynamic risk assessment of disease occurrence by ancient medical practitioners,the grasp of the dynamic evolution of the already sick state and the treatment plan,and the dynamic health plan for the after sick state.

Objective To study the expression of PLA2G2A and its significance in vaginal wall tissue of patients with pelvic organ pro-lapse(POP).Methods Twenty-three patients without POP(control group)and 26 patients with POP(POP group)admitted to the Third Affiliated Hospital of Zhengzhou University,between June 2023 and September 2024,were selected.Histological features were observed using hematoxylin and eosin and Masson's trichrome staining.Localization of PLA2G2A was detected using immunofluorescence.The PLA2G2A expression level was assessed using immunohistochemistry,real-time PCR,and Western blotting.After transfecting fibroblasts with silenced PLA2G2A,changes in collagen Ⅰ and collagen Ⅲ were measured.Results The histological structure of the vaginal wall in the POP group was significantly different from that in the control group.PLA2G2A was expressed in fibroblasts,with protein and mRNA expression levels higher than those in the control group(P＜0.05).After silencing PLA2G2A,collagen Ⅰ and collagen Ⅲ expression were upregulated.Conclusion High expression of PLA2G2A in vaginal wall tissue of patients with POP.Increased PLA2G2A expression may be closely related to the development and presence of POP.

Objective:To investigate the mediating effect of spiritual health between emotional intelligence and humanistic care ability of nursing undergraduates, and to provide reference for cultivating humanistic care ability of nursing undergraduates.Methods:From May to July, 2023, the nursing undergraduates from Hunan University of Traditional Chinese Medicine, Hunan Normal University, Xi'an Medical College were selected as the research objects by convenient sampling method, and they were investigated by general information questionnaire, spiritual health scale, emotional intelligence scale and humanistic care ability scale.Using AMOS 29.0 to construct a structural equation model, this paper explored the mediating effect of spiritual health between emotional intelligence and humanistic care ability of nursing undergraduates.Results:Finally, 1 126 valid questionnaires were collected. Among 1 126 nursing undergraduates, there were 229 males and 897 females. The total scores of spiritual health, emotional intelligence and humanistic care ability of nursing undergraduates were (90.60 ± 11.02), (126.01 ± 11.90), (174.27 ± 15.16) points, respectively. The humanistic care ability of nursing undergraduates was positively correlated with spiritual health and emotional intelligence ( r=0.441, 0.417; both P<0.01), emotional intelligence and spiritual health were positively correlated ( r=0.397, P<0.01). Spiritual health had some mediating effects between emotional intelligence and humanistic care ability, and the amount of mediating effects was 32.24%. Conclusions:The humanistic care ability of nursing undergraduates is at a medium level, and emotional intelligence can influence humanistic care ability through spiritual health. Therefore, it is suggested that nursing educators should add courses and practical activities related to spiritual health in the training plan of nursing students to promote their emotional intelligence and humanistic care ability.

Objective:To evaluate the outcomes of reconstruction with half of peroneous longus tendon autograft for the treatment of chronic Achilles tendon rupture combined with tendon defects.Methods:A retrospective case series study was conducted on the clinical data of 14 patients with chronic tendon rupture combined with defects admitted to Orthopedic Sports Medicine Center, West China Hospital, Sichuan University from November 2017 to August 2020, including 11 males and 3 females, aged 26-62 years [(42.8±10.7)years]. All the patients underwent Achilles tendon reconstruction with half of peroneus longus tendon autograft. American Orthopedic Foot and Ankle Society (AOFAS) score, Achilles tendon total rupture score (ATRS) and Visual Analogue Scale (VAS) were compared before surgery, at 12 months after surgery and at the last follow-up. At the last follow-up, MRI of the injured ankle was prescribed to evaluate tendon healing; Thomspon test was performed and the patients were asked to do single-leg heel raise; the patients were asked about their conditions in returning to daily life activities and sports. Postoperative complications were observed.Results:All the patients were followed up for 24-47 months [(35±9)months]. AOFAS score, ATRS and VAS at 12 months after surgery were (87.9±6.6)points, (80.9±2.4)points and (2.0±0.3)points respectively, superior to those before surgery [(52.7±16.9)points, (42.0±4.4)points and (4.1±0.4)points respectively] ( P<0.05). The afore-mentioned results at the last follow-up were (95.2±7.2)points, (85.9±2.5)points and (0.8±0.3)points respectively, superior to those at 12 months after surgery ( P<0.05). MRI images of the affected ankle joints showed satisfactory healing of the reconstructed Achilles tendon at the last follow-up. All the patients, being negative in Thompson test at the last follow-up, were able to complete the heel lift on the affected side. All the patients resumed activities of daily living at the last follow-up, among whom 5 resumed to moderate- to high-intensity sports activities, such as basketball sport, and moderate-to high-intensity physical training, 5 resumed light-intensity sports activities such as jogging and swimming, and the other 4 did not resume sports due to fear of re-injury or aging. One patient had delayed wound healing, which was considered gout-related. One patient complained about mild pain at the Achilles tendon in cold weather or after long walks. No re-rupture of the Achilles tendon occurred. No patient complained about discomfort at the graft harvest site, calcaneal valgus or restricted ankle plantar flexion. Conclusions:For patients with chronic Achilles tendon rupture combined with tendon defects, reconstruction with half of peroneous longus tendon autograft facilitates postoperative spinal function recovery and pain alleviation, achieves satisfaction with the returning to daily activity and sports, and has few complications.

The ultrasonic manifestations of benign and malignant breast imaging-reporting and data system(BI-RADS)4 lesions overlap in some degrees,is able to result in unnecessary biopsy or untimely therapy.Accurate classifying the nature of BI-RADS 4 breast lesions can provide reliable references for clinical decision-making.The progresses of application of new ultrasonic technologies,including automated breast volume scanner,superb micro-vascular imaging,elastography,contrast-enhanced ultrasound and artificial intelligence for assisting diagnosis of BI-RADS 4 lesions were reviewed in this article.