OBJECTIVE To systematically evaluate the effects of supplementation with different doses of vitamin D on maternal and infant outcomes in vitamin D-deficient pregnant women. METHODS Related literature on the effects of supplementing different doses of vitamin D on maternal and infant outcomes was searched in databases including CNKI， Wanfang Data， VIP， PubMed， Medline， the Cochrane Library， Embase from their inception to June 30， 2025. The risk of bias assessment tool from the Cochrane Handbook 5.1 was used to evaluate the quality of included literature. Meta-analysis of outcome indicators was performed by using RevMan 5.4 software. RESULTS A total of 15 studies were included， involving 4 664 patients [2 129 in the experimental group （daily dose ＞2 000 IU）， 2 058 in control group 1 （daily dose ≤1 000 IU） and 477 in control group 2 （daily dose ＞1 000-≤2 000 IU） ] . Meta-analysis results showed that the incidence of preeclampsia （PE） [OR＝0.71， 95%CI （0.53， 0.96）， P ＝0.03 ] ， gestational diabetes mellitus （GDM） [OR＝0.60， 95%CI （0.43， 0.84）， P ＝0.003 ] ， low birth weight of newborn [OR＝0.72， 95%CI （0.53， 0.97）， P ＝0.03 ] and macrosomia [OR＝0.53， 95%CI （0.29， 0.98）， P ＝0.04 ] in the experimental group were significant lower than control group 1； but there was no significant difference in the incidence of premature delivery [OR＝0.86， 95%CI （0.65， 1.13）， P ＝0.28 ] ， cesarean delivery [OR＝0.92， 95%CI （0.74， 1.15）， P ＝0.48 ] or stillbirth rate [OR＝0.77， 95%CI （0.48， 1.24）， P ＝0.29 ] . The incidence of low birth weight of ne wborn [OR＝0.64， 95%CI （0.41， 0.98）， P ＝0.04 ] in the experimental group was significant lower than control group 2； but there was no significant difference in the incidence of PE [OR＝0.61， 95%CI （0.25， 1.49）， P ＝0.28 ] ， the incidence of GDM [OR＝0.73， 95%CI （0.42， 1.24）， P ＝0.24 ] ， premature delivery rate [OR＝0.90， 95%CI （0.59， 1.39）， P ＝0.63 ] ， cesarean delivery rate [OR＝0.92， 95%CI （0.64， 1.33）， P ＝0.66 ] ， or stillbirth rate [OR＝0.68， 95%CI （0.24， 1.94）， P ＝0.48 ] . CONCLUSIONS Different doses of vitamin D supplementation in early pregnancy have a significant impact on maternal and infant pregnancy outcomes in vitamin D-deficient pregnant women； daily doses ＞2 000 IU have significant advantages in reducing the incidence of PE and GDM and improving the outcome of premature delivery.

Objective To investigate the clinical effectiveness of a nursing safety program for laying moxibustion treatment in sub-health population based on the Delphi method.Methods 160 sub-health patients who sought treatment between April 2022 and August 2024 in Hangzhou Red Cross Hospital were selected and randomly divided into observation group(n=80)and control group(n=80).Both groups received laying moxibustion rehabilitation therapy.The control group received routine nursing care,while the observation group received nursing intervention based on the laying moxibustion nursing safety program developed through the Delphi method.Results Through Delphi method questionnaire survey of 15 experts,three main factors affecting laying moxibustion safety were identified and 11 specific nursing points were established.The incidence of adverse events in observation group was significantly lower than that in control group(P＜0.05),and nursing satisfaction was significantly higher than that in control group(P＜0.05).Conclusion The laying moxibustion nursing safety program constructed based on the Delphi method can effectively enhance the clinical safety of laying moxibustion treatment.

As a symbiotic microbial community within the human body,the gut microbiota plays a crucial role in modulating various physiological processes,including metabolism,immunity,and endocrine function.During allogeneic hematopoietic stem cell transplantation(allo-HSCT),the hematopoietic and immune systems undergo significant changes,which are also influenced by the gut microbiota.Specifically,regarding hematopoietic function,the gut microbiota facilitates the multi-lineage differentiation of hematopoietic stem cells via NOD1-STATs and TLRs-MyD88 signaling pathways,and promotes rapid granulomonocytic lineage differentiation under infection stress.Consequently,early-stage primary graft dysfunction following transplantation may be associated with gut microbiota dysbiosis.In terms of immune function,the gut microbiota enhances the expression of antigen-presenting molecules on intestinal epithelial cells,thereby initiating acute graft-versus-host disease(aGVHD)in the gastrointestinal tract.Moreover,the gut microbiota regulates intestinal immune function through metabolites such as short-chain fatty acids,bile acids,and indole derivatives.Dysbiosis of the gut microbiota can lead to disrup-tion of the intestinal mucus barrier and immune barrier functions,further promoting the onset and progression of aGVHD in the gastrointestinal tract.Therefore,targeting the gut microbiota has emerged as an attractive therapeutic strategy and has been clinically applied.Notably,fecal microbiota transplantation combined with immunosuppressive therapy has shown significant efficacy in alleviating clinical severity and improving prognosis in steroid-refractory aGVHD,demonstrating high safety and manageable adverse reactions,representing a novel breakthrough in its treatment.

Objective:To investigate the relationship between serum histone deacetylase-3(HDAC3)and the severity of endometriosis(EMT).Methods:The clinical data of 109 EMT patients admitted to the Affiliated Hospi-tal of Inner Mongolia Medical University from June 1,2021 to November 30,2023 were extracted and analyzed.Pa-tients were divided into stage Ⅰ/Ⅱ group(56 cases)and stage Ⅲ/Ⅳ group(53 cases)according to the revised EMT staging criteria of the American Society for Reproductive Medicine(ASRM).Univariate analysis and binary Logistic regression were used to analyze the correlation factors between serum HDAC3 and the severity of EMT patients,and receiver operating characteristic(ROC)curve was plotted and the area under the curve(AUC)was calculated to evaluate the diagnostic value of stage Ⅲ/Ⅳ EMT.Results:The levels of serum HDAC3,human epididymal protein 4(HE4),serum carbohydrate antigen 125(CA125),vascular endothelial growth factor(VEGF),platelet to lymphocyte count ratio(PLR),and fibrinogen(Fib)in stage Ⅲ/Ⅳ patients were significantly higher than those in stage Ⅰ/Ⅱ patients,with statistical significant differences(P＜0.05).Binary Logistic regres-sion analysis showed that serum HDAC3,CA125,and VEGF were related factors affecting stage Ⅲ/Ⅳ EMT pa-tients(OR＞1,P＜0.05).The ROC curve showed that the AUC of serum HDAC3,CA125,and VEGF for phaseⅢ/Ⅳ EMT evaluation were 0.898,0.701,and 0.795,respectively,and the AUC for combined detection evaluation was 0.956.Conclusions:The serum HDAC3 level is related to the severity of EMT patients,and gradually increa-ses with the increase of EMT staging.HDAC3 combined with CA125 and VEGF has a high preoperative evaluation value for stage Ⅲ/Ⅳ EMT patients.

Objective:To develop and validate a clinical warning model for severe pediatric community-acquired pneumonia (CAP) using electronic health records.Methods:A retrospective cohort study was conducted, analyzing clinical data of 15 750 children hospitalized for CAP at Wuhan Children′s Hospital between January 1, 2019, and December 31, 2023. Patient data were randomly split into training and testing sets at a 7∶3 ratio. Six supervised machine learning models were constructed in the training set, optimized using five-fold cross-validation, and evaluated in the testing set. Model performance was assessed using ROC-AUC, sensitivity, specificity, positive predictive value, negative predictive value, calibration curves, and clinical decision curve analysis at optimal thresholds. The best-performing model was selected, and SHapley Additive exPlanations (SHAP) were used to interpret feature importance. A program interface was developed based on the model results, enabling integration into clinical decision support systems for automated early warning.Results:A total of 15 750 participants, ranging in age from 28 days to 18 years, were included in the study. The median age was 2 years [interquartile range (IQR): 0-4 years], with 9 555 males (60.67%) and 6 195 females (39.33%). Among them, 2 211 (14.04%) developed severe pneumonia. In the prediction models, XGB outperformed other models with an ROC-AUC of 0.884 (95% CI: 0.870-0.898), sensitivity (0.803, 95% CI: 0.772-0.832), specificity (0.828, 95% CI: 0.816-0.839). Calibration analysis showed strong agreement between predicted and observed risks (Brier score: 0.081, 95% CI: 0.075-0.086). The analysis based on the SHAP method revealed that respiratory rate, heart rate, T-lymphocyte subsets, and red blood cell volume distribution width-SD are predictive factors for severe progression of community-acquired pneumonia (CAP) in children. Conclusion:An interpretable machine learning model was developed for the early detection and personalized treatment planning of severe CAP in children, providing valuable support to clinicians.

AIM:To investigate the association between long noncoding RNA(lncRNA)growth arrest-specific transcript 5(GAS5)genetic polymorphism and the onset of polycystic ovary syndrome(PCOS).METHODS:The case-control study was performed,selecting 236 PCOS patients diagnosed at the Reproductive Medicine Center of the Affiliated Hospital of Guangxi Youjiang University for Nationalities from May 2018 to May 2019 as the case group,while 277 healthy women matched in sex and age during the same period were selected as the control group.The iMLDR single nucleotide polymorphism(SNP)was used to detected the genotypes of rs145204276 I/D,rs55829688 C/T and rs6790 G/A in GAS5 gene.The correlation between GAS5 gene polymorphism and PCOS was analyzed using logistic regression.RESULTS:The difference of GAS5 gene rs145204276 I/D polymorphism had statistical significance between control group and PCOS group.Logistic regression analysis showed that compared with the I/I genotype,the I/D and D/D genotypes,as well as the dominant model I/D+D/D,had a reduced risk of PCOS[I/D vs I:OR(95%CI)=0.61(0.42,0.88),P=0.009;D vs I/I:OR(95%CI)=0.44(0.23,0.84),P=0.013;I/D+D vs I/I:OR(95%CI)=0.57(0.40,0.81),P=0.002].Compared with the I allele,the D allele significantly reduced the risk of PCOS[D vs I:OR(95%CI)=0.62(0.47,0.82),P=0.001).There was no statistically significant difference in the polymorphism of rs55829688 C/T and rs6790 G/A between control group and PCOS group(P＞0.05).The combined analysis of haplotypes showed that the difference of D-T-A haplo-type distribution was statistically significant between control group and PCOS group[OR(95%CI)=0.61(0.45,0.84),P=0.002].CONCLUSION:The polymorphism of GAS5 gene rs145204276 I/D may be associated with genetic suscepti-bility to PCOS,and individuals carrying the D allele may have a reduced risk of developing PCOS.

As a symbiotic microbial community within the human body,the gut microbiota plays a crucial role in modulating various physiological processes,including metabolism,immunity,and endocrine function.During allogeneic hematopoietic stem cell transplantation(allo-HSCT),the hematopoietic and immune systems undergo significant changes,which are also influenced by the gut microbiota.Specifically,regarding hematopoietic function,the gut microbiota facilitates the multi-lineage differentiation of hematopoietic stem cells via NOD1-STATs and TLRs-MyD88 signaling pathways,and promotes rapid granulomonocytic lineage differentiation under infection stress.Consequently,early-stage primary graft dysfunction following transplantation may be associated with gut microbiota dysbiosis.In terms of immune function,the gut microbiota enhances the expression of antigen-presenting molecules on intestinal epithelial cells,thereby initiating acute graft-versus-host disease(aGVHD)in the gastrointestinal tract.Moreover,the gut microbiota regulates intestinal immune function through metabolites such as short-chain fatty acids,bile acids,and indole derivatives.Dysbiosis of the gut microbiota can lead to disrup-tion of the intestinal mucus barrier and immune barrier functions,further promoting the onset and progression of aGVHD in the gastrointestinal tract.Therefore,targeting the gut microbiota has emerged as an attractive therapeutic strategy and has been clinically applied.Notably,fecal microbiota transplantation combined with immunosuppressive therapy has shown significant efficacy in alleviating clinical severity and improving prognosis in steroid-refractory aGVHD,demonstrating high safety and manageable adverse reactions,representing a novel breakthrough in its treatment.

Objective:To evaluate the efficacy and safety of nebulized inhalation of recombinant human interferon (IFN) α1b injection in the treatment of respiratory syncytial virus (RSV) associated lower respiratory tract infections (pneumonia and bronchiolitis) in children.Methods:A randomized, double-blind, parallel, placebo-controlled add-on design was used.Children with pneumonia or bronchiolitis aged 2 months to 5 years who tested positive for RSV antigen within 72 hours of onset from 30 clinical trial sites including Beijing Children′s Hospital, Capital Medical University between February 2021 and December 2022 were included in this study and randomly divided into 2 groups at a ratio of 1∶1 based on a stratified-block method.Both groups received basic treatments such as cough control, asthma relieving, expectorant treatment, fever reduction, oxygen therapy, etc.The experimental group received additional nebulized inhalation of IFN α1b injection at a dose of 2.0 μg/(kg·time), twice a day.The control group received nebulized inhalation of placebo twice a day.Clinical efficacy was evaluated based on indicators such as the duration of clinical symptoms and signs, and the Kaplan-Meier method was used to calculate the median and 95% CI of the duration of clinical symptoms and signs.The Log-rank test was used to compared data between groups.Safety was assessed through the incidence of adverse reactions and laboratory tests, and the Chi-square test was used to analyze the difference between groups. Results:There were 123 children in the experimental group and 122 children in the control group.The median durations of all the 5 clinical symptoms and signs [including shortness of breath, wheezing, dyspnea (visible retractions), decreased transcutaneous oxygen saturation, and abnormal mental state] in the experimental group after treatment were slightly shortened than those in the control group [2.7 d(95% CI: 1.9-3.0 d)] vs.[2.9 d(95% CI: 2.6-3.6 d), P=0.027].The improvement in dyspnea (retractions) was especially pronounced in the experimental group, with a relief rate of 50.0% (0, 100%) on the first day of administration[compared with 0 (0, 50.0%) in the control group ( Z=2.002, P=0.025)].The median duration of dyspnea in the experimental group was nearly 1 day shorter than that in the control group [1.0 d(95% CI: 0.7-1.7 d) vs.1.8 d(95% CI: 1.0-2.5 d), P=0.046].There were no significant difference in hospital stay [6.0(5.0, 8.0) d vs.6.5(5.0, 8.0) d, Z=0.675, P=0.500], oxygen therapy duration [32.0(14.0, 96.3) h vs.39.0 (24.0, 83.2) h, Z=0.094, P=0.925], the recovery rate from clinical symptoms during treatment [(105/106, 99.1%) vs.(96/101, 95.0%)], and recurrence rate [(0/106, 0) vs.(2/101, 2.0%)] between the 2 groups (all P>0.05).However, the above-mentioned four indicators in the experimental group showed a trend of clinical benefits.The quantitative virus detection results showed that the RSV viral load in both groups decreased after treatment compared to before treatment.After 2 days of treatment, the decline rate of RSV viral load from the baseline was 0.90 lg copies/(mL·d) in the experimental group and 0.25 lg copies/(mL·d)in the control group, with a statistically significant difference ( P<0.05).Furthermore, there was no statistically significant difference in the incidence of adverse reactions between the 2 groups ( P>0.05).Importantly, no drug-related serious adverse reactions occurred in both groups. Conclusions:The nebulized inhalation therapy of IFN α1b demonstrates efficacy and safety in treating pediatric RSV associated lower respiratory tract infections.It particularly offers outstanding clinical therapeutic value for severe children.

Objective:To explore the mediating effect of illness acceptance between self-compassion and rehabilitation motivation in stroke patients with partial disability.Methods:By convenience sampling method, stroke patients who attended the neurology outpatient clinic of Xinxiang Central Hospital from February to December 2024 were selected as the research subjects. The General Information Questionnaire, Self-Compassion Scale (SCS), Chinese version of Acceptance of Illness Scale (AIS-CHI), and Stroke Rehabilitation Motivation Scale (SRMS) were used for the survey. Pearson correlation analysis was applied to analyze the relationships among self-compassion, illness acceptance, and rehabilitation motivation. AMOS 21.0 software was used to establish a structural equation model and verify the mediating effect.Results:A total of 300 questionnaires were distributed, and 289 valid ones were recovered, with an effective recovery rate of 96.33%. Among the 289 stroke patients with partial disability, the total score of SCS was (65.73±5.50), the total score of AIS-CHI was (17.46±5.62), and the total score of SRMS was (77.18±10.97). Pairwise positive correlations were found between self-compassion, illness acceptance, and rehabilitation motivation (all P<0.05). Self-compassion had a direct positive effect on rehabilitation motivation ( β=0.328, P<0.01) and a direct positive effect on illness acceptance ( β=0.439, P<0.01). Illness acceptance played a partial mediating role between self-compassion and rehabilitation motivation, and the mediating effect accounted for 31.38% of the total effect (0.150/0.478) . Conclusions:The levels of self-compassion, illness acceptance, and rehabilitation motivation in stroke patients with partial disability need to be further improved. Illness acceptance exerts a partial mediating effect between self-compassion and rehabilitation motivation. Clinically, the rehabilitation motivation of patients can be enhanced by improving their levels of self-compassion and illness acceptance.

Objective:To investigate the relationship between serum histone deacetylase-3(HDAC3)and the severity of endometriosis(EMT).Methods:The clinical data of 109 EMT patients admitted to the Affiliated Hospi-tal of Inner Mongolia Medical University from June 1,2021 to November 30,2023 were extracted and analyzed.Pa-tients were divided into stage Ⅰ/Ⅱ group(56 cases)and stage Ⅲ/Ⅳ group(53 cases)according to the revised EMT staging criteria of the American Society for Reproductive Medicine(ASRM).Univariate analysis and binary Logistic regression were used to analyze the correlation factors between serum HDAC3 and the severity of EMT patients,and receiver operating characteristic(ROC)curve was plotted and the area under the curve(AUC)was calculated to evaluate the diagnostic value of stage Ⅲ/Ⅳ EMT.Results:The levels of serum HDAC3,human epididymal protein 4(HE4),serum carbohydrate antigen 125(CA125),vascular endothelial growth factor(VEGF),platelet to lymphocyte count ratio(PLR),and fibrinogen(Fib)in stage Ⅲ/Ⅳ patients were significantly higher than those in stage Ⅰ/Ⅱ patients,with statistical significant differences(P＜0.05).Binary Logistic regres-sion analysis showed that serum HDAC3,CA125,and VEGF were related factors affecting stage Ⅲ/Ⅳ EMT pa-tients(OR＞1,P＜0.05).The ROC curve showed that the AUC of serum HDAC3,CA125,and VEGF for phaseⅢ/Ⅳ EMT evaluation were 0.898,0.701,and 0.795,respectively,and the AUC for combined detection evaluation was 0.956.Conclusions:The serum HDAC3 level is related to the severity of EMT patients,and gradually increa-ses with the increase of EMT staging.HDAC3 combined with CA125 and VEGF has a high preoperative evaluation value for stage Ⅲ/Ⅳ EMT patients.