OBJECTIVE To compare the efficacy and safety of different daily doses of aspirin in the prevention of preeclampsia （PE）. METHODS The case-control studies and prospective randomized controlled trials on aspirin with daily dose ≥ 100 mg （trial group） vs. ＜100 mg （control group） in the prevention of PE were retrieved from PubMed， Medline， Embase， the Cochrane Library， CNKI， China Biomedical Literatue Database and Wanfang Data from base-building to January 2025. After literature screening， data extraction and quality evaluation， meta-analysis was performed by using RevMan 5.3 software. RESULTS A total of 11 literatures were included， involving 3 052 pregnant women. Meta-analysis showed the incidence of PE [RR＝0.63， 95%CI （0.53，0.76）， P＜0.000 01]， gestational hypertension [RR＝0.69， 95%CI （0.50，0.94），P＝0.02]， preterm birth [RR＝0.56， 95%CI （0.47，0.66）， P＜0.000 01]， and intrauterine growth retardation [RR＝0.73，95%CI （0.61，0.87），P＝0.000 5] in trial groups were significantly lower than control group. The incidence of postpartum hemorrhage between the two groups had no statistically significant difference [RR＝1.17， 95%CI （0.90，1.53），P＝0.25]. Subgroup analysis showed that the incidence of PE in Chinese pregnant women taking 150 mg of aspirin was significantly higher than taking 100 mg of aspirin [RR＝3.40， 95%CI （1.29， 8.93）， P＝0.01]； but there was no significant difference between the two groups in the incidences of postpartum hemorrhage， preterm birth （P＞0.05）. CONCLUSIONS Aspirin with daily dose ≥100 mg is more effective in preventing PE than daily dose ＜100 mg， with lower rates of gestational hypertension， preterm birth， and intrauterine growth retardation. It does not increase the risk of postpartum hemorrhage. For pregnant women in China， daily dose 100 mg of aspirin may be more effective in preventing PE than 150 mg.

Objective To investigate the effect and mechanism of circular RNA nuclear receptor interacting protein 1(circNRIP1)expression on exhaustion of CD8+T cells in cervical cancer cells.Methods Real-time quantitative PCR was used to detect the expression of circNRIP1 in cervical epithelial cells HCerEpic and cer-vical cancer cells C-33A,Hela,SiHa,and CS121.C-33A cells were divided into Vector group,circNRIP1 group,and circNRIP1+miR-138-5p group,while CS121 cells were divided into sh-NC group,sh-circNRIP1 group,and sh-circNRIP1+miR-138-5p inhibitor.Human peripheral blood CD8+T cells were extracted,and C-33A cells in Vector group and circNRIP1 group were co-incubated with CD8+T cells for 24 hours(CD8+T/Vector group and CD8+T/Vector group).CS121 cells in sh-NC group and sh-circNRIP1 group were co-incu-bated with CD8+T cells for 24 hours(CD8+T/sh NC group and CD8+T/sh-circNRIP1 group).Cytotoxicity experiments were conducted to detect the killing ability of CD8+T cells,ELISA was used to detect the levels of interleukin(IL)-2,interferon(IFN)-γ,and tumor necrosis factor(TNF)-α in the cell supernatant.Flow cy-tometry was used to detect the expression of programmed death receptor-1(PD-1),T cell Immunoglobulin domain and Mucin domain protein-3(TIM3),and lymphocyte activation gene 3(LAG3)in CD8+T cells.Dual luciferase reporter gene experiments were conducted to verify the targeting relationship between circNRIP1 and miR-138-5p,as well as the targeting relationship between miR-138-5p and PD-L1.Results The expres-sions of circNRIP1 in C-33A,Hela,SiHa,and CS121 cells were significantly higher than those in HCerEpic(P＜0.05).The killing ability of CD8+T cells against C-33A cells in the circNRIP1 group was lower than their killing ability against Vector group cells.The levels of IL-2,IFN-γ,and TNF-α secreted by CD8+T cells in the CD8+T/circNRIP1 group were significantly lower than those in the CD8+T/Vector group(P＜0.05),and the levels of PD-1,LAG-3,and TIM-3 expressed by CD8+T cells in the CD8+T/circNRIP1 group were al-so significantly higher than those in the CD8+T/Vector group(P＜0.05).The killing ability of CD8+T cells against sh-circNRIP1 group CS121 cells was higher than their killing ability against sh-NC group cells(P＜0.05).The levels of IL-2,IFN-γ,and TNF-α secreted by CD8+T cells in the CD8+T/sh-circNRIP1 group were significantly higher than those in the CD8+T/sh-NC group(P＜0.05).The PD-1,LAG-3,and TIM-3 levels of CD8+T cells in the CD8+T/sh-circNRIP1 group were also significantly lower than those in the CD8+T/sh-NC group(P＜0.05).The results of the dual-luciferase reporter gene experiment showed that miR-138-5p was the target gene of circNRIP1,and PD-L1 was the target gene of miR-138-5p.Conclusion circNRIP1 can in-duce the exhaustion of CD8+T cells by upregulating the expression of PD-L1.

Objective To investigate the expression of circular RNA ubiquitin-associated protein 2(circ-UBAP2)and RAS-related C3 botulinum toxin substrate 1(Rac1)in cervical cancer tissues and their relation-ship with radiotherapy efficacy and prognosis.Methods A total of 96 patients with cervical cancer admitted to the hospital from January 2019 to May 2021 were selected as the research subjects.Detect the expression of circ-UBAP2 and Rac1 in the cancer tissues and adjacent tissues of the patients.The clinical data of the patients were recorded.According to the radiotherapy efficacy,they were divided into patients with effective radiother-apy(n=62)and patients with ineffective radiotherapy(n=34),and the relationship between the expressions of circ-UBAP2 and Rac1 and the radiotherapy efficacy was analyzed.The survival conditions of the patients were followed up for 3 years and they were divided into the survival group(n=81)and the death group(n=15),and the clinical data of the two groups were compared.The relationship between the expressions of circ-UBAP2 and Rac1 and the survival prognosis of patients was analyzed by Kaplan-Meier.The risk factors influ-encing the prognosis of patients were analyzed by Cox regression.Results The circ-UBAP2 expression and the positive rates of Rac1 expression in cancer tissues were both higher than those in adjacent tissues,and the difference was statistically significant(P＜0.05).The effective rate of radiotherapy in patients with high ex-pression of circ-UBAP2 and Rac1 in cancer tissues was lower than that in patients with low expression of circ-UBAP2 and Rac1,and the difference was statistically significant(P＜0.05).The 3-year overall survival rate and average survival duration of patients with high expression of circ-UBAP2 and Rac1 in cancer tissues were lower than those of patients with low expression of circ-UBAP2 and Rac1,and the difference was statistically significant(P＜0.05).There were statistically significant differences in clinical stage,tumor differentiation degree,expressions of circ-UBAP2 and Rac1,and the proportion of lymph node metastasis between the two groups(P＜0.05).The results of Cox regression analysis showed that clinical stage Ⅱ B-Ⅲ,poorly differen-tiated tumor degree,high expression of circ-UBAP2 and Rac1,and lymph node metastasis were risk factors af-fecting the prognosis of patients(P＜0.05).Conclusion circ-UBAP2 and Rac1 are abnormally highly ex-pressed in cervical cancer tissues and are related to the radiotherapy efficacy and prognosis.

Objective To investigate the expression levels of micro RNA-651(miR-651)and the transcrip-tion factor Forkhead Box N2(FOXN2)in lung cancer tissues and to analyse their relationship with patients' prognosis after lobectomy.Methods A total of 98 patients with lung cancer who underwent lobectomy from January 2020 to December 2021 in Nantong Cancer Hospital were selected as research objects,the lung cancer tissue specimens and corresponding paracancerous tissue specimens of patients were collected,the expression levels of miR-651 and FOXN2 were detected by real-time fluorescence quantitative PCR(qPCR),and their re-lationship with the prognosis of patients after lobectomy was analyzed.Results At 2-year follow-up,19(19.39％)of 98 patients had recurrent metastasis,and the median time to recurrent metastasis was 20 months(95％CI:18.626--21.374).qPCR assay showed that the expression levels of miR-651 and FOXN2 in lung cancer tissues were significantly lower than those in paracancerous tissues(P＜0.05).miR-651 and FOXN2 expression levels were significantly correlated with clinicopathological features such as tumour size,TNM stage and lymph node metastasis(P＜0.05).The results of univariate Cox regression analysis showed that the percentages of maximum tumor diameter ≥3 cm,TNM stage Ⅱ,lymph node metastasis,miR-651 low ex-pression and FOXN2 low expression were higher in the poor prognosis group than those in the good prognosis group(P＜0.05).Multifactorial Cox regression analysis showed that maximum tumor diameter ≥ 3 cm(HR=3.185,95％CI:1.105-9.182),TNM stage Ⅱ(HR=5.167,95％CI:1.939-13.771),lymph node metastasis(HR=2.860,95％CI:1.115-7.338),low miR-651 expression(HR=5.345,95％CI:1.845-15.483)and low FOXN2 expression(HR=5.404,95％CI:1.744-16.745)were independent risk factors for the prognosis of lung cancer patients after lobectomy(P＜0.05).Conclusion The expression levels of miR-651 and FOXN2 were reduced in the tissues of lung cancer patients,and both were associated with tumour size,TNM stage,lymph node metastasis,and patients' prognosis after lobectomy.

Objective:To explore the effects and safety of Qigong Pills in IVF-ET outcome of PCOS infertility patients with phlegm-dampness type.Methods:A randomized controlled trial study was carried out. In the Reproductive and Genetic Medicine Center of Dalian Women and Children Medical Center (Group) from January 2021 to December 2023, 60 patients with sputum and damp-induced PCOS infertility assisted by in-vitro fertilization and embryo transfer (IVF-ET) were enrolled and randomly divided into 2 groups by block randomization method, with 30 cases in each group. Patients in both groups took ethinylestradiol cyproterone tablets orally on the 2nd to 5th day of the 1st menstrual cycle before IVF-ET cycle, and received down-regulation treatment on the 18th to 20th day of menstruation. After confirming that the down-regulation standard was reached, Qigong Pills was added to the treatment group, and placebo was taken orally until the trigger day. Two groups of patients underwent transvaginal ultrasound-guided ovarian aspiration after injection of chorionic gonadotropin (hCG) for 24-36 h. The total amount of Gn, the days of Gn, the endometrial thickness of HCG, the number of eggs obtained, the rate of diprokaryotic (2PN) fertilization, the number of transferable embryos, the number of high-quality embryos, the rate of high-quality embryos, the incidence of OHSS and the clinical pregnancy rate were compared between the two groups.Results:Among the 60 patients, 28 cases in the final treatment group and 27 cases in the control group were included in the outcome index evaluation. During controlled hyperstimulation (COH), the total Gn [2 025 (1 575, 2 325) U vs. 2 700 (2 025, 3 150) U, Z=-3.67] and the number of Gn days of the treatment group [10 (8,11) d vs. 11 (9,13) d, Z=-2.31] were lower than those in control group ( P<0.001 or P<0.05). There was no statistical significance in endometrial thickness between 2 groups on HCG day ( P>0.05); the number of high-quality embryos [3 (3, 4) vs. 2 (2, 3), Z=0.11] and the rate of high-quality embryos [46.28% (87/188) vs. 35.19% (57/162), Z=4.42] in the treatment group were higher than those in the control group ( P<0.05). There was no statistical significance in the number of eggs obtained, the fertilization rate of 2PN and the number of transferable embryos between the two groups ( P>0.05). The incidence of OHSS was 3.6% (1/28) in the treatment group and 11.1% (3/27) in the control group, without statistical significance ( P=0.352). The clinical pregnancy rate was 53.6% (15/28) in the treatment group and 37.0% (10/27) in the control group, without statistical significance ( P=0.218). There was no significant difference in the safety indexes of liver and kidney function between 2 groups ( P>0.05). Conclusion:Qigong Pills combined with IVF-ET can effectively reduce the total amount of Gn and the number of days of treatment in PCOS infertility patients with phlegm-dampness type, increase the number and rate of high-quality embryos, and improve the outcome of IVF-ET, and it is safe and effective.

Objective To analyze the epidemiological characteristics and disease burden of drug-resistant tuberculosis cases among elderly patients in Wuhan.Methods Clinical data of elderly pa-tients with pulmonary tuberculosis in Wuhan from January 2019 to December 2022 were retrospectively analyzed.Sputum samples were collected for Mycobacterium tuberculosis isolation,and drug suscepti-bility testing was performed using the proportion method.The epidemiological characteristics of drug-resistant tuberculosis and the direct economic burden of the patients were analyzed.Results A total of 972 elderly patients with positive Mycobacterium tuberculosis tests were included.The overall tuberculosis drug resistance rate was 21.19％(206/972).Male,rural residence,lower education level(primary school or below)and retreatment history significantly increased the risk of developing drug-resistant tu-berculosis(P＜0.05).The direct economic burden for elderly patients with drug-resistant tuberculosis was 24,101.52(8,283.98,39,598.89)RMB,and the indirect economic burden was 1,858.64(528.66,3,085.26)RMB.Conclusion The incidence of drug resistance in elderly tuberculosis is high,and male,rural residence,low education level and tuberculosis retreatment are the risk factors for drug resistance in elderly tuberculosis,and their economic burden is heavy after drug resistance.

Objective:To search and summarize the best evidence for preoperative prehabilitation in patients with lung cancer complicated by chronic obstructive pulmonary disease and to inform the management of preoperative prehabilitation in patients with lung cancer combined with COPD by clinical providers.Methods:Systematically guideline websites, professional society websites, evidence-based databases, and comprehensive databases were searched for types of literature including clinical decision making, guidelines, expert consensus, evidence summaries, systematic evaluations, Meta-analyses, and randomized controlled trials. The time for the retrieval was from the inception of databases until October 31th, 2023. And the quality of the included literature was evaluated and evidence was extracted, evaluated the quality of the included literature, and extracted evidence.Results:Finally, 18 articles were included, including 8 guidelines, 8 expert consensus, and 2 systematic reviews. Summarized the 30 best evidence in 4 areas of prerehabilitation: need, timing, location, content (including smoking cessation management, respiratory exercise, exercise, nutritional support, and medication management).Conclusions:This study summarizes the best evidence for preoperative prehabilitation in patients with lung cancer combined with chronic obstructive pulmonary disease, and healthcare professionals should be mindful of the need to develop preoperative prehabilitation protocols judiciously, taking into account the specific clinical context during the subsequent translation of the evidence to the clinic.

Using the liquid chromatography-tandem mass spectrometry (LC-MS/MS) to determine the plasma level of Lyso-GL3 in patients with Fabry disease and to analyze the clinical application of the method.

BACKGROUND:In the past,it was necessary to cut off the pronator quadratus muscle in the treatment of distal radius fractures.Failure to repair the pronator quadratus muscle can lead to a series of complications. OBJECTIVE:To explore the clinical efficacy of different methods of preserving the pronator quadratus muscle combined with a palmar steel plate in the treatment of distal radius fractures. METHODS:Clinical data of 66 patients with distal radius fractures were retrospectively included,divided into the traditional Henry approach group(group A),the split brachioradialis tendon approach group(group B),and the posterior pronator quadratus muscle approach group(group C),with 22 patients in each group.Postoperative internal fixation,fracture healing,and postoperative complications were observed in the three groups.The visual analog scale score of postoperative wrist pain and forearm rotation angle were compared among the three groups.The Dienst Joint Scale was used to evaluate the wrist function of patients. RESULTS AND CONCLUSION:(1)The surgical time,intraoperative blood loss,and fracture healing time of groups B and C were significantly lower than those of group A(P<0.01).There was no significant difference in intraoperative blood loss and fracture healing time between groups B and C,but the surgical time was shorter in group B.(2)The anteroposterior and lateral wrist X-ray examination 3 days and 1 and 3 months after surgery exhibited that there were no significant differences in radial height,palm angle,and ulnar deviation angle among the three groups(P>0.05).No significant difference was detected in various indicators during the same phase among the three groups(P>0.05).(3)At a follow-up of 12 months after surgery,there were no significant differences in visual analog scale scores and forearm rotation angle among the three groups.However,the evaluation results at 1 and 3 months after surgery demonstrated significant differences in visual analog scale scores and forearm rotation angle among the three groups(P<0.05).Among them,group C had a lower visual analog scale score and a larger forearm rotation angle.(4)According to the Dienst joint scoring standard,the excellent and good rate of wrist joint function evaluation was 86%(19/22),91%(20/22),and 95%(21/22)in groups A,B,and C,respectively 12 months after surgery.(5)All patients did not experience any postoperative vascular or neurological damage or surgical site infection.Group A had three cases of tendon irritation,two cases of traumatic arthritis,and two cases of carpal tunnel syndrome.In group B,tendon irritation occurred in 1 case and joint stiffness in 1 case.There was 1 case of traumatic arthritis and 1 case of carpal tunnel syndrome in group C.(6)It is suggested that different surgical methods for treating distal radius fractures have achieved good clinical results.Placing a steel plate under the pronator muscle can alleviate early postoperative pain,promote early activity,and restore normal life.The brachioradialis tendon approach has more advantages in exposing intraoperative fractures and can shorten the surgical time.

ObjectiveTo evaluate the validity of four screening questionnaires on chronic obstructive pulmonary disease (COPD) among community residents in Shanghai, and to provide a scientific basis for selecting suitable screening questionnaires and plans for the community use. MethodsA multi-stage random sampling method was used to select community residents aged ≥40 for COPD questionnaire screening and spirometry. The screening questionnaires included the COPD Population Screener Questionnaire (COPD-PS), the COPD Screening Questionnaire (COPD-SQ), the COPD Diagnosis Questionnaire (CDQ), and the Lung Function Questionnaire (LFQ). The diagnostic gold standard for COPD was defined as a ratio of post-bronchodilator forced expiratory volume in one second to forced vital capacity (FEV1/FVC) less than 0.7. The receiver operating characteristic (ROC) curve was used to assess the validity of each questionnaire, and DeLong’s test was used to compare the area under the curve (AUC) of different questionnaires. ResultsAmong the 1 122 residents screened, 99 (8.8%) were diagnosed with COPD based on the gold standard criteria. The AUC values for the four questionnaires ranged from 0.643 to 0.682, with no statistically significant differences in screening accuracy among them (P>0.05). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for each questionnaire at recommended cut-off points were as follows: COPD-PS (sensitivity: 33.3%, specificity: 84.9%, PPV: 17.6%, NPV: 92.9%), COPD-SQ (34.3%, 85.8%, 19.0%, 93.1%), CDQ (73.7%, 42.4%, 11.0%, 94.4%), and LFQ (48.5%, 74.8%, 15.7%, 93.8%). Optimal cut-off values for this population differed from the recommended values. When selecting the optimal cut-off value, the sensitivity of COPD-PS (58.6%), COPD-SQ (55.6%), and LFQ (64.7%) increased, while the specificity of CDQ (75.9%) increased. The AUC of sequential lung function testing for all four screening questionnaires increased to 0.7 or above. The optimal cut-off values for the four questionnaires in this population differed from the recommended values. When applying the optimal cut-off values, the sensitivity of three questionnaires increased: COPD-PS (58.6%), COPD-SQ (55.6%), and LFQ (64.7%), while the specificity of CDQ rose to 75.9%. The AUC of each questionnaire increased to above 0.7 when followed by sequential lung function testing. ConclusionThe COPD-PS, COPD-SQ, CDQ, and LFQ have limited value for COPD screening among Shanghai community residents, indicating that further refinement of these tools is needed.