Objective:To explore the effectiveness of predictive exercise intervention combined with information-knowledge-attitude-practice (IKAP) model-based nursing in patients with gestational hypertension (GH) .Methods:Convenience sampling was used to select 130 GH patients admitted to Taizhou Hospital of Zhejiang Province from January 2022 to December 2024 for the study. Sixty-five GH patients admitted from January 2022 to June 2023 were set as control group, and 65 GH patients admitted from July 2023 to December 2024 were set as observation group. Control group implemented conventional nursing, and observation group was treated with predictive exercise intervention combined with IKAP model-based nursing on the basis of conventional nursing. Depression, delivery outcomes, and incidence of complications were compared between two groups of GH patients after intervention.Results:During the study period, no patients were excluded from observation group and one patient was withdrawn from control group for personal reasons, resulting in the inclusion of 64 patients. Patients in observation group at 6 weeks postpartum had lower scores on the Chinese version of the Edinburgh Postnatal Depression Scale than those in control group, and the incidence of premature labor, cesarean section, and lower limb swelling were lower than those in control group, and the differences were all statistically significant ( P<0.05) . Conclusions:Predictive exercise intervention combined with IKAP model-based nursing can improve the coagulation function of GH patients, reduce the incidence of lower limb swelling, alleviate the patient's postpartum depression, and facilitate safe delivery.

As the location with special public health environments,funeral parlors are of paramount importance in the prevention and control of infectious diseases as well as disinfection practices.This paper analyzes the unique hy-gienic characteristics of funeral parlors,summarizes relevant laws,regulations,standards,and literatures in funeral parlors at home and abroad,and elaborates the problems relevant to infection prevention and control in funeral par-lors from perspectives of body disposal risks,microbial contamination characteristics in funeral parlors,and the current status of staff's knowledge on infectious diseases.It aims to enhance the professional prevention and control capabilities of funeral service personnel and management personnel,ensure the health and safety of service recipients and staff,optimize service quality,provide theoretical basis and practical guidance for forming a sound infectious disease prevention and control system for funeral service institutions,and clarify research directions for the preven-tion and control of infectious diseases in funeral parlors in the future.

Objective To investigate the relationship between 418 C>G polymorphism of tissue metalloproteinase inhibitor-2(TIMP-2)gene and susceptibility to non-small cell lung cancer(NSCLC).Methods A total of 167 patients with NSCLC admitted to Suining Central Hospital from May 2021 to May 2023 were selected as the observation group,and 183 healthy subjects who underwent physical examination in the hospital during the same period were selected as the control group.The general data of the two groups were compared and the polymorphism of the TIMP-2 gene was analyzed.The genotype and allele frequency distribution of the polymorphic locus of the TIMP-2 gene were detected and compared between the two groups.Logistic regression was used to analyze the correlation between TIMP-2 gene 418 C>G site and NSCLC.Results The proportion of BMI≥24kg/m2 and smoking in the observation group were 67.07%and 61.08%,respectively,which were 44.26%and 40.44%in the control group,and the differences were statistically significant(χ2=18.356,14.881,all P<0.001).The variant GG homozygote produced three fragments of 230bp,51bp and 23bp in length,the wild-type CC homozygote produced 253bp and 51bp in length,and the heterozygous GC produced four pieces of 253bp,230bp,51bp and 23bp in length.The 51bp and 23bp fragments were not shown,and the TIMP-2 418 C>G gene identity was 100%.The genotype frequencies met the Hardy-Weinberg genetic equilibrium(P>0.05).The frequencies of CC,GC and GG of the TIMP-2 genotype in the observation group were 10.18%,41.92%and 47.90%,respectively,and those in the control group were 4.37%,37.70%and 57.92%,respectively,and the difference was statistically significant(χ2=6.163,P=0.046).The frequencies of the C and G alleles of TIMP-2 in the observation group were 31.14%and 68.86%,respectively,and those in the control group were 23.22%and 76.78%,respectively,and the difference was statistically significant(χ2=5.549,P=0.018).Compared with the control group Logistic regression analysis showed that genotype carrying the C allele significantly increased the risk of NSCLC(OR=2.669,95%CI:1.478～2.936,P<0.01).Compared with the GG+GC group,the proportion of patients with CC genotype who had poor chromosome karyotype prognosis,the proportion of high-risk group in the International Prognostic Scoring System(IPSS)risk group and the levels of CRP and PCT were increased,and the differences were statistically significant(t=3.633～11.249,all P<0.001).Absolute neutrophil count(ANC),Haemoglobin(HGB)and Platelet(PLT)decreased,and the differences were statistically significant(t=4.760,2.015,2.212,all P<0.05).Multivariate COX regression analysis showed that CC genotype,chromosome karyotype,IPSS risk group,ANC,HGB,PLT,CRP,and PCT were risk factors for poor prognosis in NSCLC(Wald χ2=3.072～17.611,all P<0.05).The results of the multifactor dimensionality reduction(MDR)method showed that the interaction combination of abnormal ANC,HGB,PLT,CRP,and PCT levels and TIMP-2 gene polymorphism was 2.650 times higher than that of NSCLC.Conclusion The CC genotype and C allele of the 418 C>G locus of TIMP-2 gene are significantly associated with the risk of NSCLC and are independent risk factors for NSCLC.

Objective To investigate the clinical efficacy of fire dragon pot comprehensive therapy in patients with knee paralysis due to liver and kidney deficiency following total knee arthroplasty(TKA).Methods A total of 114 patients undergoing unilateral TKA were randomly assigned to two groups using a random number table.The control group(n=57)received standard enhanced recovery after surgery(ERAS)nursing care,while the intervention group(n=57)received high-frequency general massage(HGM)therapy in addition to the standard ERAS protocol.Outcomes including visual analogue scale(VAS)scores,Hamilton Anxiety Scale(HAMA)scores,Hospital for Special Surgery(HSS)knee scores,and serum levels of inflammatory markers[C-reactive protein(CRP),neutrophil count(NE),and lymphocyte count(LY)]were compared between the two groups.Results Compared with the control group,the intervention group exhibited significantly lower VAS scores at 3 days postoperatively and at discharge,reduced HAMA scores from the preoperative period through 3 days after surgery,improved HSS scores[specifically in pain,function,range of motion,stability,and total score]at 2 weeks postoperatively,and more pronounced improvements in inflammatory markers,including lower levels of CRP and NE and higher LY levels(all P<0.05).Conclusion The comprehensive moxibustion therapy using Huolongjar effectively alleviates postoperative pain following TKA,enhances joint function,reduces anxiety levels,and mitigates inflammatory responses.This intervention is safe,simple to administer,and holds promise for clinical application and wider dissemination.

Cystic renal mass(CRM)is common in clinic,covering a variety of diseases,and the differentiation of benign and malignant CRM is crucial for treatment decisions.Imaging technologies had their own advantages for diagnosis of CRM,while new grading systems and diagnostic methods kept emerged.The definition of CRM,the application and diagnostic progresses of imaging,especially ultrasound for CRM,and the characteristics and shortcomings of existing diagnostic methods were reviewed in this article,aiming to provide reference for accurate diagnosis and treatment of CRM.

Objective:To analyze the clinical features and genetic sequencing results of a patient with Kallmann syndrome(KS) carrying digenic mutations who initially presented with osteoporosis, and to enhance awareness of this disease phenotype.Methods:Clinical data were collected, and peripheral blood DNA was extracted for whole-exome sequencing. Relevant literature was reviewed to summarize phenotypes associated with digenic/oligogenic variants involving CHD7.Results:The patient exhibited back pain, delayed development of secondary sexual characteristics, and hyposmia. Laboratory tests revealed reduced sex hormones and gonadotropin levels, while pituitary imaging was unremarkable. Bone mineral density imaging confirmed osteoporosis, and thoracolumbar X-rays showed multiple vertebral compression fractures. Genetic analysis identified a heterozygous splice-site mutation in CHD7(c.2698-1G>T) and a heterozygous missense mutation in WDR11(c.439G>A: p.D147N). According to ACMG criteria, the CHD7 mutation was classified as pathogenic, while the WDR11 variant was defined as a variant of uncertain significance(VUS). Literature review indicated that 40% of KS patients with digenic/oligogenic variants involving CHD7 presented with hearing or ocular abnormalities.Conclusion:This study reports a novel CHD7 mutation and a previously undescribed digenic combination of CHD7 and WDR11 variants in a KS patient. CHD7 variants may be implicated in auditory or ocular involvement in KS cases with digenic/oligogenic inheritances. KS patients may also manifest skeletal abnormalities in addition to hypogonadotropic hypogonadism. Tailored management of sex hormones and osteoporosis therapies across life stages is essential for optimizing bone health in KS.

Objective To explore the mechanism of Quhan Zhufeng Mixture on proliferation and apoptosis of rheumatoid arthritis fibroblast-like synoviocyte(RA-FLS)based on NDRG2/JAK2/STAT3 signaling pathway.Methods RA-FLS cells were cultured in vitro,and were divided into ① blank serum group,methotrexate group,Quhan Zhufeng Mixture low-,medium-and high-dosage groups;② blank serum group,AG490 group,Quhan Zhufeng Mixture low-,medium-and high-dosage groups.Different concentrations of drug-containing serum were used to intervene cells.Cell proliferation was detected by CCK-8 method,apoptosis was detected by flow cytometry,and mRNA expressions of Bax,Bcl-2,Caspace-3,Caspace-9,N-myc downstream regulatory gene 2(NDRG2),Janus kinase 2(JAK2)and signal transduction and transcription activator 3(STAT3)were detected by RT-qPCR,Western blot was used to detect the protein expressions of Bax,Bcl-2,Caspace-3,Caspace-9,NDRG2,JAK2,STAT3,p-JAK2 and p-STAT3 in cells.Results Compared with the blank serum group,cell survival rate in methotrexate group,Quhan Zhufeng Mixture all dosage groups significantly decreased(P<0.01),the apoptosis rate significantly increased(P<0.01),the mRNA and protein expressions of Bax and Caspase-9 significantly increased(P<0.05,P<0.01),while the mRNA and protein expression of Bcl-2 significantly decreased(P<0.01),and Caspase-3 mRNA and protein expression in methotrexate group and Quhan Zhufeng Mixture medium-and high-dosage groups significantly increased(P<0.01).Compared with the blank serum group,the mRNA and protein expression of NDRG2 significantly increased in Quhan Zhufeng Mixture all dosage groups(P<0.05,P<0.01),the mRNA and protein expressions of JAK2 and STAT3 were significantly reduced in AG490 group and Quhan Zhufeng Mixture medium-and high-dosage groups(P<0.05,P<0.01),and the expressions of p-JAK2 and p-STAT3 proteins were significantly reduced(P<0.01).Conclusion Quhan Zhufeng Mixture can regulate the proliferation and apoptosis of RA-FLS by regulating the activity of NDRG2/JAK2/STAT3 signaling pathway,playing a role in treating rheumatoid arthritis.

Objective To investigate the clinical efficacy of fire dragon pot comprehensive therapy in patients with knee paralysis due to liver and kidney deficiency following total knee arthroplasty(TKA).Methods A total of 114 patients undergoing unilateral TKA were randomly assigned to two groups using a random number table.The control group(n=57)received standard enhanced recovery after surgery(ERAS)nursing care,while the intervention group(n=57)received high-frequency general massage(HGM)therapy in addition to the standard ERAS protocol.Outcomes including visual analogue scale(VAS)scores,Hamilton Anxiety Scale(HAMA)scores,Hospital for Special Surgery(HSS)knee scores,and serum levels of inflammatory markers[C-reactive protein(CRP),neutrophil count(NE),and lymphocyte count(LY)]were compared between the two groups.Results Compared with the control group,the intervention group exhibited significantly lower VAS scores at 3 days postoperatively and at discharge,reduced HAMA scores from the preoperative period through 3 days after surgery,improved HSS scores[specifically in pain,function,range of motion,stability,and total score]at 2 weeks postoperatively,and more pronounced improvements in inflammatory markers,including lower levels of CRP and NE and higher LY levels(all P<0.05).Conclusion The comprehensive moxibustion therapy using Huolongjar effectively alleviates postoperative pain following TKA,enhances joint function,reduces anxiety levels,and mitigates inflammatory responses.This intervention is safe,simple to administer,and holds promise for clinical application and wider dissemination.

Objective To compare the effects of main artery clamping(MAC)and selective artery clamping(SAC)strategies on postoperative renal function in patients with chronic renal insufficiency undergoing robot-assisted partial nephrectomy.Methods A retrospective cohort study was conducted on 231 patients with preoperative chronic renal insufficiency[eGFR<90 mL/(min·1.73 m2)with renal injury markers or eGFR<60 mL/(min·1.73 m2)]who underwent robot-assisted partial nephrectomy in the Department of Urology of the First Affiliated Hospital of Army Medical University from February 2018 to February 2024.According to intraoperative renal artery clamping strategy,they were divided into a MAC group(n=129)and a SAC group(n=102).Preoperatively,individualized renal artery clamping strategies were developed using a machine learning-based multimodal holographic 3-D reconstruction technique.Serum creatinine(Scr)level was measured at 3 d and 3 months after surgery,and estimated glomerular filtration rate(eGFR)was calculated using the chronic kidney disease epidemiology collaboration equation(CKD-EPI)formula.Renal dynamic imaging with 99mTc-DTPA or 99mTc-MAG3 was used to assess the GFR of the affected kidney.Results At 3 d after surgery,the decrease in GFR of the affected kidney was significantly lower[(8.3±7.7)vs(16.0±10.2)mL/(min·1.73 m2),95%CI:-10.2～-5.2,P<0.001]in the SAC group than the MAC group.Scr increment analysis showed that the SAC group exhibited notably lower Scr increase[8.2(2.5,18.7)vs 15.5(5.8,28.3)μmol/L,95%CI:-12.3～-1.8,P=0.027],and milder eGFR decline[3.0(0.5,7.8)vs 7.5(2.0,14.3)mL/(min·1.73 m2),95%CI:-6.2～-0.8,P=0.015].And,in 3 months after surgery,the SAC group had lower Scr level[(89.2±23.1)vs(95.3±22.1)μmol/L,95%CI:-11.9～-0.3,P=0.042],and higher GFR of the affected kidney[(33.5±10.5)vs(26.1±10.9)mL/(min·1.73 m2),95%CI:4.6～10.2,P<0.001].Conclusion For patients with chronic renal insufficiency undergoing robot-assisted partial nephrectomy,SAC strategy is superior to MAC strategy in protecting postoperative renal function without increasing surgical risk.

Objective To develop a preoperative question prompt list(QPL)for older patients with benign prostatic hyperplasia(BPH)and evaluate its effectiveness in application.Methods This trial adopted a randomized controlled design.The QPL was developed by literature review,expert discussions,and Delphi consultation.Convenience sampling was used to subject 76 older BPH inpatients treated in our department,and then they were randomly divided into control(routine communication,n=38)and intervention(QPL-assisted communication,n=38)groups.Number of the questions patient asking,communication duration,information recall,and communication quality were compared between the 2 groups.Results In the 2 rounds of expert consultation,the response rate of questionnaire was 94.44%and 100%,the authority coefficient was 0.89 and 0.93,the coefficient of variation was 0.05～0.22 and 0～0.11,and Kendall's coefficients was 0.645(Chi-square=87.782,P<0.001)and 0.733(Chi-square=74.789,P<0.001),respectively.The final QPL included 3 themes and 7 questions.The intervention group asked more questions(4.03±1.89 vs 2.11±1.27,P<0.05)but spent similar time for communication(8.18±2.11 vs 7.67±1.72 min,P>0.05).At 1 d before discharge,better information recall(8.74±1.12 vs 6.49±1.68,P<0.001)and communication quality(60.06±6.25 vs 54.86±7.98,P<0.05)were observed in the intervention group when compared with the control group.Conclusion Our developed preoperative communication QPL is of scientificalness and effectiveness for elderly BPH patients.This tool can not only encourage question-asking behavior,but also improve information recall and communication quality in the patients.