Objective:To identify the risk factors associated with early postpartum pelvic floor muscle strength following cesarean delivery.Methods:A total of 352 women who underwent cesarean section at the Department of Obstetrics and Gynecology,Affiliated Zhongshan Hospital of Dalian University between September 2022 and Sep-tember 2024 and attended a pelvic floor rehabilitation clinic 6 to 8 weeks postpartum were enrolled in this study,and lectromyographic(EMG)values during anterior and posterior resting phases,as well as fast-twitch and slow-twitch muscle phases,were recorded so as to analyze the factors that might affect the pelvic floor strength in the early postnatal period after cesarean section.Factors with statistically significant differences were further ana-lyzed by multifactorial Logistic analysis.Results:Pre-pregnancy body mass index(BMI)＞24 kg/m2,increase in body mass during pregnancy ≥ 11.5 kg,gestational hypertension and term delivery were identified as independent risk factors for abnormal EMG values during the anterior resting phase of the pelvic floor(OR＞1,P＜0.05).In-crease in body mass during pregnancy≥11.5 kg,preterm rupture of membranes,and term delivery were risk fac-tors for abnormal pelvic floor EMG values in the post-resting stage(OR＞1,P＜0.05).Pre-pregnancy BMI＞24 kg/m2 and pre-eclampsia were risk factors for abnormal pelvic floor EMG values in the fast-muscle stage(OR＞1,P＜0.05).and a history of uterine fibroids was a risk factor for abnormal pelvic floor EMG values in the slow-muscle stage(OR＞1,P＜0.05).Conclusions:Early postpartum pelvic floor muscle strength following ce-sarean delivery is influenced by several risk factors,including pre-pregnancy BMI＞24 kg/m2,increase in body mass during pregnancy ≥ 11.5 kg,gestational hypertension,full-term labor,premature rupture of membranes,pre-eclampsia,and history of uterine fibroids,pelvic floor muscle strength is more likely to be impaired in the early postpartum period after the prenatal combination of the above risk factors,and Targeted pelvic floor rehabilitation should be initiated as early as possible during the postpartum period.

The development of Traditional Chinese Medicine(TCM)medical alliances plays a pivotal role in enhancing grassroots TCM service capabilities and meeting public demand for TCM healthcare.However,challenges persist in establishing these alliances,including insufficient Party leadership at primary TCM institutions and deficiencies in clinical services,talent de-velopment,and emergency care capacity.This study examines innovative Party building approaches in public hospitals within the new era context,analyzing practical cases of alliance development.Our findings demonstrate that integrating Party building into the governance structure of medical alliances not only strengthens Party leadership at primary TCM institutions but also significant-ly promotes TCM service development.Systematic analysis of case hospital practices reveals several key insights.Firstly,strengthening top-level design through Party committee leadership is crucial.Secondly,addressing the most pressing public healthcare concerns with genuine commitment forms the foundation.Thirdly,deep integration of Party building with core medical services represents the essential approach.Lastly,policy-responsive innovation based on consolidated achievements serves as the key driver.

The development of Traditional Chinese Medicine(TCM)medical alliances plays a pivotal role in enhancing grassroots TCM service capabilities and meeting public demand for TCM healthcare.However,challenges persist in establishing these alliances,including insufficient Party leadership at primary TCM institutions and deficiencies in clinical services,talent de-velopment,and emergency care capacity.This study examines innovative Party building approaches in public hospitals within the new era context,analyzing practical cases of alliance development.Our findings demonstrate that integrating Party building into the governance structure of medical alliances not only strengthens Party leadership at primary TCM institutions but also significant-ly promotes TCM service development.Systematic analysis of case hospital practices reveals several key insights.Firstly,strengthening top-level design through Party committee leadership is crucial.Secondly,addressing the most pressing public healthcare concerns with genuine commitment forms the foundation.Thirdly,deep integration of Party building with core medical services represents the essential approach.Lastly,policy-responsive innovation based on consolidated achievements serves as the key driver.

Objective:To identify the risk factors associated with early postpartum pelvic floor muscle strength following cesarean delivery.Methods:A total of 352 women who underwent cesarean section at the Department of Obstetrics and Gynecology,Affiliated Zhongshan Hospital of Dalian University between September 2022 and Sep-tember 2024 and attended a pelvic floor rehabilitation clinic 6 to 8 weeks postpartum were enrolled in this study,and lectromyographic(EMG)values during anterior and posterior resting phases,as well as fast-twitch and slow-twitch muscle phases,were recorded so as to analyze the factors that might affect the pelvic floor strength in the early postnatal period after cesarean section.Factors with statistically significant differences were further ana-lyzed by multifactorial Logistic analysis.Results:Pre-pregnancy body mass index(BMI)＞24 kg/m2,increase in body mass during pregnancy ≥ 11.5 kg,gestational hypertension and term delivery were identified as independent risk factors for abnormal EMG values during the anterior resting phase of the pelvic floor(OR＞1,P＜0.05).In-crease in body mass during pregnancy≥11.5 kg,preterm rupture of membranes,and term delivery were risk fac-tors for abnormal pelvic floor EMG values in the post-resting stage(OR＞1,P＜0.05).Pre-pregnancy BMI＞24 kg/m2 and pre-eclampsia were risk factors for abnormal pelvic floor EMG values in the fast-muscle stage(OR＞1,P＜0.05).and a history of uterine fibroids was a risk factor for abnormal pelvic floor EMG values in the slow-muscle stage(OR＞1,P＜0.05).Conclusions:Early postpartum pelvic floor muscle strength following ce-sarean delivery is influenced by several risk factors,including pre-pregnancy BMI＞24 kg/m2,increase in body mass during pregnancy ≥ 11.5 kg,gestational hypertension,full-term labor,premature rupture of membranes,pre-eclampsia,and history of uterine fibroids,pelvic floor muscle strength is more likely to be impaired in the early postpartum period after the prenatal combination of the above risk factors,and Targeted pelvic floor rehabilitation should be initiated as early as possible during the postpartum period.

Objective:To analyze the value of the modified 5-factor frailty index in assessing postoperative complications and mortality in elderly hip fracture patients.Methods:In this retrospective study, clinical data were collected of hip fracture patients aged 60 years and above surgically treated at Beijing Luhe Hospital affiliated to Capital Medical University between January 2015 and December 2019.Patients' group assignment was based on whether the modified frailty index score was ≤1 or ≥2, and a post-surgery follow-up was conducted for survival at 30 days, 1 year, 2 years, and 4 years, which was analyzed by the Kaplan-Meier method.Multivariate Cox regression analysis was used to identify factors affecting death in elderly patients.Results:A total of 1 208 patients were included, with 890 in the group with the index score ≤1 and 318 in the group with the index score ≥2.There was no difference in mortality at 30 days(1.6% or 14/890 vs.1.9% or 6/318, P=0.707), 1-year(11.3% or 99/874 vs.11.6% or 36/310, P=0.917), 2-years(19.7% or 168/852 vs.24.3% or 73/300, P=0.099)and 4-years(44.0% or 238/541 vs.51.5% or 106/206, P=0.071). The incidence of postoperative complications in the group with the score ≥2 was higher(14.8% or 47/318 vs.9.7% or 86/890, P=0.012), including the incidence of stroke(6.3% or 20/318 vs.1.8% or 16/890, P<0.001)and the incidence of postoperative pneumonia(6.0% or 19/318 vs.3.1% or 28/890, P=0.029), and the differences were statistically significant.Multivariate Cox regression analysis showed that age, being female, the Charlson comorbidity index score and low hemoglobin at admission were risk factors for 1-year, 2-year and 4-year mortality post-surgery(all P<0.05), while the modified frailty index score had no correlation with postoperative mortality. Conclusions:A modified frailty index ≥2 is predictive of increased risk of postoperative pneumonia and stroke in patients with hip fractures, but is not correlated with the risk of postoperative mortality.

Objective:To investigate the role of survivin in the regulation of leptin expression and its sensitivity.Methods:Survivin was overexpressed in adipocytes via lentivirus, and the RNA-sequencing(RNA-seq) was used to explore the effect of survivin on the regulation of adipocyte secretory proteins. Survivin was overexpressed in the inguinal adipose tissue(iWAT) of mice by targeted injection of adeno-associated virus(AAV). The transcription levels of leptin and adiponectin were detected by realtime quantitative PCR(RT-qPCR), and the secretion levels of leptin and adiponectin in cellular supernatants and mice serum were detected by enzyme-linked immunosorbent assay(ELISA). The protein level of phosphorylated signal transducer and activator of transcription 3(STAT3) in hypothalamus was detected by Western blotting to investigate the effect of survivin on central leptin sensitivity.Results:Survivin overexpression in both 3T3-L1 and primary white adipocyte significantly down-regulated the leptin transcriptional expression without affecting the adipocyte differentiation( P<0.01). Overexpression of survivin significantly decreased leptin level without affecting the adiponectin levels in the cellular supernatant( P<0.001). Overexpression of survivin in iWAT via AAV injection, not only specifically down-regulated leptin transcriptional level in a dose dependent manner in local adipose tissue, but also led to a decrease in serum leptin level( P<0.05). In mice fed short-term high-fat diet, STAT3 phosphorylation level in hypothalamus significantly increased, suggesting improved central leptin sensitivity. Conclusion:Survivin could downregulate leptin expression and improve leptin sensitivity in high-fat diet induced obese mice.

Objective:To analyze the research hotspots and frontiers in the training of health management talents in China based on knowledge mapping.Methods:The literature related to talent training in health management was retrieved from the databases of CNKI, Wanfang Data, and VIP Journals from 2007 to 2022. The keywords used for retrieval included “health management” “curriculum system” “health manager” “evaluation system” “health service and management” and “talent training”. The time distribution of the literature was analyzed using Excel. Bibliometric analysis was conducted to visually analyze the research in health management talent training, focusing on authorship and collaboration, research institutions, high-frequency keywords, and research hotspots. A knowledge map was created to outline the research framework.Results:A total of 378 journal articles were retrieved. Over the past decade, there has been an overall increasing trend in the number of research publications related to health management talent training. The highest number of articles was published in 2021 (63 articles). In terms of spatial distribution, highly productive authors were relatively concentrated, and research institutions were mostly universities, with Hangzhou Normal University having the highest number of publications (14 articles). The research hotspots included health managers, practice teaching modes, cross-cultivation, and discipline construction. The research frontiers concentrated on talent training modes, health service and management professions, talent demand, and curriculum system construction.Conclusions:In the past decade, health management talents training in China has received more attention and importance. However, there is limited exchange and cooperation among authors and research institutions, and the research hotspots continue to extend in the direction of specialization and diversification. The transformation from vocational education to academic education and strengthening professional construction are the frontiers of the research.

Objective:To explore the knowledge of pediatric nurses about intravenous infusion therapy, find the problems, and provide a reference for managers to provide targeted training.Methods:In this multicenter cross-sectional study, the nurses on duty were selected from 43 hospitals under the medical alliance of Beijing Children's Hospital by convenient sampling from July 24th to 31st, 2018. The self-made questionnaires were used in this study, and data were collected online through wjx.cn. The questionnaires were developed by 4 veteran venous infusion therapists according to the Infusion Therapy Standards of Practice (2016 ) as well as the Technical Standards for Intravenous Therapy Nursing Issued by the National Health Commission of the People's Republic of China in 2014. The questionnaire mainly included three parts. Part I was the basic information of the respondent subjects and hospitals; Part II was the knowledge of the subjects about domestic standards for infusion therapy and Infusion Therapy Standards of Practice; and Part III the knowledge of the subjects about infusion therapy operations and maintenance as well as the current status of infusion therapy in their departments. SPSS 17.0 was used for statistical analysis. Results:A total of 8 405 pediatric nurses were investigated in this study. The average knowledge of infusion therapy was (11.72±2.41), and the pass rate was 54.8%. The survey showed that nurses performed well in selecting infusion tools and puncture sites according to the nature of the drug, evaluating the patient and treatment plan before infusion therapy, the sealing method of peripheral vein indwelling needles, and treatment methods when resistance was encountered or no blood was returned in suction. The univariate analysis revealed that the level of the hospital, whether the hospital had a dosing center and an infusion therapy group, the nurse's education, job title, working years, position, and whether to teach young nurses were the main influencing factors to nurses' knowledge about infusion therapy ( P<0.05) . The results of Logistic regression analysis showed that whether the hospital had a dosing center and a infusion therapy group, and the nurse's education background, title, working years, position, and teaching were the main influencing factors for the nurse's knowledge of infusion therapy ( P<0.05) . Conclusions:Pediatric nurses have insufficient knowledge about infusion therapy. They need to be further trained in the basics of infusion therapy, especially in the correct use of infusion tools, the proper selection of puncture sites, and catheter maintenance.

Objective To investigate the prevalence of nonalcoholic fatty liver disease and the risk factors in Jingyuan county of Ningxia Autonomous Region.Methods The population proportionate sampling method was applied to enroll a representative sample of 10 639 adults in Jingyuan county and the study was conducted using questionnaires and physical examinations.A total of 10 553 people were included in the analysis after excluding those with missing data.High-resolution ultrasound was used to examine the liver and fasting blood was collected in the morning for measurement of blood glucose,blood lipid,and uric acid.The participants were divided into two groups of those with and without nonalcoholic fatty liver disease;the difference in blood biochemical indexes between fatty liver and non-fatty liver groups was compared,and the logistic regression model was used to explore the risk factors affecting the prevalence of fatty liver.Results The prevalence of nonalcoholic fatty liver disease was 7.60％.The prevalence of thyroid nodules was higher in men than in women (8.60％ vs.6.82％,x2=1 1.772,P=0.001).The prevalence rate of fatty liver increased with age (x2=57.336,P＜0.001),the prevalence rates among ≥18 years-＜29 years,≥30 years-＜39 years,≥40years-＜49 years,≥50 years-＜59 years,≥60 years-＜69 years,and above 70 years were 2.92％,6.50％,8.81％,9.59％,8.08％,and 4.77％ respectively.The detection rate of overweight,obesity,abdominal obesity,impaired fasting glucose,impaired glucose tolerance,diabetes,hypertension,hyperuricemia,and dyslipidemia were higher in nonalcoholic fatty liver disease group than in the normal group (P＜0.05).Logistic regression analysis showed that nonalcoholic fatty liver disease group had a higher risk for overweight,obesity,abdominal obesity,impaired fasting glucose,impaired glucose tolerance,diabetes,hypertension,hyperurcemia,and dyslipidemia (OR=5.41,12.45,2.99,1.85,2.05,3.30,1.41,2.23,and 1.98).Conclusion The incidence of nonalcoholic fatty liver in Jingyuan county of Ningxia Autonomous Region was higher.The groups of overweight,obesity,abdominal obesity,impaired fasting glucose,impaired glucose tolerance,diabetes,hypertension,hyperuricemia,and dyslipidemia were high risk factors for nonalcoholic fatty liver disease.

Objective To investigate the prevalences of the obesity and hypertension in southern mountain regions of Ningxia. Methods A cross-sectional study was conducted among a representative sample of 10 639 adults using questionnaires, physical examinations, and blood pressure measurement in southern mountain areas with a population proportionate sampling method. Results The prevalences of overweight,obesity,central obesity,high percentage of body fat,and hypertension were 33.53%,10.71%,19.50%,27.69%,and 31.57% respectively, which were 30.31%,9.62%,16.70%,24.90%,and 27.61% after age-adjustment in rural areas of Ningxia,and increased with aging(Ptrend<0.05). The prevalences of overweight,obesity,and hypertension were higher in males than those in females(P<0.05),and that of central obesity was higher in females than in males(P=0.003).The prevalences of hypertension in subjects with overweight, obesity, central obesity, high percentage of body fat were 38. 14%, 53.75%,52.69%,and 48.90%,respectively. Body mass index,waist circumference,and percentage of body fat were positively correlated with systolic and diastolic blood pressure(P<0.05). The multivariable logistic model revealed that the risk of hypertension in different types of obesity increased about 1.5 times. Conclusion There is high prevalence of obesity and hypertension among the adults in southern mountain areas of Ningxia. The prevalence of hypertension in obesity,central obesity,and high percentage of body fat is closed to or more than half of the population investigated.