Objective:To analyze the iodine nutrition status of pregnant women in Weihai City before and after (2022, 2023) the iodine deficiency disorders (IDD) intervention, evaluate the effectiveness of intervention measures, and provide a scientific basis for adjusting IDD prevention strategies in the city.Methods:In May 2023, the intervention action of IDD was carried out for pregnent women in Weihai City. In April 2022 and December 2023, respectively, a cross-sectional survey method was conducted in four districts (cities) of Weihai City. Each district (city) was divided into five areas (east, west, south, north, and central) each year, and one township (street) was selected from each areas. At least 20 pregnant women were selected from each township (street) as survey subjects, and their household salt samples and random urine samples were collected to measure salt iodine and urinary iodine concentrations, and to compare the test results.Results:A total of 922 household salt samples were tested, including 530 iodized salt samples and 469 qualified iodized salt samples. The median salt iodine was 24.00 mg/kg. The coverage rate of iodized salt, the qualified rate of iodized salt, and the consumption rate of qualified iodized salt were 57.48%, 88.49%, and 50.87%, respectively. No significant difference was observed in medians salt iodine between 2022 (24.26 mg/kg) and 2023 (24.00 mg/kg, Z = - 1.58, P = 0.113). However, the coverage rate of iodized salt and the consumption rate of qualified iodized salt in 2023 werehigher than those in 2022 [73.72% (373/506) vs 37.74% (157/416), 65.22% (330/506) vs 33.41% (139/416), χ 2 = 120.90, 92.40, P < 0.001]. A total of 922 urine samples were collected from pregnant women, with a median urinary iodine of 135.90 μg/L. The median urinary iodine of pregnant women in 2022 was 113.55 μg/L. There was a statistically significant difference in medians urinary iodine among different regions ( H = 27.91, P < 0.001). The median urinary iodine of pregnant women in 2023 was 153.00 μg/L. There was no statistically significant difference in medians urinary iodine among different regions ( H = 3.33, P = 0.343). The medians urinary iodine of pregnant women in Huancui District, Wendeng District, and Rushan City in 2023 (156.60, 155.00, 140.85 μg/L) were higher than those in 2022 (93.60, 110.00, 110.70 μg/L), and the differences were statistically significant ( Z = - 5.44, - 4.92, - 5.99, P < 0.001). The median urinary iodine of pregnant women in Weihai City in 2023 showed a statistically significant difference compared to 2022 ( Z = - 7.62, P < 0.001). Conclusions:The IDD intervention measures in Weihai City have achieved good results, and the coverage of iodized salt, the consumption rate of qualified iodized salt, and the iodine nutrition level of pregnant women have improved. We should continue to implement intervention measures, improve the iodine nutrition level of key populations, and maintain a sustained elimination of IDD.

Objective:To explore the mediating effect of attitudes to aging between intergenerational support and health behavior in elderly stroke patients.Methods:From March 2023 to February 2024, elderly stroke patients hospitalized in the Department of Neurology at Beijing Tongren Hospital, Capital Medical University, were selected as study subjects using convenience sampling. The survey was conducted using the General Information Questionnaire, Attitudes to Ageing Questionnaire (AAQ), Intergenerational Support Scale (ISS), and Stroke Health Behavior Questionnaire (SHBQ). Pearson correlation was employed to analyze the relationships among attitudes to aging, intergenerational support, and health behavior. AMOS 21.0 software was used to construct the structural equation model and verify the mediating effect.Results:A total of 250 questionnaires were distributed, and 243 valid questionnaires were collected, with a valid response rate of 97.20%. The AAQ, ISS, and SHBQ scores of 243 elderly stroke patients were (70.57±9.03), (19.74±3.65), and (71.67±5.50), respectively. Attitudes to aging were positively correlated with both intergenerational support and health behavior ( P<0.05), and intergenerational support was positively correlated with health behavior ( P<0.05). Intergenerational support had a direct positive effect on health behavior (β=0.552), and attitudes to aging had a direct positive effect on health behavior (β=0.632). Attitudes to aging partially mediated the relationship between intergenerational support and health behavior, accounting for 38.12% (0.340/0.892) of the total effect. Conclusions:Attitudes to aging partially mediates the relationship between intergenerational support and health behavior. Improving intergenerational support may foster positive attitudes to aging, thereby promoting the development of healthy behavior among elderly stroke patients.

Objective To explore the influencing factors of immune-associated thyroid dysfunction caused by sintilimab treatment in solid tumors and construct a prediction model.Methods Medical records of patients diagnosed with solid tumors and treated with sintilimab at Peking University People's Hospital(Xizhimen Campus,Tongzhou Campus,Shijiazhuang Campus)from January 2023 to September 2024 were collected to explore the influencing factors that caused immune-related thyroid dysfunction using univariate and multifactorial binary logistic regression analyses and to establish a prediction model.The predictive effect of the model was assessed using the receiver operating characteristic(ROC)curve.Results A total of 120 patients were included,and 33 presented with immune-related thyroid dysfunction.Multifactorial logistic regression analysis revealed that thyroid-stimulating hormone(TSH)[OR=2.470,95%CI=(1.279,4.771)]and treatment cycles[OR=1.298,95%CI=(1.117,1.509)]were independent risk factors for the occurrence of immune-associated thyroid dysfunction,and the difference was statistically significant(P＜0.05).The area under the ROC curve was(0.897±0.043)[95%CI=(0.813,0.981)],the Yoden index was 0.703,and the model prediction accuracy was 86.5%.Conclusion The risk of immune-related thyroid dysfunction caused by sintilimab is high,and TSH and treatment cycle are the influencing factors,and the constructed model has certain predictive value and is of reference significance.

Objective:To construct and verify a risk prediction model for pulmonary infection in patients with aneurysmal subarachnoid hemorrhage (aSAH) after craniotomy and clipping, providing theoretical basis and practical guidance for improving the quality of postoperative care.Methods:Using the convenience sampling method, a retrospective selection was made of 397 patients with aSAH after craniotomy and clipping who were hospitalized in the Department of Neurosurgery of Shanxi Bethune Hospital (Shanxi Academy of Medical Sciences) from January 2019 to December 2023 as the modeling group. They were randomly divided into the training set and the test set at a ratio of 7:3, with 278 cases in the training set and 119 cases in the test set. Patients were divided into the infection group and the non-infection group based on whether they developed pulmonary infection. Univariate analysis was used to model the risk factors of pulmonary infection after aSAH craniotomy and clamping in the group, and Lasso regression was used to construct a predictive model. A total of 119 patients with aSAH admitted to the neurosurgery department of the same hospital from January to April 2024 were selected for the external validation of the model. The predictive effect of the model was evaluated through the receiver operating characteristic (ROC) curve.Results:In the modeling group, there were 216 male patients and 181 female patients. The incidence of pulmonary infection was 38.54% (153/397). Finally, five influencing factors, namely stroke, Hunt-Hess classification, mechanical ventilation, indwelling nasogastric tube and the timing of initiating enteral nutrition, were included to construct a predictive model. The areas under the ROC curves of the nomogram prediction models of this model in the training set, test set, and external validation group were 0.859(95% CI 0.791-0.928), 0.843(95% CI 0.796-0.890), and 0.800(95% CI 0.711-0.889), respectively. The calibration curve shows that the model's prediction fits well with the actual situation and has a high degree of calibration. Decision curve analysis indicates that this model has high clinical application value under different risk thresholds. Conclusions:The risk prediction model for pulmonary infection in patients after craniotomy and clipping with aSAH has good discrimination and calibration, which can provide reference for medical staff to identify high-risk patients at an early stage and take preventive intervention measures.

Objective:To explore the effectiveness and application value of focused ultrasound ablation surgery (FUAS) combined with hysteroscopic surgery in treating solitary type Ⅱ submucosal uterine fibroids with maximum diameter >5 cm.Methods:Clinical data of 35 patients with a single type Ⅱ submucosal uterine fibroid with maximum diameter greater than 5 cm who underwent FUAS combined with hysteroscopic surgery at Qingdao Women and Children′s Hospital from June 2020 to December 2023 were collected. The clinical characteristics, treatments and treatment outcomes were retrospectively analyzed.Results:(1) Clinical characteristics: the mean age of the 35 patients was (36.7±6.6) years, with a median maximum diameter of fibroids of 56 mm (range: 51-80 mm). All patients presented with symptoms of menorrhagia, median menstrual bleeding score was 5 points (ranged from 3 to 5 points), and 34 cases (97.1%, 34/35) had concomitant anemia, the mean hemoglobin was (83.1±13.8) g/L of 35 patients. (2) Treatments: all 35 patients underwent FUAS treatment initially, with a lesion ablation rate ranging from 69.7% to 97.9% (median:90.7%), and no complications occurred. After FUAS treatment, the volume of fibroids decreased in all patients, with a volume reduction rate ranging from 30.57% to 87.22% (median:76.03%). Hysteroscopic surgery was performed 3-14 months (median: 5 months) after FUAS to remove the necrotic fibroid tissue, achieving a 100.0% (35/35) fibroid resection rate. Only 1 patient developed complications of hyperhyderation syndrome during hysteroscopic surgery, and no complications occurred in the remaining patients. (3) Evaluation of efficacy: after FUAS pretreatment, the maximum diameter of fibroids in the 35 patients decreased significantly ( Z=-5.171, P<0.001), as did the volume of fibroids ( Z=-5.159, P<0.001). The hemoglobin level increased significantly compared to the level before FUAS in all cases ( t=-8.657, P<0.001), and median menstrual bleeding score decreased to 2 points (range: 1-3 points), significantly lower than original level ( Z=-5.292, P<0.001). At the 3-month follow-up after hysteroscopic surgery, all patients were free of anemia symptoms, with menstrual bleeding scores totally decreased to 1 point, significantly lower than that before hysteroscopic surgery ( Z=-4.786, P<0.001); hemoglobin level [(118.7±5.6) g/L] significantly increased compared to that before hysteroscopic surgery ( t=-9.258, P<0.001). All patients underwent gynecological transvaginal ultrasound re-examination, which did not reveal any residual fibroids. Conclusion:FUAS combined with hysteroscopic surgery is effective in treating solitary type Ⅱ submucosal uterine fibroids with maximum diameter >5 cm, providing a new treatment option for patients.

Objective:To investigate nationwidely the alert threshold for intraoperative bleeding intervention during dilation and curettage (D&C) for type Ⅱ cesarean scar pregnancy (CSP) in the first trimester.Methods:A retrospective cross-sectional survey was conducted. From March 11 to April 14, 2022, obstetricians and gynecologists affiliated with professional associations or institutions of Family Planning Subgroup, Chinese Society of Obstetrics and Gynecology, Chinese Medical Associaton were surveyed using “Expert Consultation Questionnaire on Alert Threshold for Intraoperative Blood Loss in CSP”. The questionnaire was distributed via WeChat using the Questionnaire Star platform. Observation indicators included professional expertise of participants, preferred treatment modalities for type Ⅱ CSP, and an alert threshold for intraoperative bleeding during D&C.Results:A total of 361 valid questionnaires were collected. Among 361 participants, 73.7% (266/361) held the title of associate chief physician or higher, 61.2% (221/361) had ≥20 years of clinical experience, and 71.8% (178/248) worked in tertiary general hospitals. The most common treatment for type Ⅱ CSP was D&C following pretreatment with medication, uterine artery embolization (UAE), or high intensity focused ultrasound (HIFU), the percentage was 35.73% (129/361). 51.2% (185/361) of participants recommended an alert threshold of 100 ml for intraoperative bleeding during D&C. Cross-analysis revealed that participants managing <30 cases annually preferred ultrasound-guided D&C (32.0%, 56/175), those managing 30-99 cases or 100-199 cases per year favored pretreatment with medication, UAE or HIFU+D&C (39.0%, 55/141; 52.9%, 18/34), those managing ≥200 cases per year preferred hysteroscopic D&C (4/11). The most frequently selected alert threshold was 100 ml. In the subgroup analysis of participants with ≥100 cases annual admissions for CSP, 46.7% (21/45) of participants chose medication, UAE or HIFU pretreatment+D&C, while 53.3% (24/45) supported setting the alert threshold at 100 ml.Conclusions:The preferred treatment for type Ⅱ CSP is D&C following medication, UAE or HIFU pretreatment, with an intraoperative bleeding alert threshold of 100 ml. Timely alerts and proactive interventions could reduce injury severity, improve outcomes, and optimize CSP management strategies.

Objective:To analyze the epidemiological characteristics and survival rate of nasopharynx cancer (NPC) in Guangdong Province from 2011 to 2019.Methods:Based on the cancer registry data of Guangdong Province from 2011 to 2019, the crude rate, age-standardized rate (the standard population was the fifth Chinese national census of 2000) and age-specific rate of incidence and mortality of NPC were calculated, and the regional distribution characteristics were also explored. The average annual percentage change (AAPC) of the incidence and mortality rates were analyzed by using Joinpoint regression model. The observed survival rate was estimated by period survival method, and the expected survival rate was calculated by Ederer Ⅱ method.Results:The crude incidence rate and age standardized incidence rate of NPC showed a decreasing trend, and the AAPC was -1.9% and -2.1%, respectively ( P＜0.05). The crude mortality rate and age standardized mortality rate of NPC also showed a decreasing trend, and the AAPC was -4.8% and -4.6%, respectively ( P＜0.05). The incidence and mortality rates are both higher in men than those in women during the nine years. The age-specific incidence rate of NPC reached its peak in the 50-64 years old age group, and the mortality rate reached its peak in the 65-74 years old age group in Guangdong province. In 2019, the age-standardized incidence rate of NPC was 9.49/100 000 (13.89/100 000 in men and 5.19/100 000 in women). The incidence and mortality of NPC varied greatly among different areas, and the areas with highest incidence and mortality rate were both in Zhaoqing. In 2020, the five-year observed survival rate of NPC in Guangdong Province was 67.2%, the 5-year relative survival rate was 75.3% and the 5-year standardized relative survival rate was 68.9%. Conclusions:Both the incidence and mortality rates of NPC in Guangdong province show decreasing trend, and the decreasing level of the mortality rate is higher than that of the incidence rate, but the two rates are still at high levels. The prevention and control work should focus on male, middle-aged and elderly population and Zhaoqing, Zhongshan, Foshan areas.

Objective:To explore the effectiveness and application value of focused ultrasound ablation surgery (FUAS) combined with hysteroscopic surgery in treating solitary type Ⅱ submucosal uterine fibroids with maximum diameter >5 cm.Methods:Clinical data of 35 patients with a single type Ⅱ submucosal uterine fibroid with maximum diameter greater than 5 cm who underwent FUAS combined with hysteroscopic surgery at Qingdao Women and Children′s Hospital from June 2020 to December 2023 were collected. The clinical characteristics, treatments and treatment outcomes were retrospectively analyzed.Results:(1) Clinical characteristics: the mean age of the 35 patients was (36.7±6.6) years, with a median maximum diameter of fibroids of 56 mm (range: 51-80 mm). All patients presented with symptoms of menorrhagia, median menstrual bleeding score was 5 points (ranged from 3 to 5 points), and 34 cases (97.1%, 34/35) had concomitant anemia, the mean hemoglobin was (83.1±13.8) g/L of 35 patients. (2) Treatments: all 35 patients underwent FUAS treatment initially, with a lesion ablation rate ranging from 69.7% to 97.9% (median:90.7%), and no complications occurred. After FUAS treatment, the volume of fibroids decreased in all patients, with a volume reduction rate ranging from 30.57% to 87.22% (median:76.03%). Hysteroscopic surgery was performed 3-14 months (median: 5 months) after FUAS to remove the necrotic fibroid tissue, achieving a 100.0% (35/35) fibroid resection rate. Only 1 patient developed complications of hyperhyderation syndrome during hysteroscopic surgery, and no complications occurred in the remaining patients. (3) Evaluation of efficacy: after FUAS pretreatment, the maximum diameter of fibroids in the 35 patients decreased significantly ( Z=-5.171, P<0.001), as did the volume of fibroids ( Z=-5.159, P<0.001). The hemoglobin level increased significantly compared to the level before FUAS in all cases ( t=-8.657, P<0.001), and median menstrual bleeding score decreased to 2 points (range: 1-3 points), significantly lower than original level ( Z=-5.292, P<0.001). At the 3-month follow-up after hysteroscopic surgery, all patients were free of anemia symptoms, with menstrual bleeding scores totally decreased to 1 point, significantly lower than that before hysteroscopic surgery ( Z=-4.786, P<0.001); hemoglobin level [(118.7±5.6) g/L] significantly increased compared to that before hysteroscopic surgery ( t=-9.258, P<0.001). All patients underwent gynecological transvaginal ultrasound re-examination, which did not reveal any residual fibroids. Conclusion:FUAS combined with hysteroscopic surgery is effective in treating solitary type Ⅱ submucosal uterine fibroids with maximum diameter >5 cm, providing a new treatment option for patients.

Objective:To investigate nationwidely the alert threshold for intraoperative bleeding intervention during dilation and curettage (D&C) for type Ⅱ cesarean scar pregnancy (CSP) in the first trimester.Methods:A retrospective cross-sectional survey was conducted. From March 11 to April 14, 2022, obstetricians and gynecologists affiliated with professional associations or institutions of Family Planning Subgroup, Chinese Society of Obstetrics and Gynecology, Chinese Medical Associaton were surveyed using “Expert Consultation Questionnaire on Alert Threshold for Intraoperative Blood Loss in CSP”. The questionnaire was distributed via WeChat using the Questionnaire Star platform. Observation indicators included professional expertise of participants, preferred treatment modalities for type Ⅱ CSP, and an alert threshold for intraoperative bleeding during D&C.Results:A total of 361 valid questionnaires were collected. Among 361 participants, 73.7% (266/361) held the title of associate chief physician or higher, 61.2% (221/361) had ≥20 years of clinical experience, and 71.8% (178/248) worked in tertiary general hospitals. The most common treatment for type Ⅱ CSP was D&C following pretreatment with medication, uterine artery embolization (UAE), or high intensity focused ultrasound (HIFU), the percentage was 35.73% (129/361). 51.2% (185/361) of participants recommended an alert threshold of 100 ml for intraoperative bleeding during D&C. Cross-analysis revealed that participants managing <30 cases annually preferred ultrasound-guided D&C (32.0%, 56/175), those managing 30-99 cases or 100-199 cases per year favored pretreatment with medication, UAE or HIFU+D&C (39.0%, 55/141; 52.9%, 18/34), those managing ≥200 cases per year preferred hysteroscopic D&C (4/11). The most frequently selected alert threshold was 100 ml. In the subgroup analysis of participants with ≥100 cases annual admissions for CSP, 46.7% (21/45) of participants chose medication, UAE or HIFU pretreatment+D&C, while 53.3% (24/45) supported setting the alert threshold at 100 ml.Conclusions:The preferred treatment for type Ⅱ CSP is D&C following medication, UAE or HIFU pretreatment, with an intraoperative bleeding alert threshold of 100 ml. Timely alerts and proactive interventions could reduce injury severity, improve outcomes, and optimize CSP management strategies.

Objective:To explore the anal function and postoperative complications of 2-stage Turnbull-Cutait pull-through coloanal anastomosis (TCA) for low rectal cancer.Methods:Patients undergoing radical rectal cancer resection from Feb 2023 to Nov 2024 in the First Hospital of Jilin University were divided into the TCA surgery group and the low anterior resection combined with prophylactic stoma (LAR) surgery group.Results:Among the 102 patients, there were 50 cases in the TCA group and 52 cases in the LAR group. In the single-arm analysis of the TCA group, the overall complication rate was 44%. The incidence rates of severe LARS at 1 month, 3 months, and 6 months after surgery were 97%, 77%, and 64% respectively. There was no significant difference in the complication rate within 30 days after surgery between the two groups,(44% vs. 38%, χ2=0.135, P>0.05). There was no significant difference in the incidence rate of severe LARS between the TCA group and the LAR group (77% vs. 69%, χ2=0.202, P>0.05), and there was not significant difference in the incidence rate of severe LARS between the two groups at the 6th month after surgery,(64% vs. 48%, χ2=1.132, P>0.05). Conclusion:In patients who underwent TCA surgery, the LARS symptoms gradually decreased over time. Compared with patients undergoing low anterior resection and stoma reversal, there were no significant differences in complications within 30 days after surgery and LARS symptoms within half a year.