Objective Based on the propensity score matching(PSM),the effect of flexible ureteroscopy combined with flexible negative pressure suction sheath in the treatment of infectious renal calculus lithotomy was analyzed.Methods From April 2022 to April 2024,87 patients with infectious renal calculus in our hospital were selected retrospectively.All patients were treated with flexible ureteroscopic lithotripsy(FURL).According to the different choice of ureteral access sheath(UAS)during operation,they were divided into negative pressure sheath group(n=43)and conventional sheath group(n=44).In the negative pressure sheath group,the flexible negative pressure suction sheath was used for FURL,and in the conventional sheath group,the conventional sheath was used for FURL.The general data of patients with infectious renal calculus between groups were compared,and the indicators were balanced by PSM.The clinical efficacy,perioperative indicators,levels of procalcitonin(PCT)and white blood cell count(WBC)and postoperative complications of patients with infectious renal calculus were compared between the two groups.Results After 1∶1 ratio matching by PSM,42 pairs of patients with infectious renal calculus were obtained,.The stone clearance rate of negative pressure sheath group[90.48%(38/42)]was significantly higher than that of conventional sheath group[71.43%(30/42)](P<0.05).The minimum intrapelvic pressure,average intrapelvic pressure and maximum intrapelvic pressure in the negative pressure sheath group were lower than those in the conventional sheath group,operation time and hospitalization time in the negative pressure sheath group were shorter than those in the conventional sheath group(P<0.05).The levels of PCT and WBC in the negative pressure sheath group were lower than those in the conventional sheath group at 2 h after operation,and the time for PCT and WBC to recover to the normal level were shorter than those in the conventional sheath group(P<0.05).The total incidence of postoperative complications in negative pressure sheath group[9.52%(4/42)]was significantly lower than that in conventional sheath group[28.57%(12/42)](P<0.05).Conclusion Flexible ureteroscopy combined with flexible negative pressure suction sheath is effective in the treatment of renal calculus,which is helpful to reduce intra-operative renal pelvis pressure,shorten operation time,reduce PCT and WBC levels after operation,and promote patients'early recovery with good safety.

Objective:To adapt the Mindful Breastfeeding Scale (MINDF-BFS) into Chinese and assess its reliability and validity among breastfeeding mothers in China.Methods:Following the Beaton cross-cultural adaptation guideline, the original scale was translated, back-translated, discussed by experts, pre-tested, culturally adapted, and revised to develop the Chinese version of the MINDF-BFS. A convenience sampling method was used to select 305 postpartum women from Guangzhou Women and Children's Medical Center, Guangzhou Medical University, who visited between March and June 2024, as the study participants. The reliability and validity of the Chinese version of MINDF-BFS were evaluated.Results:The Chinese version of MINDF-BFS consisted of nine items, with the item-level content validity index ranged from 0.900 to 1.000, and the average scale-level content validity index was 0.990. Exploratory factor analysis extracted one common factor, with a variance contribution of 73.290%. Confirmatory factor analysis showed a good model fit. The Cronbach's α coefficient for the scale was 0.923, the split-half reliability coefficient was 0.915, and the test-retest reliability coefficient was 0.926.Conclusions:The Chinese version of MINDF-BFS has good psychometric properties and is suitable for assessing the mindful breastfeeding levels of Chinese postpartum women.

Objective Based on the propensity score matching(PSM),the effect of flexible ureteroscopy combined with flexible negative pressure suction sheath in the treatment of infectious renal calculus lithotomy was analyzed.Methods From April 2022 to April 2024,87 patients with infectious renal calculus in our hospital were selected retrospectively.All patients were treated with flexible ureteroscopic lithotripsy(FURL).According to the different choice of ureteral access sheath(UAS)during operation,they were divided into negative pressure sheath group(n=43)and conventional sheath group(n=44).In the negative pressure sheath group,the flexible negative pressure suction sheath was used for FURL,and in the conventional sheath group,the conventional sheath was used for FURL.The general data of patients with infectious renal calculus between groups were compared,and the indicators were balanced by PSM.The clinical efficacy,perioperative indicators,levels of procalcitonin(PCT)and white blood cell count(WBC)and postoperative complications of patients with infectious renal calculus were compared between the two groups.Results After 1∶1 ratio matching by PSM,42 pairs of patients with infectious renal calculus were obtained,.The stone clearance rate of negative pressure sheath group[90.48%(38/42)]was significantly higher than that of conventional sheath group[71.43%(30/42)](P<0.05).The minimum intrapelvic pressure,average intrapelvic pressure and maximum intrapelvic pressure in the negative pressure sheath group were lower than those in the conventional sheath group,operation time and hospitalization time in the negative pressure sheath group were shorter than those in the conventional sheath group(P<0.05).The levels of PCT and WBC in the negative pressure sheath group were lower than those in the conventional sheath group at 2 h after operation,and the time for PCT and WBC to recover to the normal level were shorter than those in the conventional sheath group(P<0.05).The total incidence of postoperative complications in negative pressure sheath group[9.52%(4/42)]was significantly lower than that in conventional sheath group[28.57%(12/42)](P<0.05).Conclusion Flexible ureteroscopy combined with flexible negative pressure suction sheath is effective in the treatment of renal calculus,which is helpful to reduce intra-operative renal pelvis pressure,shorten operation time,reduce PCT and WBC levels after operation,and promote patients'early recovery with good safety.

Objective:To adapt the Mindful Breastfeeding Scale (MINDF-BFS) into Chinese and assess its reliability and validity among breastfeeding mothers in China.Methods:Following the Beaton cross-cultural adaptation guideline, the original scale was translated, back-translated, discussed by experts, pre-tested, culturally adapted, and revised to develop the Chinese version of the MINDF-BFS. A convenience sampling method was used to select 305 postpartum women from Guangzhou Women and Children's Medical Center, Guangzhou Medical University, who visited between March and June 2024, as the study participants. The reliability and validity of the Chinese version of MINDF-BFS were evaluated.Results:The Chinese version of MINDF-BFS consisted of nine items, with the item-level content validity index ranged from 0.900 to 1.000, and the average scale-level content validity index was 0.990. Exploratory factor analysis extracted one common factor, with a variance contribution of 73.290%. Confirmatory factor analysis showed a good model fit. The Cronbach's α coefficient for the scale was 0.923, the split-half reliability coefficient was 0.915, and the test-retest reliability coefficient was 0.926.Conclusions:The Chinese version of MINDF-BFS has good psychometric properties and is suitable for assessing the mindful breastfeeding levels of Chinese postpartum women.

Objective:Screening factors that might influence rheumatoid arthritis (RA) complicating interstitial lung diseases (ILD) by constructing and validating a model for early diagnostic.Methods:The study subjects were composed of 712 RA patients in the Department of Rheumatology and Immunology of the Second Hospital of Shanxi Medical University during December 2019 to October 2022. Fifty-two variables such as their demographic data, clinical symptoms, and laboratory indexes were collected. Patients were categorized into RA-only group and RA-ILD group with or without the occurrence of ILD disease. After data preprocessing, subjects were randomly assigned to the modeling and validation groups in a 7:3 ratio.Univariate analysis comparing baseline characteristics of the two groups of patients. Feature selection was performed using LASSO and SVM-RFE regression algorithms.Screening indicators were analyzed by logistic regression and the results were used to develop a nomograms model for the early diagnosis of RA complicating interstitial lung disease; and the modeling group was evaluated for its performance for internal assessment of the model and internal validation using data from the validation group.Results:A total of 712 subjects participated in the study, of which 498 in the modeling group and 214 in the validation group. Univariate analysis showed that the differences between the two groups were statistically significant ( P<0.05) in 18 characteristic indexes, including male, gender, age, smoking history, drinking history, number of swollen joints, number of painful joints, use of prednisone, WBC, ESR, CRP, IL-2, IL-10, IL-17, TNF-α, INF-γ, AFA family, APF, and serum albumin. The LASSO algorithm identified 13 risk variables for RA-ILD, the SVM-RFE algorithm identified 12 variables for RA-ILD, and the intersecting risk variables were male, age, history of alcohol consumption, number of painful joints, prednisone acetate, IL-2, AFA family, TNF-α, serum albumin, and IL-10. The results of multifactorial logistic regression analysis confirmed that the differences between males [ OR(95% CI)=3.61(2.11, 6.18)], gender, age [ OR(95% CI)=1.05(1.03, 1.08)], number of painful joints [ OR(95% CI)=1.03(1.01, 1.06)], IL-2 [ OR(95% CI)=0.91 (0.84, 0.99)], and TNF-α[ OR (95% CI)=1.06 (1.02, 1.10)] were statistically significant ( P<0.05) and were independently influences on ILD complicated by RA. The modeling and validation groups that were used to construct early diagnostic Nomograms had high calibration curve accuracies, and the model had a high diagnostic power, which was mainly demonstrated by the receiver operating characteristic (ROC) area under the curve (AUC) and decision curve analysis(DCA), the model modeling group had an AUC of 0.76 (95% CI=0.71, 0.81), with net benefit rates of 3%~82% and 93%~99%, whereas the model validation group had an AUC of 0.71 (95% CI=0.64, 0.79), with net benefit rates of 5%~11%, 14%~60% and 85%~89%. Conclusion:Male, gender, age, number of painful joints, IL-2, and TNF-α are independent factors for RA complicated with ILD, and the Nomogram model constructed has good performance in early diagnosis of the disease.

Objective::This study focused on the prediction of preterm birth (PTB). It aimed to identify the transcriptomic signature essential for the occurrence of PTB and evaluate its predictive value in early, mid, and late pregnancy and in women with threatened preterm labor (TPTL).Methods::Blood transcriptome data of pregnant women were obtained from the Gene Expression Omnibus database. The activity of biological signatures was assessed using gene set enrichment analysis and single-sample gene set enrichment analysis. The correlation among molecules in the interleukin 6 (IL6) signature and between IL6 signaling activity and the gestational week of delivery and latent period were evaluated by Pearson correlation analysis. The effects of molecules associated with the IL6 signature were fitted using logistic regression analysis; the predictive value of both the IL6 signature and IL6 alone were evaluated using receiver operating characteristic curves and pregnancy maintenance probability was assessed using Kaplan-Meier analysis. Differential analysis was performed using the DEseq2 and limma algorithms.Results::Circulatory IL6 signaling activity increased significantly in cases with preterm labor than in those with term pregnancies (normalized enrichment score (NES) = 1.857, P = 0.001). The IL6 signature (on which IL6 signaling is based) was subsequently considered as the candidate biomarker for PTB. The area under the curve (AUC) values for PTB prediction (using the IL6 signature) in early, mid, and late pregnancy were 0.810, 0.695, and 0.779, respectively; these values were considerably higher than those for IL6 alone. In addition, the pregnancy curves of women with abnormal IL6 signature differed significantly from those with normal signature. In pregnant women who eventually had preterm deliveries, circulatory IL6 signaling activity was lower in early pregnancy (NES = -1.420, P = 0.031) and higher than normal in mid (NES = 1.671, P = 0.002) and late pregnancy (NES = 2.350, P < 0.001). In women with TPTL, the AUC values for PTB prediction (or PTB within 7 days and 48 hours) using the IL6 signature were 0.761, 0.829, and 0.836, respectively; the up-regulation of IL6 signaling activity and its correlation with the gestational week of delivery ( r = -0.260, P = 0.001) and latency period ( r = -0.203, P = 0.012) were more significant than in other women. Conclusion::Our findings suggest that the IL6 signature may predict PTB, even in early pregnancy (although the predictive power is relatively weak in mid pregnancy) and is particularly effective in symptomatic women. These findings may contribute to the development of an effective predictive and monitoring system for PTB, thereby reducing maternal and fetal risk.

Objective:To compare the efficacy and safety of different dosages of new drugs in the treatment of PsA by using network meta-analysis.Methods:Three medical databases (PubMed, Web of Science, Cochrane Library) were searched for the studies that compared the efficacy and safety of 4 new drugs (secukinumab, ixekizumab, apremilast, tofacitinib) with different dosages in the treatment of PsA. Data from included studies were analyzed by Stata 15.0.Results:A total of 16 RCTs were included. The results of the network meta-analysis showed that: (1) Among the overall patients, in terms of ACR20 response rate, the larger the surface under the cumulative ranking (SUCRA), the more effective it is. Secukinumab 300 mg Q4W(96.1%) had the best efficacy, followed by ixekizumab 80 mg Q4W(79.0%), ixekizumab 80 mg Q2W(75.1%), secukinumab 150 mg Q4W(73.2%), apremilast 30 mg BID(50.6%), apremilast 20 mg BID(38.6%), tofacitinib 5 mg BID(18.1%), tofacitinib 10 mg BID(17.7%) and placebo(2.0%). (2) In terms of PASI75 response rate, the larger the area under the SUCRA curve, the more effective it is. Ixekizumab 80 mg Q4W(96.1%) had the best efficacy, followed by ixekizumab 80 mg Q2W(88.7%), secukinumab 300 mg Q4W(75.6%), secukinumab 150 mg Q4W(63.3%), apremilast 30 mg BID(44.5%), apremilast 20 mg BID(38.4%), tofacitinib 10 mg BID(30.0%), tofacitinib 5 mg BID(12.5%) and placebo(1.0%). (3) Among the overall patients, in terms of safety, the smaller the area under the SUCRA curve, the higher the safety it is. Secukinumab 300 mg Q4W (17.3%) has the best safety. (4) The results of subgroup analysis showed that in terms of ACR20 response rate, ixekizumab 80 mg Q2W(85.3%) had the best efficacy in bDMARDs-na?ve patients, while in bDMARDs-IR patients, secukinumab 300 mg Q4W(83.9%) had the best efficacy.Conclusion:Among all patients, secukinumab 300 mg Q4W is the best in terms of ACR20 response rate and safety, but ixekizumab 80 mg Q4W is more effective in improving PsA lesions comparing yo other drugs.

Objective::This study focused on the prediction of preterm birth (PTB). It aimed to identify the transcriptomic signature essential for the occurrence of PTB and evaluate its predictive value in early, mid, and late pregnancy and in women with threatened preterm labor (TPTL).Methods::Blood transcriptome data of pregnant women were obtained from the Gene Expression Omnibus database. The activity of biological signatures was assessed using gene set enrichment analysis and single-sample gene set enrichment analysis. The correlation among molecules in the interleukin 6 (IL6) signature and between IL6 signaling activity and the gestational week of delivery and latent period were evaluated by Pearson correlation analysis. The effects of molecules associated with the IL6 signature were fitted using logistic regression analysis; the predictive value of both the IL6 signature and IL6 alone were evaluated using receiver operating characteristic curves and pregnancy maintenance probability was assessed using Kaplan-Meier analysis. Differential analysis was performed using the DEseq2 and limma algorithms.Results::Circulatory IL6 signaling activity increased significantly in cases with preterm labor than in those with term pregnancies (normalized enrichment score (NES) = 1.857, P = 0.001). The IL6 signature (on which IL6 signaling is based) was subsequently considered as the candidate biomarker for PTB. The area under the curve (AUC) values for PTB prediction (using the IL6 signature) in early, mid, and late pregnancy were 0.810, 0.695, and 0.779, respectively; these values were considerably higher than those for IL6 alone. In addition, the pregnancy curves of women with abnormal IL6 signature differed significantly from those with normal signature. In pregnant women who eventually had preterm deliveries, circulatory IL6 signaling activity was lower in early pregnancy (NES = -1.420, P = 0.031) and higher than normal in mid (NES = 1.671, P = 0.002) and late pregnancy (NES = 2.350, P < 0.001). In women with TPTL, the AUC values for PTB prediction (or PTB within 7 days and 48 hours) using the IL6 signature were 0.761, 0.829, and 0.836, respectively; the up-regulation of IL6 signaling activity and its correlation with the gestational week of delivery ( r = -0.260, P = 0.001) and latency period ( r = -0.203, P = 0.012) were more significant than in other women. Conclusion::Our findings suggest that the IL6 signature may predict PTB, even in early pregnancy (although the predictive power is relatively weak in mid pregnancy) and is particularly effective in symptomatic women. These findings may contribute to the development of an effective predictive and monitoring system for PTB, thereby reducing maternal and fetal risk.

Objective:To explore the prenatal ultrasound manifestations of fetal congenital right aortic arch and its diagnostic significance.Methods:The characteristics of prenatal ultrasound images (focusing on the three vessel trachea section) and clinical data of 128 cases of fetal congenital right aortic arch diagnosed in Dalian Women and Children′s Medical Center(Group) from January 2014 to January 2019 were analyzed retrospectively.Results:Among 128 cases of fetal congenital right aortic arch, 111 cases were right aortic arch and leftductus arteriosus with aberrant left subclavian artery (RAA-LDA-ALSA), 1 case was diagnosed as left aortic arch atresia of double aortic arch by operation after birth; 9 cases were right aortic arch and right ductus arteriosus (RAA-RDA); 6 cases were mirror-image right active aortic arch and left ductus arteriosus connected to descending aorta (RAA-BAMB-LDA-DAO); 2 cases were mirror-image right aortic arch and left ductus arteriosus connected to the left innominate artery (RAA-BAMB-LDA-LINA). The three vessels and trachea view (3VT) had characteristic sonographic features.If necessary, coronary section of the upper thoracic aorta and / or stic were added - HD live flow technology assisted the diagnosis of 3vt section.Conclusions:Three vessel trachea view is a sensitive and effective view for prenatal detection and diagnosis of congenital right aortic arch. Upper thoracic aorta coronal section and combined stic - HD live flow technology can make up for its shortcomings. Prenatal ultrasound diagnosis of right aortic arch hasguiding significance for prenatal prognosis consultation.

Objective:To investigate the effects of different partial deletions in azoospermia factor (AZF) locus of Y-chromosome on the clinical outcome of severe oligoasthenozoospermia patients by intracytoplasmic sperm injection (ICSI).Methods:A retrospective cohort study was conducted on the patients undergoing high-throughput sequencing for Y chromosome microdeletion screening and ICSI treatment in Reproductive Medicine Center of Henan Provincial People's Hospital from December 2017 to July 2020. According to whether carrying AZFc microdeletions or not, the patients were divided into the AZFc-deletion group and control group. And AZFc-deletion group was divided into 3 subgroups, b2/b3 deletion, b2/b4 deletion and gr/gr deletions subgroup, by the types of partial deletion.Results:The day 3 (D3) available embryo rate, the high-quality embryo rate, and the blastocyst formation rate in patients with AZFc deletion were statistically lower than those in control group [70.4% (556/790) vs. 78.5% (2867/3651), P<0.001; 24.7% (199/807) vs. 34.3% (1284/3747), P<0.001; 51.7% (277/536) vs. 58.0% (1540/2592), P=0.007], and there were no statistical differences in implantation rate, clinical pregnancy rate, live birth rate during transplantation cycle between the two groups (all P>0.05). The AZFc b2/b3 deletion subgroup had no significant differences in D3 available embryo rate, high-quality embryo rate, blastocyst formation rate, implantation rate, clinical pregnancy rate and live birth rate, compared with control group (all P>0.05). The rate of high-quality embryos in patients with the b2/b4 deletion subgroup [23.2% (32/138)] was lower than that of control group ( P=0.004), but there were no statistical differences in D3 available embryo rate, blastocyst formation rate, implantation rate, clinical pregnancy rate and live birth rate (all P>0.05). The D3 available embryo rate [71.6% (280/391)], the high-quality embryo rate [20.8% (84/403)] and the blastocyst formation rate [48.7% (133/273)] in patients of gr/gr deletion subgroup were significantly lower than those in control group ( P=0.002, P<0.001, P<0.001), but there were no statistical differences in implantation rate, clinical pregnancy rate and live birth rate (all P>0.05). Conclusion:AZFc b2/b3 deletion and b2/b4 deletion in the AZFc locus of Y chromosome have no significant effect on embryonic development and pregnancy outcome in patients with severe oligoasthenozoospermia undergoing ICSI. Gr/gr deletion has most adverse effect on embryonic development but no effect on pregnancy outcome.