From the perspective of transfusion medicine and based on the vision and framework of patient blood management, this article combines the advances in basic science, blood transfusion, laboratory, and clinical medicine. It aims to systematically review the key elements and characteristics of patient fibrinogen management by maintaining and optimizing patients' hemostatic function while reducing blood transfusions. This review enriches the connotation of transfusion medicine, especially patient blood management, and provides valuable insights for clinical practice.

Purpose/Significance To quantitatively analyze and evaluate 26 health informatization construction policies issued at the national level,so as to provide basis for improving related policies.Method/Process Based on the policy modeling consistency(PMC)index model,a health informatization construction policy evaluation index system is constructed,which includes 9 first-level indicators and 36 second-level indicators.Appling it to the evaluation of various policy texts,and the health informatization construction policies are analyzed in a holistic and concrete way.Result/Conclusion The overall score of the health informatization construction policies is ex-cellent.2 policies are at the perfect level,80.6％of policies are at the excellent level,and there are no bad level policy texts.However,the driving force of the policy and the balance of policy recipients need to be further improved.

Objective Using the methods of heart rate variability(HRV)and deceleration capacity of heart rate(DC),which mo-nitor cardiac autonomic nervous function,to study the correlation between the nocturnal blood pressure dropping rate and cardiac autonom-ic nervous function in female patients with essential hypertension,and to explore the related factors affecting the nocturnal blood pressure dropping rate in female patients with essential hypertension.Methods A total of 187 female patients with essential hypertension admitted to the Second Hospital of Lanzhou University from January 2019 to August 2023 were selected.General data,nocturnal blood pressure dropping rate,HRV time domain parameters(SDNN,SDANN,SDNNI,PNN50)and DC were collected.According to the nocturnal sys-tolic blood pressure dropping rate,they were divided into three groups:dipper group,non-dipper group,and reverse dipper group.The differences of general data and 24-hour,daytime and nighttime mean blood pressure and heart rate,HRV time domain parameters and DC values among three groups were compared,and the correlation between the nocturnal blood pressure dropping rate and HRV time do-main parameters,DC values and other general data was analyzed,and the factors affecting the nocturnal blood pressure dropping rate of fe-male patients with essential hypertension were analyzed by simple and multiple linear regression.Results The nocturnal blood pressure dropping rate in female patients with essential hypertension was linearly positive correlated with SDNN,SDANN,SDNNI and DC values(β were 0.235,0.016,0.102,0.493,P＜0.05),and linearly negative correlated with menopause(β=-3.798,P＜0.05).The re-sults of multiple linear regression analysis showed that SDNN,menopause,age,diabetes were the factors affecting the nocturnal blood pressure dropping rate.Conclusion In female patients with essential hypertension,the imbalance of cardiac autonomic nerve regulation,menopause,age and diabetes are the main risk factors affecting the nocturnal blood pressure dropping rate.

Objective To translate the Inflammatory Bowel Disease Disability Visual Analogue Scale (IBD Disk) into Chinese and conduct cross-cultural adaptation, and to test its reliability and validity among patients with inflammatory bowel disease (IBD). Methods Based on the modified Brislin translation model, the IBD Disk was translated into Chinese through forward translation, back translation, group discussion, and cross-cultural adaptation. From January to December 2022, a convenience sampling method was used to select 299 IBD patients for investigation to verify the reliability and validity of the Scale. Results The Chinese version of the IBD Disk includes 10 items, with decision values of 4.79 to 15.68 (>3.00), and P value was less than 0.05, indicating high discriminatory power for each item; the total Cronbach's α coefficient of the scale was 0.88, and the test-retest reliability was 0.87, indicating a good reproducibility of the scale; confirmatory factor analysis results indicated that the scale had ideal fit; Pearson correlation analysis results indicated that the total score of the IBD Disk was significantly positively correlated with the total score of the Inflammatory Bowel Disease Disability Index Scale (IBD-DI) (r=0.81, P < 0.001), suggesting good correlation between the IBD Disk and the IBD-DI. Conclusion The Chinese version of the IBD Disk has good reliability and validity, and is suitable to be used as a disability assessment tool for IBD patients in Chinese culture.

Objective To systematically evaluate the measurement characteristics and methodological quality of Chinese-version inflammatory bowel disease (IBD) disability measurement tools. Methods A systematic search was conducted in PubMed, Web of Science, CNKI, WanFang Database and VIP Database for studies related to the evaluation of measurement characteristics of disability measurement tools for IBD patients, with a search period from inception to September 12, 2023. Based on the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) requirements, two researchers independently screened the literature and extracted the relevant data. The COSMIN risk of bias checklist and quality criteria rating scale were used to assess the measurement characteristics and formulate final recommendations. Results Five studies were included in this study, involving four Chinese-version IBD disability measurement tools. None of the included studies fully reported the 10 measurement characteristics recommended by the COSMIN methodological quality criteria. The final included measurement tools were all rated as Grade B or C recommendations. Conclusion It is recommended that the Chinese-version IBD Disability Index and the Chinese-translated IBD Patient Burden Scale can be temporarily used in clinical practice to assess ability in patients with inflammatory bowel disease, but their measurement characteristics still require further validation.

Objective:To estimate the safety of myomectomy in twin pregnant women with intramural myomas during cesarean section.Methods:The clinical data of 145 cases of twin pregnancies with intramural myomas who were delivered by cesarean section in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from June 2013 to December 2021 were collected. Maternal demographics, fibroids′ characteristics, maternal and fetal outcomes were compared between groups of cesarean section with myomectomy (myomectomy group, 49 cases) and cesarean section only (non-myomectomy group, 96 cases).Results:Compared with non-myomectomy group, myomectomy group had significantly prolonged operative time [50.0 minutes (37.5-57.5 minutes) vs 40.0 minutes (35.0-50.0 minutes), respectively; P=0.007] and significantly longer postoperative hospital stay [4.0 days (3.0-4.0 days) vs 3.0 days (3.0-4.0 days), respectively; P=0.047). Other maternal and fetal outcomes such as estimated blood loss, hemoglobin difference, postpartum hemorrhage, blood transfusion, B-Lynch structure, uterine artery ligation, postoperative fever and neonatal Apgar score showed no significant differences (all P>0.05). For intramural myomas <5 cm, there were no significant differences in maternal and fetal outcomes between myomectomy group and non-myomectomy group (all P>0.05). For intramural myomas ≥5 cm, operative time [55.0 minutes (40.0-60.0 minutes) vs 42.5 minutes (40.0-50.0 minutes), respectively; P=0.019] was significantly prolonged, postoperative hospital stay [4.0 days (4.0-5.0 days) vs 4.0 days (3.0-4.0 days), respectively; P=0.048] was significantly longer in myomectomy group than non-myomectomy group, but there were no significant differences in other maternal and fetal outcomes (all P>0.05). Conclusion:For twin pregnancies with intramural myomas, it is safe and feasible to remove intramural myomas during cesarean section by experienced obstetricians.

BACKGROUND: Childhood adversities pose deleterious consequences on health and well-being, but limited studies explore whether unique patterns of adverse childhood experiences (ACEs) impact the mental health of emerging adults and the mediating role of current stressful events (CSEs). This study examined classes of ACEs and how they relate to CSEs, psychological distress, and subjective well-being among Eritrean College undergraduates. METHODS: Cross-sectional data on ACEs, CSEs, symptoms of psychological distress, and subjective well-being were collected from a national sample of college students (N = 507). We identified ACE patterns using latent class analysis and further examined whether CSEs mediated the effects of ACE classes on psychological distress and subjective well-being. RESULTS: 86.4% of the sample experienced at least one ACE. Collective violence, domestic violence, and physical abuse were the most common ACEs. Three subgroups, low ACEs (66.3%), household violence (19.1%), and multiple ACEs (14.6%) were identified. We found that relative to low ACEs, household violence (β = 0.142, 95% CI 0.046, 0.248) and multiple ACEs (β = 0.501, 95% CI 0.357, 0.666) indirectly influenced psychological distress through CSEs, and CSEs mediated the relationships between household violence (β = -0.096, 95% CI -0.176, -0.033), multiple ACEs (β = -0.338, 95% CI -0.498, -0.210), and subjective well-being. However, there were nonsignificant relative direct effects of ACE patterns on both psychological distress and subjective well-being. CONCLUSIONS Experiencing multiple ACEs and household violence in conjunction with CSEs significantly predict psychological distress and subjective well-being. Contextual interventions for the early identification of ACEs and the management of CSEs may play a crucial role in the prevention of mental health problems.
Adolescent ; Adult ; Adverse Childhood Experiences/statistics & numerical data* ; Cross-Sectional Studies ; Female ; Health Status ; Humans ; Latent Class Analysis ; Male ; Mental Health/statistics & numerical data* ; Models, Psychological ; Prevalence ; Stress, Psychological/psychology* ; Students/statistics & numerical data* ; Universities ; Young Adult

Grid management plays an important role in improving the efficiency of social service management. The authors explored the establishment of a nosocomial infection grid management model and implemented it at a tertiary general hospital in Shanghai. χ2 test results showed that since the hospital fully implemented the grid management model in early 2016, the number of hospital infections, surgical site infections, type I surgical incision infections, and ventilator-related pneumonia had shown a downward trend year by year. The number of inspections before the use of antibacterial drugs, the number of blood cultures submitted for fever patients, and the timing of hand hygiene compliance showed an increasing trend year by year( P<0.05), and the management of nosocomial infection was more effective than the previous period. The application of grid management model required establishment of grid organization structure, control of key links, implementation of the special personnel responsibility, formulation of a performance evaluation system, and implementation of incentive measures. The grid management model can significantly reduce the risk of hospital infection, improve the efficiency of hospital infection management, and was valuable to be applicated and promoted in medical institutions.

Objective:To explore the progress and prospect of evaluation methods for infertility patients.Methods:From September 2017 to December 2020,199 cases of infertility patients who have accepted mini-hysteroscopy examination in the Department of Gynecological Endocrinology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University.The patients who had primary ovary insufficiency,tubal infertility were excluded;patients with hysteroscopy contradiction,such as acute or sub-acute vaginal tract inflammation,en-dometrium lesion or endometrium carcinoma,severe cardiovascular,liver or kidney insufficiency were excluded.40 patients were excluded and 15 patients lost follow up,144 patients were eventually included in the analysis.The patient's age,body mass index,infertility etiology,preoperative and postoperative stimulate ovulation cycle,pregnancy state and pregnancy time were recorded.The effect of mini-hysteroscopy on ovulation induction cycle was analyzed in pregnant patients.Results:The average age of 144 patients was 32.10±4.67 years old.96 (66.67％) patients were found to have intrauterine abnormalities,while 48 (33.33％) patients were found to have normal intrauterine cavity.48 cases of pregnancy,accounting for 33.33％;the median and interquartile ranges[M (Q1,Q3)]of ovulation induction cycles before and after surgery were respectively[3 (0,5)],[2 (1,3)],the difference was statistically significant(P ＜ 0.05).Among the 48 pregnant patients,32 of them had no structural lesions in hysteroscopy,the ovula-tion induction cycle of these patients before and after hysteroscopy were respectively[5 (0,9)],[1 (0,3)],the difference was statistically significant (P ＜ 0.05).Conclusion:Uterine cavity evaluation is important for the assessments of fertility.As an advanced diagnosis instrument,mini-hysteroscopy can not only timely detect the intrauterine abnormalities of patients,but also with great application value in shorten the ovulation cycle in infertility patients and increase the pregnancy rate.