Objective:To establish a normal data model of fetal right ventricular size and function using echocardiography，and to explore the clinical value of quantitative assessment of right ventricular size and function in the diagnosis of congenital heart diseases.Methods:（1）A simple random sampling method was employed to collect 1 004 pregnant women with normal singleton pregnancies at 24 to 32 +6 weeks of gestation who underwent fetal cardiac ultrasound examinations at the First Affiliated Hospital of Air Force Medical University from January 2021 to December 2023. Two-dimensional and M-mode echocardiography were used to measure the right ventricular end-diastolic diameter（RVEDD），right ventricular end-diastolic area（RVEDA），tricuspid annular plane systolic excursion（TAPSE）during systole，and the right ventricular fractional area change（RVFAC）was calculated. The correlations between the above parameters and ultrasound gestational age（USGA）were analyzed. Moreover，percentile growth curves for each parameter were plotted. With the above parameters as dependent variables and the USGA as the independent variable，a Z-score model was established through regression analysis.（2）A stratified sampling method was adopted to select 30 fetuses diagnosed with hypoplastic right heart syndrome（HRHS）and 30 fetuses diagnosed with pulmonary stenosis（PS）during the same period as the case group. The model was verified，and the morphological and functional characteristics of the right ventricle were analyzed. Results:The data of RVEDD，RVEDA，TAPSE，and RVFAC in normal fetuses showed a skewed distribution. Each parameter showed good linear correlations with USGA（ r=0.836，0.834，0.846，0.242；all P<0.001）. The constructed percentile curves for each parameter indicated that RVEDD，RVEDA and TAPSE increased significantly with the growth of USGA，while RVFAC showed a slow downward trend. All parameters in the HRHS group and TAPSE and RVFAC in the PS group deviated significantly from the normal reference range（all P<0.001）. Conclusions:By analyzing RVEDD，RVEDA，TAPSE and RVFAC of normal fetuses，the percentile and Z-score normal reference value models of multiple parameters of fetal right ventricular size and function have been established，providing corresponding standards for quantitative analysis.

Objective:To establish a normal data model of fetal right ventricular size and function using echocardiography，and to explore the clinical value of quantitative assessment of right ventricular size and function in the diagnosis of congenital heart diseases.Methods:（1）A simple random sampling method was employed to collect 1 004 pregnant women with normal singleton pregnancies at 24 to 32 +6 weeks of gestation who underwent fetal cardiac ultrasound examinations at the First Affiliated Hospital of Air Force Medical University from January 2021 to December 2023. Two-dimensional and M-mode echocardiography were used to measure the right ventricular end-diastolic diameter（RVEDD），right ventricular end-diastolic area（RVEDA），tricuspid annular plane systolic excursion（TAPSE）during systole，and the right ventricular fractional area change（RVFAC）was calculated. The correlations between the above parameters and ultrasound gestational age（USGA）were analyzed. Moreover，percentile growth curves for each parameter were plotted. With the above parameters as dependent variables and the USGA as the independent variable，a Z-score model was established through regression analysis.（2）A stratified sampling method was adopted to select 30 fetuses diagnosed with hypoplastic right heart syndrome（HRHS）and 30 fetuses diagnosed with pulmonary stenosis（PS）during the same period as the case group. The model was verified，and the morphological and functional characteristics of the right ventricle were analyzed. Results:The data of RVEDD，RVEDA，TAPSE，and RVFAC in normal fetuses showed a skewed distribution. Each parameter showed good linear correlations with USGA（ r=0.836，0.834，0.846，0.242；all P<0.001）. The constructed percentile curves for each parameter indicated that RVEDD，RVEDA and TAPSE increased significantly with the growth of USGA，while RVFAC showed a slow downward trend. All parameters in the HRHS group and TAPSE and RVFAC in the PS group deviated significantly from the normal reference range（all P<0.001）. Conclusions:By analyzing RVEDD，RVEDA，TAPSE and RVFAC of normal fetuses，the percentile and Z-score normal reference value models of multiple parameters of fetal right ventricular size and function have been established，providing corresponding standards for quantitative analysis.

Objective In this study,the diversity of the TCR β chain CDR3 in peripheral blood of patients with different typical Traditional Chinese Medicine(TCM)syndromes of liver cirrhosis was analyzed by immune repertoire sequencing,the material basis and regularity of the syndromes of liver cirrhosis was discussed.Methods 20 patients with cirrhosis,including liver and gallbladder damp heat(LGHD),liver depression and spleen deficiency(LDSD),and liver and kidney yin deficiency(LKYD)were enrolled into case group,and 10 healthy patients were used as the healthy control group.DNA was extracted from peripheral blood samples,and multiplex PCR amplification of TCR β chain CDR3 was performed,followed by high-throughput sequencing of the products to analyze the diversity of the TCR β chain CDR3.Results The nt sequence numbers unique to CDR3 and aa sequence numbers unique to CDR3 of LDSD between liver cirrhosis syndromes were less than LKYD(P<0.05).Clonality,Pielous,Shannon.Index and DE50 of LGHD and LKYD had significant differences(P<0.05)between two groups,as well as the frequency of multiple fragments in V and J regions and V-J gene recombination of LGHD vs.LDSD,LGHD vs.LKYD,and LKYD vs.LDSD,respectively(P<0.05).LGHD vs.LDSD,TRBV21-1,TRBV12-4,TRBV11-1 subtype and 7 pairs of V-J recombination have statistical differences(P<0.05).LGHD vs.LKYD,TRBV10-2,TRBV7-6,TRBV5-8 subtypes and 30 pairs of V-J recombination were statistically different(P<0.05).LDSD vs.LKYD,there were statistical differences between TRBJ1-5 subtype and 18 pairs of V-J recombination(P<0.05).Conclusions The present study was conducted to find that the diversity of TCR CDR3 in liver cirrhosis syndrome is significantly different and conforms to the regularity of syndrome from excess to deficiency by explore the immunological characteristics of different TCM syndromes of liver cirrhosis,and to provide new support for the objective basis of"combination of disease and TCM syndrome"and"diagnosis and treatment".We explored the different expression patterns and specificity of adaptive immune gene rearrangement in patients with different TCM syndromes to identify different expression patterns and specific markers of adaptive immune gene rearrangements of typical TCM syndromes in liver cirrhosis.

The proposal of new quality productive forces provide the key driving force and strategy for the high-quality de-velopment of public hospitals and the acceleration of health modernization.In the era of promoting high-quality development with new quality productive forces,large public hospitals,as the main force to promote the development of China's health cause,ex-plore the path of international innovation and development has become its important mission.This paper summarizes experience of The First Affiliated Hospital,Sun Yat-sen University on how to promote discipline construction,scientific innovation,talent train-ing,brand construction,etc.,through international exchange and cooperation.The authors put forward suggestions for public hospitals on cultivating new quality productive forces,aiming to provide reference for empowering high-quality development through international exchange and cooperation while facing new challenges.

Delayed lactation activation is a risk factor for early termination of postpartum breastfeeding with high prevalence and adverse effects on the immediate and long-term growth and development of preterm infants,especially very low birth weight infants.This article reviews the delayed lactation activation,evaluation methods of lactation activation in premature mothers and the intervention measures to shorten the delay of lactation activation,in order to provide the basis for the development of relevant studies and the formulation of effective intervention programs.

Objective To develop a geriatric-friendly care plan for elderly patients with chronic heart failure based on the 4Ms theoretical model and to validate its clinical effectiveness.Methods Based on literature review and patient interviews,a 4Ms geriatric-friendly care plan for elderly patients with heart failure was developed.The convenience sampling method was used to select A total of 160 patients admitted to a tertiary hospital in Zhejiang Province from August 2022 to June 2023 were selected as the study subjects.Among them,80 patients from January to June 2023 were assigned to an experimental group,and 80 patients from August to December 2022 were assigned to a control group.The experimental group received the 4Ms geriatric-friendly care plan developed in this study,while the control group received routine care.The differences in elderly-related complications during hospitalization,length of hospital stay,total hospitalization costs,satisfaction,and post-discharge outcomes(including readmission rates,improper medication and exercise capacity)were compared between the 2 groups.Results A total of 3 cases were lost,resulting in 78 cases in the experimental group and 79 cases in the control group.The experimental group had higher hospital satisfaction,lower hospitalization days,and lower total hospitalization costs compared to the control group(all P＜0.01).Within 3 months post-discharge,the experimental group had lower readmission and inappropriate medication score,with better exercise capacity compared to the control group(all P＜0.05).Conclusion The 4Ms geriatric-friendly care plan developed in this study demonstrates scientific and practical value.It effectively improves patient satisfaction,medication compliance,and exercise capacity,while reducing hospitalization days and readmission rates.This plan has significant references.

Intestinal fibrosis in Crohn′s disease (CD) presents a significant clinical challenge, imposing a substantial burden on patients, their families and society. This article explores the histopathological and pathophysiological changes associated with intestinal fibrosis, providing a detailed summary of the related phenomena and processes. Additionally, we discuss the methods for detecting and assessing intestinal fibrosis, including radiological examinations, histopathological investigations, and the application of serum biomarkers. Finally, we delve into the therapeutic strategies for intestinal fibrosis in CD and the challenges faced in this realm, offering vital insights for further research and treatment of the disease.

Intestinal fibrosis in Crohn′s disease (CD) presents a significant clinical challenge, imposing a substantial burden on patients, their families and society. This article explores the histopathological and pathophysiological changes associated with intestinal fibrosis, providing a detailed summary of the related phenomena and processes. Additionally, we discuss the methods for detecting and assessing intestinal fibrosis, including radiological examinations, histopathological investigations, and the application of serum biomarkers. Finally, we delve into the therapeutic strategies for intestinal fibrosis in CD and the challenges faced in this realm, offering vital insights for further research and treatment of the disease.

The proposal of new quality productive forces provide the key driving force and strategy for the high-quality de-velopment of public hospitals and the acceleration of health modernization.In the era of promoting high-quality development with new quality productive forces,large public hospitals,as the main force to promote the development of China's health cause,ex-plore the path of international innovation and development has become its important mission.This paper summarizes experience of The First Affiliated Hospital,Sun Yat-sen University on how to promote discipline construction,scientific innovation,talent train-ing,brand construction,etc.,through international exchange and cooperation.The authors put forward suggestions for public hospitals on cultivating new quality productive forces,aiming to provide reference for empowering high-quality development through international exchange and cooperation while facing new challenges.

Delayed lactation activation is a risk factor for early termination of postpartum breastfeeding with high prevalence and adverse effects on the immediate and long-term growth and development of preterm infants,especially very low birth weight infants.This article reviews the delayed lactation activation,evaluation methods of lactation activation in premature mothers and the intervention measures to shorten the delay of lactation activation,in order to provide the basis for the development of relevant studies and the formulation of effective intervention programs.