OBJECTIVE To evaluate the efficacy and safety of amoxicillin combined with proton pump inhibitor （PPI） or potassium-competitive acid blocker （P-CAB） for Helicobacter pylori （Hp） eradication. METHODS Randomized controlled trial （RCTs） on amoxicillin combined with PPI or P-CAB for Hp eradication were retrieved from PubMed， Embase， the Cochrane Library， Web of Science， CNKI， Wanfang， and VIP data. The search time frame was from database inception to September 5， 2025. After literature screening， data extraction， and quality assessment， a network meta-analysis was performed using Stata 17.0 software. RESULTS A total of 12 RCTs involving 5 515 patients were included， encompassing 8 therapeutic regimens： PPI combined with high-dose amoxicillin for 14 days （TR1）， PPI combined with low-dose amoxicillin for 14 days （TR2）， P-CAB combined with high-dose amoxicillin for 7 days （TR3）， P-CAB combined with high-dose amoxicillin for 14 days （TR4）， P-CAB combined with high-dose amoxicillin for 10 days （TR5）， P-CAB combined with low-dose amoxicillin for 7 days （TR6）， P-CAB combined with low-dose amoxicillin for 14 days （TR7）， and P-CAB combined with low-dose amoxicillin for 10 days （TR8）. The network meta-analysis results showed that， in terms of intention-to-treat Hp eradication rates， the eradication rates of TR5 and TR4 were significantly higher than those of TR3， TR8， TR6 and TR1 （ P ＜0.05）. The surface under the cumulative ranking curve （SUCRA） values from highest to lowest were： TR4 （89.7%）＞TR5 （82.3%）＞TR7 （71.5%）＞ TR2 （48.6%）＞TR1 （43.9%）＞TR8 （28.7%）＞TR3 （22.7%）＞TR6 （12.6%）. Regarding safety， the incidence of adverse reactions in TR3 and TR5 was significantly lower than that in TR1 （ P ＜0.05）. The SUCRA values from highest to lowest were： TR1 （91.3%）＞TR4 （79.8%）＞TR5 （55.0%）＞TR7 （50.9%）＞TR8 （41.3%）＞TR2 （36.4%）＞TR3 （27.6%） ＞TR6 （17.7%）. CONCLUSIONS Although the regimen of P-CAB combined with high-dose amoxicillin for 14 days demonstrates the best efficacy， the combination of P-CAB with high-dose amoxicillin for 10 days exhibits a better balanced profile in terms of both efficacy and safety.

ObjectiveTo explore the effect of the medical-community linkage model on activities of daily living, psychological status and motor function of stroke patients in the community. MethodsA total of 60 stroke patients admitted to two community health service centers and their affiliated stations in Fengtai District, Beijing, from January, 2024 to August, 2025 were enrolled and randomly divided into control group (n = 30) and intervention group (n = 30). The control group received routine medicine, dietary care and rehabilitation management, while the intervention group underwent rehabilitation with the medical-community linkage model, for twelve weeks. They were assessed with modified Barthel Index (MBI), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) and Fugl-Meyer Assessment (FMA) before and after intervention. ResultsAfter intervention, the MBI, HAMA, HAMD and FMA scores of patients improved in both groups (|t| > 5.599, P < 0.001), and improved more in the intervention group than in the control group (P < 0.05), except MBI. The HAMA and HAMD scores of family members decreased in both groups (|t| > 10.333, P < 0.001), and decreased more in the intervention group than in the control group (t > 5.681, P < 0.001). ConclusionThe medical-community linkage model can further improve the motor function of stroke patients in community, as well as the psychological status of both patients and their family members.

Background: and Purpose Vertebrobasilar fusiform aneurysms (VBFAs) carry substantial morbidity and mortality, but optimal management for unruptured VBFAs remains unclear. We compared the safety and efficacy of conservative management (CM), stent-assisted coiling (SAC), and flow diverters (FDs) in patients with unruptured VBFAs, focusing on long-term prognosis. Methods: This study included data from a nationwide Chinese cohort of patients with vertebrobasilar dissecting aneurysms. Inverse probability of treatment weighting (IPTW) balanced confounders across groups. The primary outcome was poor prognosis (modified Rankin Scale score >2). Secondary outcomes included aneurysm rupture, ischemic stroke, compression symptoms, and VBFA-related deaths. Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup and sensitivity analyses were performed. Results: Among 1,115 patients with unruptured VBFAs, 838 (median age, 54 years; 655 men) were included. After IPTW, baseline characteristics were balanced. Median follow-up was 54 months. FD was associated with a lower risk of poor prognosis than CM (OR, 0.48 [95% CI, 0.30 to 0.77]; p=0.002), with no difference between CM and SAC. FD also reduced aneurysm rupture (OR, 0.20 [95% CI, 0.07 to 0.60]; p=0.004) and compression symptoms (OR, 0.30 [95% CI, 0.13 to 0.68]; p=0.004) versus CM. Time-to-event analyses further revealed significant differences in vertebral artery lesions and Type I–II VBFAs, whereas no significant differences were observed in basilar or vertebrobasilar junction lesions or in Type III–IV VBFAs. Conclusions Compared with CM, FD was associated with improved long-term outcomes in unruptured VBFAs, particularly in vertebral artery lesions and Type I–II VBFAs, although residual confounding cannot be excluded.

OBJECTIVE To investigate the mechanism by which Shenfukang capsule （SFK） ameliorates renal interstitial fibrosis （RIF） by regulating macrophage-fibroblast crosstalk via the signal transducer and activator of transcription 3 （STAT3）/Yes-associated protein （YAP） pathway. METHODS RAW264.7 macrophages were induced to polarize with transforming growth factor-β 1 （TGF-β 1 ）. Subsequently， a non-contact co-culture system of macrophages with renal fibroblasts NRK-49F， as well as a non-contact co-culture system of macrophages with YAP-knockdown renal fibroblasts， were established. Cells were treated with low， medium， and high concentrations （4， 8， 16 μg/mL） of SFK， as well as a STAT3 inhibitor （STAT3-I，1.64 μg/mL） and losartan potassium tablets （positive control， 0.28 μg/mL）， for 48 h. After intervention， the protein and mRNA expression levels of CD86， CD163， and STAT3 in macrophages， as well as CD86， F4/80， and STAT3 mRNA， were detected. In co-cultured renal fibroblasts， the protein and mRNA expression levels of α -smooth muscle actin （ α -SMA）， Vimentin， collagen type Ⅰ （Col-Ⅰ）， matrix metalloproteinase-1 （MMP-1）， and YAP were detected. In co-cultured YAP-knockdown renal fibroblasts， the protein and mRNA expression levels of α -SMA， Vimentin， and MMP-1 were also detected. RESULTS Following TGF-β 1 induction， the protein expression levels of CD86， CD163， and STAT3， as well as the mRNA expression levels of CD86， F4/80， and STAT3 in macrophages were significantly increased （ P ＜0.05）. The conditioned medium from polarized macrophages activated renal fibroblasts， as evidenced by significantly increased protein and mRNA expression levels of α -SMA， Vimentin， Col-Ⅰ， and YAP， and significantly decreased protein and mRNA expression levels of MMP-1 in renal fibroblasts （ P ＜0.05）. Treatment with SFK and STAT3-I reversed the changes in the above indicators， with the medium concentration SFK group showing stronge r effects on some indicators than the low and high concentration groups. In the non-contact co-culture experiment of macrophages and YAP-knockdown renal fibroblasts， there were no statistically significant differences in the protein and mRNA expression of α-SMA， Vimentin， and MMP-1 among the groups. CONCLUSIONS SFK can inhibit macrophage-renal fibroblast crosstalk by blocking the STAT3/YAP pathway， thereby delaying the progression of RIF.

Objective To analyze cysteinylaspartate specific proteinase-3,caspase-7,caspase-9,AMP activated protein kinase(AMPK)in the diagnosis and prognosis evaluation of sepsis.Methods Sixty patients with sepsis from the Affiliated Hospital of Xiangnan University from March 2020 to March 2023 were selected as the observation group,and another 60 healthy individuals from the physical examination center of the hospital during the same period were selected as the control group.Acute physiology and chronic health evaluationⅡ(APACHEII)score was used to evaluate the severity of the patient's condition.Serum caspase-3,caspase-7,caspase-9,AMPK and APACHEII scores were detected,and compared between the two groups.These parameters were compared with serum Caspase-3,caspase-7,caspase-9,AMPK and APACHEII scores in different disease severity groups.The patients were divided into survival group(50 cases)and death group(10 cases)according to prognosis.Serum Caspase-3,caspase-7,caspase-9,AMPK and APACHEII scores were compared between the two groups,and the correlation between serum caspase-3,caspase-7,caspase-9,AMPK and APACHEII scores were analyzed by Pearson.Receiver operating characteristic(ROC)was drawn,the area under the curve(AUC)was calculated,the predictive efficacy of serum caspase-3,caspase-7,caspase-9 and AMPK in patients death with sepsis were analyzed.Results The serum levels of caspase-3,caspase-7,caspase-9,AMPK,and APACHEII score in the observation group were higher than those in the control group,and the differences were statistically significant(t=19.501～44.219,all P<0.05).The serum caspase-3,caspase-7,caspase-9,AMPK,and APACHEII scores in the sep-tic shock group were higher than those in the severe and mild groups,and the differences were statistically significant(t=2.091～6.946,all P<0.05).The serum caspase-3,caspase-7,caspase-9,AMPK,and APACHEII scores of the death group were higher than those of the survival group,and the differences were statistically significant(t=4.576～8.835,all P<0.05).Serum caspase-3,caspase-7,caspase-9 and AMPK were positively correlated with APACHEII scores(r=0.382～0.406,all P<0.05).The AUC of combined detection of serum caspase-3,caspase-7,caspase-9,and AMPK for predicting death in sepsis patients was 0.863,with 95%confidence interval of 0.805-0.958.which was greater than that of single indicator detection,and the difference is statistical-ly significant(Z=2.912～2.294,all P<0.05).Conclusion Serum caspase-3,caspase-7,caspase-9,and AMPK in sepsis patients showed abnormally high expressions,which were closely related to disease severity and prognosis.Combined detection could improve the sensitivity and specificity of death prediction,which has certain reference value.

AIM:To construct a network calcula-tor based on machine learning(ML)models to pre-dict the risk of delayed awakening from anaesthesia in breast cancer(BC)patients.METHODS:A total of 435 BC patients surgically treated at our hospital from January 2023 to June 2024 were selected.The Boruta algorithm was used to screen for important characteristic variables for the risk of delayed awak-ening from anaesthesia.All patients were randomly assigned to a training set(n=261)and a test set(n=174)based on a 3:2 ratio and nine ML models were constructed and trained.Nine ML models were evaluated on the basis of receiver operating charac-teristic(ROC)curves for a random sample of 10 sub-jects and the clinical utility of the models was as-sessed using decision curve analysis.Combined with SHapley Additive exPlanations(SHAP)bar graphs,summary graphs and force diagrams additional in-terpretation and visualization of the ML model.Con-struction of a network calculator for predicting the risk of delayed awakening from anesthesia in BC pa-tients using the R package.RESULTS:Of the 435 BC patients,25.1%experienced delayed awakening from anesthesia.Boruta algorithm screened seven feature variables.The ROC curve shows that the XG-Boost model has the highest area under the curve(AUC)for 10 random samples among the 9 ML mod-els,and the decision curve shows that the XGBoost model has a significant clinical net benefit.The SHAP bar graph shows the importance of ASA classi-fication,surgery time,anesthesia time,intraopera-tive blood loss,propofol,preoperative anemia,and intraoperative hypothermia,and the SHAP summa-ry graph reflects the distribution of the ranges of in-fluence of the seven important characteristic vari-ables,which are"separated at the ends."The SHAP force diagram visualization XGBoost model predict-ed the risk of delayed awakening from anesthesia for individual patients with a predictive value of 0.998 for patients with delayed awakening from an-esthesia and 0.008 91 for patients without delayed awakening from anesthesia.A web-based calculator(https://xz-nomogram.shinyapps.io/DE_web/)based on an interpretable XGBoost model effective-ly predicts the risk of delayed awakening from anes-thesia in BC patients.CONCLUSION:ASA classifica-tion,surgery time,propofol,intraoperative blood loss,anaesthesia time,preoperative anaemia and intraoperative hypothermia are important charac-teristic variables for the risk of delayed awakening from anaesthesia in BC patients.The network calcu-lator based on the interpretable XGBoost model can accurately and quickly quantify the risk of de-layed awakening from anaesthesia,which can help clinicians to effectively adjust the treatment strate-gy and better improve the prognosis of patients.

Objective:To investigate the efficacy of high-flux hemodialysis combined with hemoperfusion in patients with uremia.Methods:Eighty patients with uremia who received treatment at the Quzhou Hospital Affiliated to Wenzhou Medical University (Quzhou People's Hospital) from January 2020 to December 2022 were selected for this prospective randomized controlled trial. Participants were grouped using a random number table method, with 40 patients in the study group receiving high-flux hemodialysis combined with hemoperfusion, and 40 patients in the control group receiving high-flux hemodialysis alone. Toxicity clearance, calcium-phosphate metabolism, immune function, and vascular endothelial function were assessed using competitive enzyme-linked immunosorbent assay, immunofluorescence assay, fully automated biochemical analyzers, and immunoturbidimetric assay. The differences in toxicity clearance, calcium-phosphate metabolism, immune function, and vascular endothelial function were compared between the two groups.Results:Compared with before treatment, both groups showed a significant decrease in parathyroid hormone (PTH), blood creatinine, β 2-microglobulin, blood urea nitrogen, blood phosphorus, advanced glycation end products (AGEs), intercellular adhesion molecule-1 (ICAM-1), and homocysteine (Hcy) after treatment. Specifically, PTH levels decreased from (353.28 ± 50.26) ng/L to (235.26 ± 31.51) ng/L in the control group and from (357.17 ± 52.18) ng/L to (174.16 ± 26.35) ng/L in the study group; blood creatinine decreased from (969.47 ± 110.44) μmol/L to (511.57 ± 91.96) μmol/L in the control group and from (957.58 ± 121.99) μmol/L to (414.37 ± 87.41) μmol/L in the study group; β 2-microglobulin decreased from (40.27 ± 7.98) mg/L to (22.06 ± 3.26) mg/L in the control group and from (41.65 ± 8.40) mg/L to (17.70 ± 3.43) mg/L in the study group; blood urea nitrogen decreased from (30.64 ± 5.63) mmol/L to (14.02 ± 2.80) mmol/L in the control group and from (30.04 ± 5.90) mmol/L to (10.07 ± 1.94) mmol/L in the study group; blood phosphorus decreased from (2.23 ± 0.49) mmol/L to (1.80 ± 0.36) mmol/L in the control group and from (2.26 ± 0.53) mmol/L to (1.53 ± 0.31) mmol/L in the study group ; Hcy decreased from (35.87 ± 5.34) μmol/L to (30.93 ± 4.65) μmol/L in the control group and from (36.21 ± 5.27) μmol/L to (20.26 ± 4.53) μmol/L in the study group; ICAM-1 decreased from (574.96 ± 56.81) ng/L to (419.87 ± 40.76) ng/L in the control group and from (569.84 ± 52.37) ng/L to (384.51 ± 35.12) ng/L in the study group; AGEs levels decreased from (330.41 ± 43.69) mg/L to (297.64 ± 38.59) mg/L in the control group and from (326.98 ± 41.25) mg/L to (165.42 ± 15.74) mg/L in the study group. Conversely, compared with before treatment,blood calcium, immunoglobulin G, immunoglobulin M, immunoglobulin A, CD 4+, CD 4+/CD 8+ ratio, complement 3, and complement 4 all increased after treatment. Specifically, blood calcium increased from (1.90 ± 0.43) mmol/L to (2.27 ± 0.32) mmol/L in the control group and from (1.93 ± 0.46) mmol/L to (2.61 ± 0.36) mmol/L in the study group; IgG increased from (7.73 ± 1.56) g/L to (9.21 ± 2.04) g/L in the control group and from (7.82 ± 1.62) g/L to (10.7 ± 2.02) g/L in the study group; IgM increased from (0.42 ± 0.07) g/L to (1.29 ± 0.11) g/L in the control group and from (0.40 ± 0.08) g/L to (1.52 ± 0.08) g/L in the study group; IgA increased from (0.44 ± 0.16) g/L to (1.54 ± 0.25) g/L in the control group and from (0.48 ± 0.19) g/L to (1.93 ± 0.38) g/L in the study group; CD 4+ increased from (32.77 ± 5.71)% to (38.18 ± 4.92)% in the control group and from (32.11 ± 5.34)% to (46.07 ± 4.95)% in the study group; the CD 4+/CD 8+ ratio increased from (1.07 ± 0.14) to (1.29 ± 0.15) in the control group and from (1.07 ± 0.17) to (1.61 ± 0.26) in the study group; C3 increased from (0.80 ± 0.12) g/L to (1.01 ± 0.20) g/L in the control group and from (0.79 ± 0.14) g/L to (1.19 ± 0.23) g/L in the study group; and C4 increased from (0.32 ± 0.15) g/L to (0.67 ± 0.17) g/L in the control group and from (0.33 ± 0.14) g/L to (0.86 ± 0.12) g/L in the study group. All these differences were statistically significant between the two groups ( t = 12.01, 19.47, 33.98, 33.72, 17.64, 20.36, 22.75, 24.28, 19.25, 22.77, 4.71, 29.54, 32.01, 27.39, -5.06, -11.39, -4.79, -9.65, -61.55, -97.13, -36.63, -32.21, -7.71, -16.90, -5.78, -11.34, -9.21, -13.28, -13.25, -33.73, all P < 0.05). Additionally, when compared with the control group, the study group showed superior results ( t = -9.40, -4.84, -5.82, -7.33, -3.59, -10.40, -4.16, -20.07, 4.47, 3.28, 5.43, 7.14, 6.73, 3.73, 5.76, all P < 0.05). Conclusions:High-flux hemodialysis combined with hemoperfusion for the treatment of uremia can effectively improve calcium and phosphorus metabolism and vascular endothelial function, as well as enhance immune function and toxicity clearance rate.

Objective:To investigate the effects of warm compresses with Jianlou Decoction combined with aspirin enteric coated tablets on the function of autologous arteriovenous fistula (AVF) and hemodynamics in patients with uremia. Methods:A prospective study was conducted involving 90 patients with uremia who underwent AVF creation at Quzhou Hospital Affiliated to Wenzhou Medical University (Quzhou People's Hospital), from January 2018 to December 2023. The patients were randomly divided into a control group (45 patients receiving aspirin enteric coated tablets) and a study group (45 patients receiving warm compresses with Jianlou Decoction combined with aspirin enteric coated tablets). The internal diameter and blood flow of the fistula, vascular endothelial function, hemodynamics, the presence of vascular murmurs, elasticity, fistula patency and function, and the occurrence of complications were compared between the two groups. Results:After 1 month of treatment, the internal diameter of AVF increased in each group [study group: (6.69 ± 1.93) mm vs. (5.02 ± 1.56) mm; control group: (5.69 ± 1.78) mm vs. (4.93 ± 1.30) mm] compared with before treatment ( t = 8.29, 2.63, both P < 0.05). The blood flow of AVF increased in each group [study group: (530.49 ± 91.88) mL/min vs. (236.51 ± 21.84) mL/min; control group: (418.16 ± 53.87) mL/min vs. (242.36 ± 22.33) mL/min] compared with before treatment ( t = 23.85, 28.69, both P < 0.05). After 1 month of treatment, the internal diameter and blood flow of AVF in the study group were greater compared with those in the control group ( t = 2.55, 7.07, both P < 0.05). After 1 month of treatment, the levels of endothelin-1 in each group significantly decreased compared with before treatment [control group: (64.83 ± 11.80) μmol/L vs. (102.48 ± 16.60) μmol/L; study group: (49.48 ± 12.15) μmol/L vs. (104.60 ± 16.52) μmol/L] compared with before treatment ( t = -19.13, -23.51, both P < 0.05). The levels of nitric oxide [control group: (95.65 ± 14.87) ng/L vs. (78.56 ± 13.47) ng/L; study group: (86.36 ± 14.68) ng/L vs. (76.59 ± 13.56) ng/L], vascular diameter [control group: (7.20 ± 0.63) mm vs. (2.53 ± 0.50) mm; study group: (5.42 ± 0.66) mm vs. (2.47 ± 0.55) mm], vascular wall thickness [control group: (0.82 ± 0.05) mm vs. (0.28 ± 0.07) mm; study group: (0.60 ± 0.05) mm vs. (0.29 ± 0.10) mm], and blood flow [control group: (825.00 ± 65.00) mL/min vs. (314.84 ± 72.75) mL/min; study group: (623.71 ± 74.19) mL/min vs. (321.24 ± 71.62) mL/min] in each group significantly increased compared with before treatment ( t = 9.50, 4.99, 48.94, 26.89, 48.33, 22.11, 55.92, 29.50, all P < 0.05). Additionally, after 1 month of treatment, the levels of endothelin-1 in the study group were significantly lower than those in the control group ( t = 6.08, P < 0.05). The levels of nitric oxide, vascular diameter, vascular wall thickness, and blood flow in the study group were greater than those in the control group ( t = 2.98, 13.15, 21.99, 13.69, all P < 0.05). After 1 month of treatment, the shear stress of the radial artery in each group decreased significantly compared with before treatment [control group: (42.96 ± 6.54) dyne/cm2 vs. (47.62 ± 7.36) dyne/cm2; study group: (34.31 ± 6.71) dyne/cm2 vs. (46.71 ± 7.56) dyne/cm2, t = -13.30, -4.67, both P < 0.05]. The blood flow velocity at the venous end of the anastomosis significantly increased in both groups compared with pre-treatment levels [control group: (85.51 ± 8.48) cm/s vs. (74.60 ± 10.80) cm/s; study group: (119.18 ± 10.27) cm/s vs. (73.27 ± 10.37) cm/s, t = 35.92, 10.03, both P < 0.05]. The shear stress of the radial artery in the study group was lower ( t = -6.18, P < 0.05), while the blood flow velocity at the venous end of the anastomosis was higher ( t = 16.95, P < 0.05) compared with the control group. The incidence of vascular murmurs [11.11% (5/45) vs. 28.89% (13/45)] and the failure/reconstruction rate of the fistula [4.44% (2/45) vs. 24.44% (11/45)] were significantly lower compared with the control group ( Z = -2.10, -2.68, both P < 0.05). The rate of good vascular elasticity [93.33% (42/45) vs. 71.11% (32/45)] and the patency rate of the AVF [93.33% (42/45) vs. 73.33% (33/45) in the study group were significantly higher compared with the control group ( Z = 2.74, 2.53, both P < 0.05). The total incidence of complications in the study group was significantly higher than that in the control group [2.22% (1/45) vs. 20.00% (9/45), χ2 = 7.20, P < 0.05). Conclusions:Warm compresses with Jianlou Decoction combined with aspirin enteric coated tablets can increase the internal diameter and blood flow of AVF in patients with uremia, improve endothelial function and hemodynamics, reduce thrombus formation, enhance fistula function and patency rates, and decrease the incidence of fistula failure/reconstruction and complications.

OBJECTIVE To investigate the current status of water management for terminal rinsing of digestive en-doscope in medical institutions in Fujian Province,and to provide reference for improving regional quality control standards.METHODS An electronic questionnaire survey was conducted from Jul.2024 to Aug.2024 through convenient sampling in secondary and above hospitals of 9 prefecture-level cities in Fujian Province.The survey covered topics such as water treatment system configuration,maintenance and water quality monitoring.RESULTS A total of 108 questionnaires were distributed and 104 valid questionnaires were collected,with an effec-tive response rate of 96.30％.The survey revealed that 78.85％(82/104)of the hospitals adopted separate water supply for each department,and 82.69％used purified water for terminal rinsing.Only 19.23％installed the final filter membrane at the water outlet.In addition,66.35％of the hospitals did not specify the service life of the wa-ter supply pipeline,and the pipeline disinfection implementation rate was 60.58％,but 31.75％of them had ir-regular disinfection frequencies,with chlorine-based disinfectants(50.79％)and peracetic acid(34.92％)being the main disinfectants.The regular conductivity monitoring rate was 47.12％,and the microbial monitoring cov-erage rate reached 90.38％,with the monitoring frequency mainly being once every quarter(60.64％),but only 20.21％used R2A medium,and 12.77％adopted the membrane filtration method for inoculation.Tertiary hospi-tals were superior to secondary hospitals in terms of film membrane pore size pass rate(87.50％vs.56.86％),pipeline disinfection implementation rate(71.43％vs.50.91％)and advanced detection method application(P＜0.05).CONCLUSIONS There are issues in the management of water used for terminal rinsing of digestive endo-scopes in Fujian Province,including non-standard equipment maintenance,inconsistent monitoring methods and insufficient awareness among management personnel.It is recommended to enhance management quality by optimizing the water treatment system setup,establishing standardized monitoring procedures and strengthening professional training for personnel.

This article reported a pregnant woman admitted to the hospital due to "25 +2 weeks of amenorrhea and a 1-day history of shortened cervical canal accompanied by vaginal bleeding". The patient with pregestational diabetes mellitus and suboptimal glycemic control required prolonged hospitalization for tocolytic therapy due to shortened cervical length. She developed a cough at 31 weeks and 4 days of gestation, followed by right-sided intercostal pain and hypotension after coughing at 31 weeks and 6 days of gestation. Bedside chest ultrasound showed a small anechoic fluid collection (approximately 1.1 cm in width) in the right pleural cavity. The emergency cesarean section was performed at 31 weeks and 4 days of gestation. However, the intraoperative bleeding and other conditions were inconsistent with the obstetric clinical presentations of blood loss. Subsequent repeated ultrasound and CT examinations confirmed the diagnosis of pulmonary sequestration and right-sided progressive hemopneumothorax. On the same day, an emergency right lower lobectomy was performed, achieving stable postoperative recovery. Both mother and infant had favorable outcomes. Hemopneumothorax complicated by pulmonary sequestration is uncommon, and its occurrence during pregnancy is exceedingly rare. Multidisciplinary consultations, aggressive, rapid, and accurate diagnosis, and combined treatment are critical to ensuring maternal-fetal survival. Hemopneumothorax caused by the rupture of pulmonary sequestration during pregnancy represents a life-threatening condition. Emergency thoracotomy can timely clarify the cause, arrest bleeding, relieve compression, and resect the lesion, thereby reducing mortality and the complications risk.