Objective To develop a risk assessment scale for immune checkpoint inhibitor (ICI)-associated myocarditis based on multidisciplinary collaboration, and to evaluate its diagnostic performance. Methods Based on multidisciplinary cooperation, integrating clinical experience from oncology and cardiology, literature data, and patient conditions, a risk assessment scale for ICI-associated myocarditis was developed. A total of 101 patients with malignancies who received immunotherapy at Zhongshan Hospital, Fudan University, from October 2020 to October 2024 were included as the validation cohort. Patients were stratified into low-risk (0-1 point), medium-risk (2-4 points), and high-risk (≥5 points) groups based on their scale scores. The association between pretictive risk stratifications and actual assessment results was assessed using the Cox proportional hazards regression model. The predictive value of the scale for ICI-associated myocarditis was evaluated using receiver operating characteristic (ROC) curve. Agreement between the scale scores and actual assessment results was assessed using Cohen’s Kappa coefficient. Results Based on the scale pretictive results, 28(27.7%), 8(7.9%), 65(64.4%) patients were at low risk, medium risk, and high risk for ICI-related myocarditis, respectively; however, 46(45.5%), 8(7.9%), 47(46.5%) were at low risk, medium risk, and high risk actually. Kaplan-Meier survival analysis showed that the cumulative incidence of ICI-related myocarditis in the high-risk group was significantly higher than that in the medium- and low-risk groups (P＜0.05). In the multivariable-adjusted Cox proportional hazards model, the ICI-related myocarditis risk in high-risk group was about 4 times that in the low-risk group. ROC curve analysis demonstrated that the average area under the curve (AUC) for predicting ICI-related myocarditis was 0.81, with an accuracy of 0.74. The Cohen’s Kappa coefficient was 0.55, indicating moderate agreement. In the actual high-risk group, no patient was predicted to be at low risk; in the actual low-risk group, 16 patients were predicted to be at high risk. Conclusions This risk assessment scale for ICI-associated myocarditis shows high predictive performance. It provides oncologists with a simple yet effective multidisciplinary diagnostic reference tool, potentially enhancing early identification of ICI-associated myocarditis.

Objective To explore the association between the relative expression level of SNORD55 in peripheral blood and the outcomes of all-cause mortality and stroke in patients with atrial fibrillation(AF),and to evaluate the predictive value of SNORD55 for prognosis.Methods A total of 133 patients with non-valvular AF admitted in Department of Cardiology of the First Affiliated Hospital of Army Medical University from January 2014 to December 2017 were enrolled in this study.Their baseline information was collected,and the relative expression level of plasma SNORD55 was detected.Cox proportional hazards model was used to explore the association between the relative expression level of SNORD55 in peripheral blood and all-cause mortality as well as stroke in the patients.The predictive performance of CHA2DS2-VASc score for all-cause mortality and stroke was compared with the score combined with the relative expression level of SNORD55 in the AF patients.The area under the receiver operating characteristic curve(AUC)was utilized to evaluate the discrimination,and the net reclassification index(NRI)and comprehensive discriminant improvement index(IDI)were calculated to evaluate the improvement of reclassification ability.Decision curve analysis(DCA)was applied to analyze the change in clinical net benefit.Results The results of multivariate Cox regression showed that high expression of SNORD55 in peripheral blood was an independent risk factor for all-cause mortality and stroke in the AF patients.In predicting the outcomes of all-cause mortality and stroke,the addition of relative expression SNORD55 level with the CHA2DS2-VASc score obtained higher AUC value[0.80(95％CI:0.67～0.93)vs 0.67(95％CI:0.53～0.81),P＜0.05].In predicting the outcome of all-cause death and stroke,combination of the relative expression level of SNORD55 with CHA2DS2-VASc score increased both NRI[54.3(95％CI:10.6～61.9)vs 31.9(95％CI:2.8～47.5),P＜0.05]and IDI[16.1(95％CI:2.4～27.0)vs 7.9(95％CI:0.5～14.8),P＜0.05].The results of DCA showed that our combination of CHA2DS2-VASc score relative expression level of SNORD55 had higher clinical net benefits than the foreign ABC score in the prediction of the outcomes.Conclusion Peripheral blood SNORD55 level is an independent risk factor for all-cause mortality and stroke in AF patients,and has good predictive performance for all-cause mortality and stroke in the patients.

Objectives To explore the association of peripheral blood PIWI-interacting RNA,piR-hsa-2700592,with all-cause mortality and stroke outcomes in patients with atrial fibrillation(AF),and to determine whether piR-hsa-2700592 has the potential to be an AF biomarker.Methods A total of 127 patients with non-valvular AF were enrolled,and the relative expression level of plasma piR-hsa-2700592 was detected.Cox proportional hazard regression was used to analyze the correlation between the expression of piR-hsa-2700592 and all-cause death as well as stroke outcome in the patients.Then the molecule expression level was combined with CHA2DS2-VASc score and ABC stroke(or death)score to establish 2 new prediction models,the improvement of the predictive performance was compared and analyzed.Receiver operating characteristic(ROC)curve analysis(area under the curve,AUC),net reclassification index(NRI),and comprehensive discriminant improvement index(IDI)were used to evaluate the predictive performance,and decision curve analysis(DCA)was employed to assess the clinical benefit.Results Multivariate Cox regression analysis showed that the patients with higher expression level of piR-hsa-2700592 in peripheral blood had a higher risk of stroke(HR:2.203,95%CI:1.120～4.332;P=0.022).In the stroke outcome,combination of plasma piR-hsa-2700592 expression level with CHA2DS2-VASc score and ABC stroke score obtained an AUC of 0.70(95%CI:0.55～0.85,P＜0.001)and 0.84(95%CI:0.73～0.96,P=0.02),respectively.But,no significant association was observed between high plasma piR-hsa-2700592 level and all-cause mortality in the AF patients(HR:1.997;95%CI:0.884～4.509;P=0.096).Combination of plasma piR-hsa-2700592 level improved the discriminative capability than the single CHA2DS2-VASc score and ABC stroke score models,with an NRI and IDI value of 44.20%(95%CI:3.40～59.90,P＜0.001)and 8.20%(95%CI:0.60～15.40,P＜0.001),respectively for the new CHA2DS2-VASc score model,and an NRI and IDI value of 44.20%(95%CI:9.80～58.90,P＜0.001)and 10.40%(95%CI:0.70～21.40,P＜0.001),respectively for the new ABC stroke score model.The DCA curve showed that both new prediction models obtained better net clinical benefits.Conclusion High peripheral blood expression of piR-hsa-2700592 is an independent risk factor for stroke in the AF patients,and the indicator has a good predictive value for prognosis of the patients.piR-hsa-2700592 might be used as a potential biomarker in the diagnosis and prevention of cardiovascular diseases.

OBJECTIVE To explore the mechanism of limonin treating in hepatic fibrosis through network pharmacology, and validate its mechanism by molecular docking and animal experiments. METHODS Firstly, the targets of limonin and hepatic fibrosis were screened from the SwissTargetPrediction, GeneCards and DisGeNet database, etc. Meanwhile, the common targets of limonin and hepatic fibrosis were obtained from the bioinformatics website. The protein protein interaction network of common target was constructed by using STRING database and Cytoscape software, and the CytoNCA plug-in was used to screen core targets. And then the enrichment analysis of GO and KEGG on the common target was performed by Metascape database. Thereby, the possible mechanism of limonin against hepatic fibrosis were predicted. Finally, the AutoDock Vina was used for molecular docking verification, and the prediction results of network pharmacology were verified by animal experiments. RESULTS The prediction results indicated that limonin might acted on 86 targets including AKT1, VEGFA and HIF1A, and participated in biological processes including hormone response, protein phosphorylation, angiogenesis, and PI3K-Akt pathway, HIF-1 pathway, VEGF pathway and other signaling pathways related to hepatic fibrosis. The results of protein protein interaction network topology analysis showed that the 11 core targets including AKT1, VEGFA, HIF1A and PIK3CA, etc. Molecular docking results showed that limonin had strong affinity and relatively stable binding conformation with the core targets. In the animal experiments, compared with the model group, hyaluronidase(HA) and laminin(LN) in rat serume in high-dose group of limonin(LH) and low-dose group of limonin(LL)(except for LN in LL group) were declined(P<0.01 or P<0.05), and the degree of inflammation and hepatic fibrosis were relieved to different degrees in liver tissue of the LH group and LL group; Western blotting and qPCR detection showed that protein and mRNA expression levels of AKT, HIF-1α and VEGF(except for VEGF in LL group) was down-regulated in the LH group and LL group(P<0.01 or P<0.05). CONCLUSION Limonin may acts on AKT1, VEGFA, HIF1A and other core targets to treat hepatic fibrosis angiogenesis, which may be related to the inhibition of AKT/HIF-1α/VEGF signaling pathway.

Objective:To explore the establishment of a Cox proportional hazard prediction model for the re-cent(within a week)delivery of pregnant women with threatened early preterm labor(28-33+6 weeks).Meth-ods:The clinical data of 293 patients with threatened early preterm labor at 28-33+6 weeks admitted to the De-partment of Obstetrics,Affiliated Hospital of North Sichuan Medical College from January 2021 to December 2022 were retrospectively collected.According to whether the patient gave birth recently(within a week)during hospi-talization,they were divided into delivery group(n=88)and non-delivery group(n=205).Demographic data,specialty conditions and clinical biochemical indicators were collected,and the differences of each observation in-dex between the two groups were compared.Cox multivariate analysis was used to screen variables,and then the Cox proportional hazard prediction model was constructed to calculate the hazard ratio(HR).The C-index was used to test the predictive ability of the model,and the nomogram was drawn to visualize the Cox proportional hazard prediction model.The calibration curve was used to test the consistency between the model prediction re-sults and the actual situation.Results:The average age of the delivery group was 30.2±5.0 years old,and the average prolonged pregnancy time was 61.3±47.5 hours.Compared to the group that gave birth and did not give birth,the proportion of patients with body mass index(BMI)at admission,parity＞1,gestational diabetes mellitus or diabetic pregnancy combined(GDM/PGDM),abnormal fetal orientation,regular contractions at admis-sion,vaginal cleanliness≥ Ⅲ,white blood cell count ≥10 ×109/L at admission and cervical length＜20 mm,the difference was statistically significant(P＜0.05).Multivariate Cox regression analysis:BMI＞30 kg/m2(HR 2.178,95％CI 1.208-3.928,P=0.010),parity＞1(HR 3.095,95％CI 1.759-5.447,P＜0.001),regular uterine contraction(HR3.447,95％CI 2.216-5.362,P＜0.001),cervical length＜20 mm(HR3.594,95％CI 2.289-5.646,P＜0.001)and white blood cell count≥10 ×109/L(HR2.124,95％CI 1.352-3.335,P=0.001)on admission were independent risk factors for recent(within a week)delivery of pregnant women with threatened early preterm birth.When the above 5 indicators were included in the prediction model,the C-index was 0.797(95％CI 0.750-0.844),indicating that the model had good prediction ability.The calibration chart shows that the prediction results of the model are in good agreement with the actual results.Conclusions:Preg-nant women with BMI＞30 kg/m2 at admission,parity＞1,regular uterine contraction at admission,cervical length＜20 mm at admission and white blood cell count≥10 ×109/L at admission are prone to premature delivery in the near future.Cox proportional risk prediction model based on the above risk factors has certain accuracy,which can be used to guide clinical workers to take corresponding intervention measures in advance to avoid or reduce the possibility of premature delivery in the near future and improve maternal and infant outcomes.

Objective:To explore the establishment of a Cox proportional hazard prediction model for the re-cent(within a week)delivery of pregnant women with threatened early preterm labor(28-33+6 weeks).Meth-ods:The clinical data of 293 patients with threatened early preterm labor at 28-33+6 weeks admitted to the De-partment of Obstetrics,Affiliated Hospital of North Sichuan Medical College from January 2021 to December 2022 were retrospectively collected.According to whether the patient gave birth recently(within a week)during hospi-talization,they were divided into delivery group(n=88)and non-delivery group(n=205).Demographic data,specialty conditions and clinical biochemical indicators were collected,and the differences of each observation in-dex between the two groups were compared.Cox multivariate analysis was used to screen variables,and then the Cox proportional hazard prediction model was constructed to calculate the hazard ratio(HR).The C-index was used to test the predictive ability of the model,and the nomogram was drawn to visualize the Cox proportional hazard prediction model.The calibration curve was used to test the consistency between the model prediction re-sults and the actual situation.Results:The average age of the delivery group was 30.2±5.0 years old,and the average prolonged pregnancy time was 61.3±47.5 hours.Compared to the group that gave birth and did not give birth,the proportion of patients with body mass index(BMI)at admission,parity＞1,gestational diabetes mellitus or diabetic pregnancy combined(GDM/PGDM),abnormal fetal orientation,regular contractions at admis-sion,vaginal cleanliness≥ Ⅲ,white blood cell count ≥10 ×109/L at admission and cervical length＜20 mm,the difference was statistically significant(P＜0.05).Multivariate Cox regression analysis:BMI＞30 kg/m2(HR 2.178,95％CI 1.208-3.928,P=0.010),parity＞1(HR 3.095,95％CI 1.759-5.447,P＜0.001),regular uterine contraction(HR3.447,95％CI 2.216-5.362,P＜0.001),cervical length＜20 mm(HR3.594,95％CI 2.289-5.646,P＜0.001)and white blood cell count≥10 ×109/L(HR2.124,95％CI 1.352-3.335,P=0.001)on admission were independent risk factors for recent(within a week)delivery of pregnant women with threatened early preterm birth.When the above 5 indicators were included in the prediction model,the C-index was 0.797(95％CI 0.750-0.844),indicating that the model had good prediction ability.The calibration chart shows that the prediction results of the model are in good agreement with the actual results.Conclusions:Preg-nant women with BMI＞30 kg/m2 at admission,parity＞1,regular uterine contraction at admission,cervical length＜20 mm at admission and white blood cell count≥10 ×109/L at admission are prone to premature delivery in the near future.Cox proportional risk prediction model based on the above risk factors has certain accuracy,which can be used to guide clinical workers to take corresponding intervention measures in advance to avoid or reduce the possibility of premature delivery in the near future and improve maternal and infant outcomes.

Objective:To explore the establishment of a Cox proportional hazard prediction model for the re-cent(within a week)delivery of pregnant women with threatened early preterm labor(28-33+6 weeks).Meth-ods:The clinical data of 293 patients with threatened early preterm labor at 28-33+6 weeks admitted to the De-partment of Obstetrics,Affiliated Hospital of North Sichuan Medical College from January 2021 to December 2022 were retrospectively collected.According to whether the patient gave birth recently(within a week)during hospi-talization,they were divided into delivery group(n=88)and non-delivery group(n=205).Demographic data,specialty conditions and clinical biochemical indicators were collected,and the differences of each observation in-dex between the two groups were compared.Cox multivariate analysis was used to screen variables,and then the Cox proportional hazard prediction model was constructed to calculate the hazard ratio(HR).The C-index was used to test the predictive ability of the model,and the nomogram was drawn to visualize the Cox proportional hazard prediction model.The calibration curve was used to test the consistency between the model prediction re-sults and the actual situation.Results:The average age of the delivery group was 30.2±5.0 years old,and the average prolonged pregnancy time was 61.3±47.5 hours.Compared to the group that gave birth and did not give birth,the proportion of patients with body mass index(BMI)at admission,parity＞1,gestational diabetes mellitus or diabetic pregnancy combined(GDM/PGDM),abnormal fetal orientation,regular contractions at admis-sion,vaginal cleanliness≥ Ⅲ,white blood cell count ≥10 ×109/L at admission and cervical length＜20 mm,the difference was statistically significant(P＜0.05).Multivariate Cox regression analysis:BMI＞30 kg/m2(HR 2.178,95％CI 1.208-3.928,P=0.010),parity＞1(HR 3.095,95％CI 1.759-5.447,P＜0.001),regular uterine contraction(HR3.447,95％CI 2.216-5.362,P＜0.001),cervical length＜20 mm(HR3.594,95％CI 2.289-5.646,P＜0.001)and white blood cell count≥10 ×109/L(HR2.124,95％CI 1.352-3.335,P=0.001)on admission were independent risk factors for recent(within a week)delivery of pregnant women with threatened early preterm birth.When the above 5 indicators were included in the prediction model,the C-index was 0.797(95％CI 0.750-0.844),indicating that the model had good prediction ability.The calibration chart shows that the prediction results of the model are in good agreement with the actual results.Conclusions:Preg-nant women with BMI＞30 kg/m2 at admission,parity＞1,regular uterine contraction at admission,cervical length＜20 mm at admission and white blood cell count≥10 ×109/L at admission are prone to premature delivery in the near future.Cox proportional risk prediction model based on the above risk factors has certain accuracy,which can be used to guide clinical workers to take corresponding intervention measures in advance to avoid or reduce the possibility of premature delivery in the near future and improve maternal and infant outcomes.

Objective:To explore the establishment of a Cox proportional hazard prediction model for the re-cent(within a week)delivery of pregnant women with threatened early preterm labor(28-33+6 weeks).Meth-ods:The clinical data of 293 patients with threatened early preterm labor at 28-33+6 weeks admitted to the De-partment of Obstetrics,Affiliated Hospital of North Sichuan Medical College from January 2021 to December 2022 were retrospectively collected.According to whether the patient gave birth recently(within a week)during hospi-talization,they were divided into delivery group(n=88)and non-delivery group(n=205).Demographic data,specialty conditions and clinical biochemical indicators were collected,and the differences of each observation in-dex between the two groups were compared.Cox multivariate analysis was used to screen variables,and then the Cox proportional hazard prediction model was constructed to calculate the hazard ratio(HR).The C-index was used to test the predictive ability of the model,and the nomogram was drawn to visualize the Cox proportional hazard prediction model.The calibration curve was used to test the consistency between the model prediction re-sults and the actual situation.Results:The average age of the delivery group was 30.2±5.0 years old,and the average prolonged pregnancy time was 61.3±47.5 hours.Compared to the group that gave birth and did not give birth,the proportion of patients with body mass index(BMI)at admission,parity＞1,gestational diabetes mellitus or diabetic pregnancy combined(GDM/PGDM),abnormal fetal orientation,regular contractions at admis-sion,vaginal cleanliness≥ Ⅲ,white blood cell count ≥10 ×109/L at admission and cervical length＜20 mm,the difference was statistically significant(P＜0.05).Multivariate Cox regression analysis:BMI＞30 kg/m2(HR 2.178,95％CI 1.208-3.928,P=0.010),parity＞1(HR 3.095,95％CI 1.759-5.447,P＜0.001),regular uterine contraction(HR3.447,95％CI 2.216-5.362,P＜0.001),cervical length＜20 mm(HR3.594,95％CI 2.289-5.646,P＜0.001)and white blood cell count≥10 ×109/L(HR2.124,95％CI 1.352-3.335,P=0.001)on admission were independent risk factors for recent(within a week)delivery of pregnant women with threatened early preterm birth.When the above 5 indicators were included in the prediction model,the C-index was 0.797(95％CI 0.750-0.844),indicating that the model had good prediction ability.The calibration chart shows that the prediction results of the model are in good agreement with the actual results.Conclusions:Preg-nant women with BMI＞30 kg/m2 at admission,parity＞1,regular uterine contraction at admission,cervical length＜20 mm at admission and white blood cell count≥10 ×109/L at admission are prone to premature delivery in the near future.Cox proportional risk prediction model based on the above risk factors has certain accuracy,which can be used to guide clinical workers to take corresponding intervention measures in advance to avoid or reduce the possibility of premature delivery in the near future and improve maternal and infant outcomes.

Objective:To explore the establishment of a Cox proportional hazard prediction model for the re-cent(within a week)delivery of pregnant women with threatened early preterm labor(28-33+6 weeks).Meth-ods:The clinical data of 293 patients with threatened early preterm labor at 28-33+6 weeks admitted to the De-partment of Obstetrics,Affiliated Hospital of North Sichuan Medical College from January 2021 to December 2022 were retrospectively collected.According to whether the patient gave birth recently(within a week)during hospi-talization,they were divided into delivery group(n=88)and non-delivery group(n=205).Demographic data,specialty conditions and clinical biochemical indicators were collected,and the differences of each observation in-dex between the two groups were compared.Cox multivariate analysis was used to screen variables,and then the Cox proportional hazard prediction model was constructed to calculate the hazard ratio(HR).The C-index was used to test the predictive ability of the model,and the nomogram was drawn to visualize the Cox proportional hazard prediction model.The calibration curve was used to test the consistency between the model prediction re-sults and the actual situation.Results:The average age of the delivery group was 30.2±5.0 years old,and the average prolonged pregnancy time was 61.3±47.5 hours.Compared to the group that gave birth and did not give birth,the proportion of patients with body mass index(BMI)at admission,parity＞1,gestational diabetes mellitus or diabetic pregnancy combined(GDM/PGDM),abnormal fetal orientation,regular contractions at admis-sion,vaginal cleanliness≥ Ⅲ,white blood cell count ≥10 ×109/L at admission and cervical length＜20 mm,the difference was statistically significant(P＜0.05).Multivariate Cox regression analysis:BMI＞30 kg/m2(HR 2.178,95％CI 1.208-3.928,P=0.010),parity＞1(HR 3.095,95％CI 1.759-5.447,P＜0.001),regular uterine contraction(HR3.447,95％CI 2.216-5.362,P＜0.001),cervical length＜20 mm(HR3.594,95％CI 2.289-5.646,P＜0.001)and white blood cell count≥10 ×109/L(HR2.124,95％CI 1.352-3.335,P=0.001)on admission were independent risk factors for recent(within a week)delivery of pregnant women with threatened early preterm birth.When the above 5 indicators were included in the prediction model,the C-index was 0.797(95％CI 0.750-0.844),indicating that the model had good prediction ability.The calibration chart shows that the prediction results of the model are in good agreement with the actual results.Conclusions:Preg-nant women with BMI＞30 kg/m2 at admission,parity＞1,regular uterine contraction at admission,cervical length＜20 mm at admission and white blood cell count≥10 ×109/L at admission are prone to premature delivery in the near future.Cox proportional risk prediction model based on the above risk factors has certain accuracy,which can be used to guide clinical workers to take corresponding intervention measures in advance to avoid or reduce the possibility of premature delivery in the near future and improve maternal and infant outcomes.

Objective:To explore the establishment of a Cox proportional hazard prediction model for the re-cent(within a week)delivery of pregnant women with threatened early preterm labor(28-33+6 weeks).Meth-ods:The clinical data of 293 patients with threatened early preterm labor at 28-33+6 weeks admitted to the De-partment of Obstetrics,Affiliated Hospital of North Sichuan Medical College from January 2021 to December 2022 were retrospectively collected.According to whether the patient gave birth recently(within a week)during hospi-talization,they were divided into delivery group(n=88)and non-delivery group(n=205).Demographic data,specialty conditions and clinical biochemical indicators were collected,and the differences of each observation in-dex between the two groups were compared.Cox multivariate analysis was used to screen variables,and then the Cox proportional hazard prediction model was constructed to calculate the hazard ratio(HR).The C-index was used to test the predictive ability of the model,and the nomogram was drawn to visualize the Cox proportional hazard prediction model.The calibration curve was used to test the consistency between the model prediction re-sults and the actual situation.Results:The average age of the delivery group was 30.2±5.0 years old,and the average prolonged pregnancy time was 61.3±47.5 hours.Compared to the group that gave birth and did not give birth,the proportion of patients with body mass index(BMI)at admission,parity＞1,gestational diabetes mellitus or diabetic pregnancy combined(GDM/PGDM),abnormal fetal orientation,regular contractions at admis-sion,vaginal cleanliness≥ Ⅲ,white blood cell count ≥10 ×109/L at admission and cervical length＜20 mm,the difference was statistically significant(P＜0.05).Multivariate Cox regression analysis:BMI＞30 kg/m2(HR 2.178,95％CI 1.208-3.928,P=0.010),parity＞1(HR 3.095,95％CI 1.759-5.447,P＜0.001),regular uterine contraction(HR3.447,95％CI 2.216-5.362,P＜0.001),cervical length＜20 mm(HR3.594,95％CI 2.289-5.646,P＜0.001)and white blood cell count≥10 ×109/L(HR2.124,95％CI 1.352-3.335,P=0.001)on admission were independent risk factors for recent(within a week)delivery of pregnant women with threatened early preterm birth.When the above 5 indicators were included in the prediction model,the C-index was 0.797(95％CI 0.750-0.844),indicating that the model had good prediction ability.The calibration chart shows that the prediction results of the model are in good agreement with the actual results.Conclusions:Preg-nant women with BMI＞30 kg/m2 at admission,parity＞1,regular uterine contraction at admission,cervical length＜20 mm at admission and white blood cell count≥10 ×109/L at admission are prone to premature delivery in the near future.Cox proportional risk prediction model based on the above risk factors has certain accuracy,which can be used to guide clinical workers to take corresponding intervention measures in advance to avoid or reduce the possibility of premature delivery in the near future and improve maternal and infant outcomes.