Objective To establish a prediction model for the occurrence of non-occupational carbon monoxide poisoning events in Beijing, and to provide scientific basis and theoretical support for the prevention and warning of poisoning events. Methods Based on the monitoring data of non-occupational carbon monoxide poisoning events in Beijing from 2016 to 2024, the seasonal ARIMA model and seasonal index model were established to analyze the data and predict the occurrence of events. Results Between 2016 and 2024, a total of 436 cases of non-occupational carbon monoxide poisoning were reported in Beijing, showing a downward trend. The established SARIMA model and seasonal index model were SARIMA (1,0,0) (1,1,0) 12, Yt = (-0.0339t+5.8863) × St, and the average relative errors were 65.42% and 29.19%, respectively. In terms of months, the SARIMA model had better predictive performance during April and summer (June to August), while the seasonal index model was superior in other months. By combining the two models, the predicted number of events in 2025 was as follows: 3, 2, 2, 3, 1, 5, 2, 7, 1, 1, 1, and 2. Conclusion The seasonal index model has the best prediction effect on the non-occupational carbon monoxide poisoning events in Beijing throughout the year, and the number of summer events predicted by SARIMA model is closer to the actual values. The two models can be combined to predict the trend of non-occupational carbon monoxide poisoning, which provides a scientific basis for the prevention and control of carbon monoxide poisoning in the future.

OBJECTIVE: To compare the clinical efficacy of electroacupuncture (EA) at neuro-arterial stimulation points with topical western medication in treating post-stroke shoulder-hand syndrome (SHS). METHODS: A total of 72 patients with post-stroke SHS were randomly assigned to an observation group (n=36, 2 cases dropped out) and a control group (n=36, 3 cases dropped out). Both groups received standard neurological treatment, comprehensive rehabilitation, and physical therapy. The observation group received EA at neuro-arterial stimulation points, including the ipsilateral stellate ganglion point, vagus nerve trunk and auricular branch (left side), and stimulation points of the radial and ulnar arteries, radial nerve, ulnar nerve, and median nerve, once daily for 4 weeks. The control group was treated with topical diclofenac diethylamine emulgel, and mucopolysaccharide polysulfate cream was added for patients with pronounced early-stage edema, twice a day for 4 weeks. The VAS pain score and hand edema volume were recorded before treatment, at 2 and 4 weeks during treatment, and 2 weeks after treatment completion (follow-up). Musculoskeletal ultrasound was used to measure the thickness of the dorsal hand and middle finger skin on the affected side before and after 4 weeks of treatment. RESULTS: Compared before treatment, the VAS pain scores and edema volume of the affected hand in both groups were decreased at week 2, week 4, and follow-up (P<0.05). At week 4, both groups showed lower VAS pain scores and edema volume than those at week 2 (P<0.05); during follow-up, both VAS pain scores and edema volume were further reduced compared to those at week 4 (P<0.05). At week 2, week 4, and follow-up, the VAS scores and edema volume of the affected hand in the observation group were lower than those in the control group (P<0.05). Compared before treatment, the dorsal hand skin thickness and middle finger skin thickness on the affected side were decreased in both groups after 4 weeks of treatment (P<0.05). Compared with the control group, the observation group showed thinner dorsal hand and middle finger skin thickness after 4 weeks of treatment (P<0.05). CONCLUSION EA at neuro-arterial stimulation points effectively alleviates pain and edema in patients with post-stroke SHS, and demonstrates superior efficacy compared to topical western medication.
Humans ; Male ; Female ; Middle Aged ; Electroacupuncture ; Aged ; Stroke/complications* ; Acupuncture Points ; Adult ; Reflex Sympathetic Dystrophy/physiopathology* ; Treatment Outcome ; Hand

Objective To study the predictive value of the Prognostic Assessment Scale for Patients with Spontaneous Intracerebral Hemorrhage(ICH-LR2S2)and the Prehospital Risk Assessment Scale for Prehospital Deterioration Risk Assessment Scale(ICH-APS)for the development of stroke-associated pneu-monia(SAP)in patients with spontaneous intracerebral hemorrhage.Methods A total of 349 patients with spontaneous intracerebral hemorrhage who were hospitalized for the first time in this hospital from July 2023 to July 2024 were selected as the research subjects.The general demographic data and medical documentations of the patients were collected,and ICH-LR2S2 score and ICH-APS score were carried out within 48 hours after admission.According to whether pneumonia occurred within 7 days after admission,the patients were divided into the SAP group and the non-SAP group,and the diagnostic efficiency of the ICH-LR2S2 score and ICH-APS score for SAP in patients with spontaneous intracerebral hemorrhage was evaluated.Results Among the 349 patients with spontaneous intracerebral hemorrhage,98 patients(28.08％)had pneumonia.The results of multivariate logistic regression analysis showed that age,history of chronic obstructive pulmonary disease(COPD),nasogastric tube,tracheal intubation,National Institutes of Health Stroke Scale(NIHSS)score,Glasgow Coma Scale(GCS)score,C-reactive protein,fasting blood glucose,dysphagia,ICH-LR2S2 score,ICH-APS-A score,and ICH-APS-B score were independent influencing factors for SAP in patients with spontane-ous intracerebral hemorrhage(P＜0.05).The results of the receiver operating characteristic(ROC)curve showed that the ICH-LR2S2 score had the highest diagnostic efficiency for SAP in patients with spontaneous intracerebral hemorrhage,with an area under the curve(AUC)of 0.837,a sensitivity of 0.827,a specificity of 0.783,and a Youden index of 0.610.Conclusion ICH-LR2S2 score has a high predictive value for the occur-rence of SAP in patients with spontaneous intracerebral hemorrhage.

Objective:To explore the mechanism by which moxibustion improves cold-induced blood stasis pattern(CIBSP)and to uncover the biological basis underlying the correlation between the Conception Vessel(CV),Governor Vessel(GV),Thoroughfare Vessel(TV),and the uterus by investigating the effects of mild moxibustion on the hypothalamic-pituitary-ovary axis(HPOA)in CIBSP model rats.Methods:Forty-eight female Sprague-Dawley rats were divided into a blank group,a model group,a CV group,a GV group,a TV group,and a non-meridian non-point(NMNP)group according to the random number table method,with 8 rats in each group.Except for rats in the blank group,the other rats were subjected to an ice water bath plus epinephrine to prepare CIBSP models.Each intervention group was given mild moxibustion on the first day of modeling.Qihai(CV6),Guanyuan(CV4),and Zhongji(CV3)were selected in the CV group;Huangshu(KI16),Dahe(KI12),and Henggu(KI11)were selected in the TV group;Xuanshu(GV5),Mingmen(GV4),and Yaoyangguan(GV3)were selected in the GV group;three NMNP spots were selected in the NMNP group.Mild moxibustion was administered for 20 min each time,once a day,for 14 consecutive days.The symptom scores of CIBSP and uterine electromyogram were compared among groups;morphological changes in reproductive organs were observed by hematoxylin-eosin staining;enzyme-linked immunosorbent assay was used to detect serum reproductive hormones and neurotransmitters.The mRNA and protein expression levels of estrogen receptor(ER),follicle-stimulating hormone receptor(FSHR),and luteinizing hormone receptor(LHR)were detected by real-time quantitative polymerase chain reaction,immunohistochemistry,or Western blotting assays.Results:Compared to the blank group,the model group showed a significantly increased CIBSP symptom score,an amplified in vivo uterine myoelectric value;decreased ovarian follicles,thinner endometrial epithelium,and disordered structure with the pathological examination,decreased serum levels of reproductive hormones,6-keto-prostaglandin F1α(6-keto-PGF1α),and β-endorphin(β-EP),increased thromboxane B2(TXB2),5-hydroxytryptamine(5-HT),and substance P(SP),and decreased mRNA and protein expression of ovarian ER,FSHR,and LHR(P<0.05 or P<0.01).Compared to the model and NMNP groups,each point-intervention group showed a decreased CIBSP symptom score and uterine myoelectric value;increased ovarian follicles,thickened endometrium,increased glands,up-regulated serum reproductive hormones,6-keto-PGF1α,and β-EP,down-regulated serum TXB2,5-HT,and SP and increased mRNA and protein expression of ovarian ER,FSHR,and LHR(P<0.05 or P<0.01).Conclusion:Moxibustion at points from the CV,GV,and TV("three branches from one source")can improve the reproductive neuroendocrine function of CIBSP rats,and this effect may be mediated through the regulation of the HPOA.These detections suggest that the biological basis of point-uterus correlation may be based on HPOA regulation.

Objective To investigate the consistency and diagnostic efficacy of 1.5T and 3.0T MRI in the kidney clear cell likeli-hood score(ccLS)v2.0.Methods A retrospective collection was conducted on the data of 176 pathologically confirmed small renal mass(SRM).Two radiologists independently scored the MRI images using the ccLS v2.0.The Kappa test was used to assess inter-observer consistency,and receiver operating characteristic(ROC)curves were plotted to analyze the diagnostic efficacy.The area under the curve(AUC),sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NP V)were calculated.Results The inter-observer consistency for ccLS v2.0 score was good for 1.5T MRI and excellent for 3.0T MRI(Kappa values were 0.754 and 0.836,respectively).On 1.5T MRI examination,a ccLS≥4 points was identified as the optimal threshold,with AUC of 0.935 and 0.923 for the two radiologists,sensitivities of 92.45％and 88.68％,and specificities of 88.00％and 92.00％,respec-tively.For 3.0T MRI examination,using the same threshold,the AUC were 0.933 and 0.901,with sensitivities of 91.43％and 90.00％,and specificities of 78.57％and 78.57％for both radiologists.Conclusion The ccLS v2.0 demonstrates good consistency across high and low field intensity MRI,and a threshold of ccLS≥4 pionts provides high diagnostic efficacy for clear cell renal cell carcinoma(ccRCC).

Objective To investigate the value of predicting microsatellite instability(MSI)status in endometrial cancer based on whole-tumor apparent diffusion coefficient(ADC)histogram.Methods The data of 131 endometrial cancer patients who underwent preoperative MRI examination and were confirmed by pathology were retrospectively analyzed.According to the pathological immu-nohistochemical results,they were divided into microsatellite stability(MSS)group(103 cases)and MSI group(28 cases).The whole-tumor volume of interest(VOI)was outlined using ITK-SNAP software,and ADC histogram analysis was performed using uAI Research Portal software.The t-test or Mann-Whitney U-test were used to compare the differences between the two groups,and multifactorial logistic regression analysis was used to screen independent predictors for the above parameters with differences.The area under the curve(AUC),sensitivity and specificity were calculated using the receiver operating characteristic(ROC)curve.Results The ADC histogram parameters that were statistically significant between groups were ADC10th,ADC90th,ADCmaximum,ADCmedian,ADCmean,ADCrange,ADCinterquartile range,ADCuniformity,ADCvariance,ADCenergy,ADCentropy,ADCtotal energy,ADCroot mean square,ADCmean absolute deviation,ADCrobust mean absolute deviation,all the above parameters were significantly smaller in the MSI group than in the MSS group.Further multifactorial logistic regression analysis results showed that ADCmedian[odds ratio(OR)=1.019,P=0.020]and ADCroot mean square(OR=0.977,P=0.005)were independent predictors of the MSI status in endometrial cancer.The results of ROC curve showed that the AUC of ADCmedian and ADCroot mean square for predicting MSI status were 0.699 and 0.731,respectively,and the AUC of combining the two parameters to predict MSI status was 0.760,with a sensitivity of 57.14%and a specificity of 86.41%.Conclusion The parameters of ADCmedian and ADCroot mean square based on whole-tumor ADC histogram can be used to predict the MSI status of endometrial cancer,and the combined use of these two parameters helps to improve the efficacy of predicting MSI.

Objective To explore the influencing factors of readmission within 90 days in frail patients with chronic obstructive pulmonary disease(COPD),construct an early warning model and evaluate its discrimination and effectiveness.Methods A total of 831 COPD patients with frailty were included and divided into the readmission group(290 cases)and the control group(541 cases)based on whether they were readmitted within 90 days after discharge.The electronic medical record data were collected and compared between the two groups of patients.Multivariate Logistic regression analysis was used to screen independent influencing factors for readmission within 90 days in COPD weak patients.A predictive model was established.The column chart was drawn.The discriminability of the predictive model was evaluated through receiver operating characteristic(ROC)curves.The clinical practicality and the predictive model calibration were evaluated through decision curves and calibration curves.Results The body mass index(BMI)of the readmission group was lower than that of the non readmission group,and the proportion of acute exacerbation of COPD hospitalizations≥2 times in the past year,the Edmonton frailty scale(REFS)score and the Chalson comorbidity index(CCI)were higher in the readmission group than those of the non readmission group(P＜0.05).Multivariate Logistic regression analysis showed that BMI(OR=0.721,95%CI:0.636-0.818),the number of acute exacerbations of COPD hospitalizations in the past year(OR=3.040,95%CI:1.944-4.753),REFS score(OR=1.726,95%CI:1.486-2.005)and CCI score(OR=3.917,95%CI:3.079-4.983)were all independent influencing factors for readmission within 90 days in COPD frail patients(P＜0.05).Based on the results of multiple factor Logistic regression analysis,the column chart warning model was constructed.The AUC value of the ROC curve was 0.847(95%CI:0.820-0.874),the specificity was 87.20%and the sensitivity was 64.50%.The calibration curve of the predictive model was close to the diagonal,and the calibrationa degree was good.The decision curve suggested that the prediction model had clinical practicality.Conclusion The early warning model constructed based on the influencing factors of readmission hospitalization within 90 days in weak patients with COPD has good predictive effect and clinical practicability.

Objective:To investigate the awareness levels of doctors from various departments regarding fertility preservation to provide reference and suggestions for further improving awareness and promoting multidisciplinary development in fertility preservation.Methods:From November to December 2023, the China Alliance of Fertility Preservation initiated this survey covering 88 hospitals in 23 cities across 20 provinces in China. The survey focused on the degree of understanding of basic concepts, technological perceptions, treatment concepts, and related challenges regarding fertility preservation. Descriptive statistics and Fisher's exact test were used to analyze the difference in awareness levels across various departments.Results:There was a significant difference in the awareness of fertility preservation guidelines among physicians from different departments ( P<0.001). Reproductive center physicians had the highest level of understanding [68.3% (41/60)]. Doctors in the reproductive centers had a higher awareness rate of the five fertility preservation techniques (ovarian tissue cryopreservation, oocyte cryopreservation, sperm cryopreservation, testicular tissue cryopreservation, and embryo cryopreservation) than that in other departments (all P<0.05). Regarding treatment concepts, more reproductive center physicians believed that psychological counselling about fertility preservation before oncological treatment was necessary ( P=0.016). Hematologists had more worries and concerns about fertility preservation treatment. Additionally, 96.7% (58/60) of reproductive center physicians expressed the need to establish effective referral mechanisms within the same city, province, or across provinces. However, 55.6% (35/63) of oncologists, 64.6% (31/48) of hematologists, and 77.8% (7/9) of pediatricians considered treating primary tumors far more important than fertility preservation. Conclusion:Doctors from different departments have varying levels of understanding regarding fertility preservation. It is necessary to strengthen the dissemination and training of fertility preservation knowledge among physicians from various departments, as well as to promote a multidisciplinary treatment model to improve efficiency, to establish a comprehensive referral mechanism to improve patients' opportunities for fertility preservation.

Objective:To explore the mediating effect of accompanied childbirth experience among spouses of primipara on dynamic adjustment after marriage and paternal role adaptation, with the aim of providing reference for further improving accompanying childbirth services.Methods:Spouses of primipara who participated in accompanying childbirth at Nanjing Drum Tower Hospital Group Suqian Hospital from January 2023 to June 2024 were selected as the research subjects through convenience sampling. The general information questionnaire, the Chinese version of Dynamic Adjustment Scale, the Parents' Experiences of Childbirth and the Newborn Father's Role Adaptation Questionnaire were used to conduct a cross-sectional survey, and establish the intermediary model between the dynamic adjustment after marriage and the paternal role adaptation.Results:A total of 244 spouses of primipara were included, with an age of (28.86 ± 5.77) years. The score for dynamic adjustment in spouses of primipara was (110.82 ± 16.33) points, the score for experiences of childbirth was (124.27 ± 13.89) points, and the score for paternal role adaptation was (71.66 ± 9.22) points. The accompanied childbirth experience among spouses of primipara was positively correlated with the dynamic adjustment after marriage and the paternal role adaptation ( r=0.197, 0.511, both P<0.01). The dynamic adjustment after marriage was positively correlated with the paternal role adaptation ( r=0.403, P<0.01). The accompanied childbirth experience among spouses had a partial mediating effect between the dynamic adjustment after marriage and the parental role adaptation, which the mediating effect was 0.182, accounting for 32.79% of the total effect. Conclusions:The dynamic adjustment after marriage can directly predict the paternal role adaptation, and the experience of accompanying childbirth has a partial mediating effect between the two. The role adaptation level of the spouses of the primiparas should be improved by further improving the delivery service to meet the needs of the primiparas and their spouses.

Objective To explore the diagnostic value of 18F-fluorodeoxyglucose(FDG)PET/CT in primary pulmonary enteric adenocarcinoma.Methods The clinical and imaging data of 9 patients with primary pulmonary enteric adenocarcinoma who under-went 18F-FDG PET/CT examination were retrospectively analyzed,including lesion distribution,morphology,maximum standardized uptake value(SUVmax),clinical symptoms and signs,gastroscopy finding,puncture pathological results,and serum tumor markers[carbohydrate antigen 72-4(CA72-4),cytokeratin 19 fragment antigen 21-1(CYFRA21-1),carcinoembryonic antigen(CEA),carbo-hydrate antigen 199(CA199)].Results Pathological examination confirmed a diagnosis of primary pulmonary enteric adenocarcinoma after excluding gastrointestinal primary tumors through clinical evaluation.In all nine patients,18F-FDG PET/CT examination did not reveal any evidence of digestive system malignancies,and gastrointestinal microscopy was negative.Primary lesions were observed as masses or nodular types in 6 cases(5 in the left lung and 1 in the right lung),while 3 cases exhibited diffuse bilateral pulmonary involvement(manifested as multiple patchy opacities,nodules,ground-glass opacities,and consolidations).All pulmonary primary lesions showed increased 18F-FDG uptake,with SUVmax ranging from 2.7 to 12.8,mean 8.6±3.7.The six masses-or nodular-type primary lesions showed maximum diameters ranging from 2.1 to 10.5 cm,mean(5.23±3.06)cm.Four cases demonstrated hilar and mediastinal lymph node metastases,intrapulmonary metastases,and distant metastases,while 1 case showed only distant metastasis.Elevated levels of serum tumor markers were observed as follows:CA72-4 in 7 cases(10-273.3 U/mL),CEA in 7 cases(5-147.4 ng/mL),CA199 in 6 cases(31.22-4 364 U/mL),and CYFRA21-1 in 5 cases(8.31-99.7 ng/mL).Conclusion When pathological biopsy of a pulmonary lesion suggests primary pulmonary enteric adenocarcinoma after excluding gastrointestinal primary tumors,and 18F-FDG PET/CT shows no gastrointestinal masses,this may support the diagnosis of primary pulmonary enteric adenocarcinoma.