Objective:To investigate the prevalence of infertility and the factors affecting it in women of reproductive age in Qinghai Province.Methods:From July to December 2024, a multi-stage stratified cluster random sampling approach was used to recruit women aged 20-49 years in 10 districts across 8 cities in Qinghai Province for a questionnaire survey assessing the prevalence of infertility. Univariate and multivariate binary logistic regression analyses were then performed to identify factors associated with infertility in Qinghai Province.Results:A total of 3 925 questionnaires were distributed, with 3 837 valid responses ultimately collected. Preliminary screening identified 581 infertility cases, yielding an infertility rate of approximately 15.1%. Among these, 170 cases were primary infertility and 411 were secondary infertility, accounting for 29.26% and 70.74% of infertility cases, respectively. The highest infertility rate was observed in Yushu City, Yushu Prefecture, at 26.1% (71/272), followed by Chengxi District, Xining City at 25.3% (174/688). The lowest infertility rate was recorded in Delingha City, Haixi Prefecture, at only 2.9% (9/311). Univariate analysis revealed that household registration status ( P<0.001), age ( P=0.016), age at marriage ( P=0.001), highest educational attainment ( P<0.001), per capita annual income ( P=0.001), body mass index (BMI, P=0.005), altitude ( P<0.001), age at menarche ( P=0.011), menstrual regularity ( P<0.001), menstrual cycle ( P=0.001), menstrual duration ( P<0.001), presence of blood clots ( P<0.001),whether the women smoking ( P=0.008), whether the women staying up late ( P=0.022), and whether the husband staying up late ( P<0.001) were independent factors for infertility. Multivariate binary logistic regression analysis revealed that non-agricultural household registration ( OR=1.637, 95% CI: 1.304-2.054, P<0.001), BMI≥24.0 kg/m2 ( OR=1.326, 95% CI: 1.077-1.632, P=0.008), age at menarche >14 years ( OR=1.405, 95% CI: 1.158-1.705, P=0.001), irregular menstrual cycles ( OR=1.512, 95% CI: 1.127-2.029, P=0.006), menstrual cycle <21 d ( OR=1.572, 95% CI: 1.237-1.998, P<0.001), menstrual duration <7 d ( OR=2.080, 95% CI: 1.529-2.831, P<0.001), and smoking ( OR=2.359, 95% CI: 1.056-5.271, P=0.036) were independent risk factors for infertility. Age and altitude were not independent risk factors for infertility in Qinghai Province. Conclusion:The prevalence of infertility in Qinghai Province is approximately 15.1%. Non-agricultural household registration, BMI≥24.0 kg/m2, age at menarche >14 years, irregular menstrual cycles, menstrual cycle <21 d, menstrual duration <7 d, and smoking are factors influencing infertility, while high altitude does not increase the risk of infertility among women in Qinghai Province.

Objective To explore the application of bundled nursing care for recurrent obstruc-tive esophageal cancer treated by photodynamic therapy.Methods Thirty patients with recurrent ob-structive esophageal cancer were administered with photosensitizer hematoporphyrin derivative injec-tion.After 24 hours,an optical fiber was introduced under endoscopic guidance,and 630 nm laser was used to irradiate the tumor locally.The degree of relief in dysphagia,improvement in perform-ance status,changes in body mass index,and treatment-related adverse reactions were recorded.Bundled nursing strategies were implemented,including preoperative assessment,education,prepara-tion,postoperative positioning,observation,prevention of complications,and light protection meas-ures.Results After treatment,the median diameter of the narrowest esophageal lesion was increased[(8.92±0.64)mm versus(4.77±0.60)mm],the Karnofsky Performance Status(KPS)score was improved[(77.69±5.99)versus(84.62±6.60)],BMI was increased[(17.17±1.66)kg/m2 ver-sus(18.08±1.60)kg/m2],and the Stooler dysphagia grade was decreased compared with treatment be-fore.The main treatment-related adverse reactions were retrosternal pain and fever.Conclusion Photo-dynamic therapy for recurrent obstructive esophageal cancer has a rapid onset of action and mild ad-verse reactions,and ensures the smooth implementation of PDT and patients'safety.

Objective:To investigate the prevalence of infertility and the factors affecting it in women of reproductive age in Qinghai Province.Methods:From July to December 2024, a multi-stage stratified cluster random sampling approach was used to recruit women aged 20-49 years in 10 districts across 8 cities in Qinghai Province for a questionnaire survey assessing the prevalence of infertility. Univariate and multivariate binary logistic regression analyses were then performed to identify factors associated with infertility in Qinghai Province.Results:A total of 3 925 questionnaires were distributed, with 3 837 valid responses ultimately collected. Preliminary screening identified 581 infertility cases, yielding an infertility rate of approximately 15.1%. Among these, 170 cases were primary infertility and 411 were secondary infertility, accounting for 29.26% and 70.74% of infertility cases, respectively. The highest infertility rate was observed in Yushu City, Yushu Prefecture, at 26.1% (71/272), followed by Chengxi District, Xining City at 25.3% (174/688). The lowest infertility rate was recorded in Delingha City, Haixi Prefecture, at only 2.9% (9/311). Univariate analysis revealed that household registration status ( P<0.001), age ( P=0.016), age at marriage ( P=0.001), highest educational attainment ( P<0.001), per capita annual income ( P=0.001), body mass index (BMI, P=0.005), altitude ( P<0.001), age at menarche ( P=0.011), menstrual regularity ( P<0.001), menstrual cycle ( P=0.001), menstrual duration ( P<0.001), presence of blood clots ( P<0.001),whether the women smoking ( P=0.008), whether the women staying up late ( P=0.022), and whether the husband staying up late ( P<0.001) were independent factors for infertility. Multivariate binary logistic regression analysis revealed that non-agricultural household registration ( OR=1.637, 95% CI: 1.304-2.054, P<0.001), BMI≥24.0 kg/m2 ( OR=1.326, 95% CI: 1.077-1.632, P=0.008), age at menarche >14 years ( OR=1.405, 95% CI: 1.158-1.705, P=0.001), irregular menstrual cycles ( OR=1.512, 95% CI: 1.127-2.029, P=0.006), menstrual cycle <21 d ( OR=1.572, 95% CI: 1.237-1.998, P<0.001), menstrual duration <7 d ( OR=2.080, 95% CI: 1.529-2.831, P<0.001), and smoking ( OR=2.359, 95% CI: 1.056-5.271, P=0.036) were independent risk factors for infertility. Age and altitude were not independent risk factors for infertility in Qinghai Province. Conclusion:The prevalence of infertility in Qinghai Province is approximately 15.1%. Non-agricultural household registration, BMI≥24.0 kg/m2, age at menarche >14 years, irregular menstrual cycles, menstrual cycle <21 d, menstrual duration <7 d, and smoking are factors influencing infertility, while high altitude does not increase the risk of infertility among women in Qinghai Province.

Objective To investigate the correlation between perioperative oxygen concentration and postoperative organ injury and other adverse reactions in children undergoing neurosurgery.Methods This study is a single-center retrospective cohort study,including 512 children aged≤14 years and operating duration≥2 hours who were transferred after surgery to postanesthesia care unit(PACU),Department of Anesthesiology,Beijing Tiantan Hospital,Capital Medical University from October 2018 to September 2023.His electronic medical record system was used to review and collect the patient's medical records during hospitalization.Including baseline data,anesthetic use,duration of anesthesia,intraoperative oxygen concentration,postoperative diagnosis,and surgical method;blood pressure,heart rate,oxygen saturation,pain score and special conditions during anesthesia recovery;infection during postoperative hospitalization(including wound infection,intracranial infection),respiratory complications[confirmed by chest radiograph/chest computed tomography(CT)report],changes in renal function(first postoperative serum creatinine value-last preoperative serum creatinine value),and incidence of delirium during recovery period during anesthesia were recorded.The area under oxygen concentration-time curve area under curve AUCFiO2=the product of intraoperative oxygen concentration(%)and duration of anesthesia(min)was calculated,and then 512 children were divided into 3 groups according to the AUCFiO2 tripartite(group 1:AUCFiO2<8 720%min,group 2:8 720%·min≤AUCFiO2≤13 800%·min,group 3:AUCFiO2>13 800%·min)were included in the data analysis.Results The incidence of emergency delirium(ED)during postoperative recovery was 24%,26.9%and 19.4%,and the incidence of acute kidney injury(AKI)was 0.6%,2.3%and 0.6%,respectively.There was no significant difference between the three groups(P>0.05).The incidence of postoperative pulmonary complications in the three groups was 20.6%,20.8%and 31.5%,respectively,and there was significant statistical difference among the three groups(P<0.05).There were no significant differences in nausea,vomiting,hypoxemia,and PACU residence time among the three groups during anesthesia recovery room(P>0.05),and there were significant differences in intracranial infection,wound infection and hospital stay during hospitalization(P<0.05).Conclusion Although oxygen concentration AUCFiO2 has no correlation with the occurrence of postoperative AKI and ED,the longer the exposure time of conventional oxygen administration strategy,the higher the incidence of postoperative pulmonary complications and postoperative infection,and the longer the hospitalization time of children.

Objective To investigate the correlation between perioperative oxygen concentration and postoperative organ injury and other adverse reactions in children undergoing neurosurgery.Methods This study is a single-center retrospective cohort study,including 512 children aged≤14 years and operating duration≥2 hours who were transferred after surgery to postanesthesia care unit(PACU),Department of Anesthesiology,Beijing Tiantan Hospital,Capital Medical University from October 2018 to September 2023.His electronic medical record system was used to review and collect the patient's medical records during hospitalization.Including baseline data,anesthetic use,duration of anesthesia,intraoperative oxygen concentration,postoperative diagnosis,and surgical method;blood pressure,heart rate,oxygen saturation,pain score and special conditions during anesthesia recovery;infection during postoperative hospitalization(including wound infection,intracranial infection),respiratory complications[confirmed by chest radiograph/chest computed tomography(CT)report],changes in renal function(first postoperative serum creatinine value-last preoperative serum creatinine value),and incidence of delirium during recovery period during anesthesia were recorded.The area under oxygen concentration-time curve area under curve AUCFiO2=the product of intraoperative oxygen concentration(%)and duration of anesthesia(min)was calculated,and then 512 children were divided into 3 groups according to the AUCFiO2 tripartite(group 1:AUCFiO2<8 720%min,group 2:8 720%·min≤AUCFiO2≤13 800%·min,group 3:AUCFiO2>13 800%·min)were included in the data analysis.Results The incidence of emergency delirium(ED)during postoperative recovery was 24%,26.9%and 19.4%,and the incidence of acute kidney injury(AKI)was 0.6%,2.3%and 0.6%,respectively.There was no significant difference between the three groups(P>0.05).The incidence of postoperative pulmonary complications in the three groups was 20.6%,20.8%and 31.5%,respectively,and there was significant statistical difference among the three groups(P<0.05).There were no significant differences in nausea,vomiting,hypoxemia,and PACU residence time among the three groups during anesthesia recovery room(P>0.05),and there were significant differences in intracranial infection,wound infection and hospital stay during hospitalization(P<0.05).Conclusion Although oxygen concentration AUCFiO2 has no correlation with the occurrence of postoperative AKI and ED,the longer the exposure time of conventional oxygen administration strategy,the higher the incidence of postoperative pulmonary complications and postoperative infection,and the longer the hospitalization time of children.

Objective To investigate the role of PPARγ/GluT4 axis in insulin resistance(IR),cell proliferation and apoptosis of granulosa cells.Methods A total of 45 married women with PCOS who received routine IVF-ET assisted pregnancy treatment in Center of Reproductive Medicine,Qinghai Provincial People's Hospital were enrolled in this study from August 2018 to August 2020.All the patients were divided into IR group(PCOS-IR group,HOMA-IR≥2.57,n=23)and non-IR group(PCOS-NIR group,HOMA-IR<2.57,n=22)according to HOMA-IR.Meanwhile,21 married patients with infertility due to male or fallopian tube factors were enrolled as control group(Con).miR-27a mimics,miR-27a inhibitors(miR-27a inhibitor)and corresponding controls(mimics NC and inhibitor NC)transfected PCOS-IR granulosa cells,which were then divided into miR-27a mimics group,miR-27a inhibitor group,mimics-NC group and inhibitor-NC group.Double luciferase report test confirmed that miR-27a binded to PPARγ.Cell proliferation and apoptosis were detected by CCK-8 method and Annexinv-FITC/PI method.The expression of miR-27a,GluT4,PPARγ,Bax related to B lymphomas-2,Cleaved caspase-3 and B lymphomas-2(Bcl-2)were detected by RT-qPCR and Western blot respectively.Results Compared with Con group,the expression of miR-27a increased(P<0.01),while the expression of PPARγ mRNA and protein decreased in PCOS-NIR and PCOS-IR groups(P<0.01).Compared with PCOS-NIR group,the expression of miR-27a increased(P<0.05),while the expression of PPARγ mRNA and protein decreased in PCOS-IR group(P<0.01).The double luciferase report showed that there was a targeted binding site between PPARγ and miR-27a.Compared with inhibitor-NC group,the cell activity increased at 24 h,48 h,72 h and 96 h in miR-27a inhibitor group(P<0.05 or P<0.01),while the apoptosis rate decreased inmiR-27a inhibitor and mimics-NC group(P<0.05 or P<0.01).Compared with miR-27a inhibitor group,the apoptosis rate increased,and the cell activity decreased at 24,48,72 and 96 h in mimics-NC and miR-27a mimics groups(P<0.05 or P<0.01).Compared with the inhibitor-NC group,the expression of miR-27a,Bax and Cleaved caspase-3 increased(P<0.05 or P<0.01),while the expression of GluT4,PPARγ and Bcl-2 decreased in miR-27a mimics group(P<0.01).In miR-27a inhibitor group,the protein expressions of GluT4,PPARγ and Bcl-2 increased(P<0.05 or P<0.01),while miR-27a,Bax and Cleaved caspase-3 decreased(P<0.01).Compared with miR-27a inhibitor group,the expressions of miR-27a,Bax and Cleaved caspase-3 increased(P<0.01),while the expressions of GluT4,PPARγ and Bcl-2 decreased in mimics-NC and miR-27a mimics groups(P<0.05 or P<0.01).Conclusion The expression level of miRNA-27a is related to IR,cell proliferation,and apoptosis of granulosa cells,which may be related to PPARγ signal path.

OBJECTIVE To observe the efficacy and safety of goserelin combined with estradiol valerate in the treatment of endometriosis （EMs） in patients of childbearing age after laparoscopic surgery. METHODS The clinical data of 144 patients with EMs of childbearing age who underwent laparoscopic surgery in our hospital from January 2020 to December 2022 were collected retrospectively， and those patients were divided into control group （70 cases） and combination group （74 cases） based on different postoperative medication regimens. Control group was given Acetate goserelin sustained-release implant on the 1st to 5th day of their first menstrual cycle after laparoscopic surgery， while combination group was additionally given Estradiol valerate tablets on the basis of control group. The short-term and long-term efficacy of 2 groups were observed； preoperative and postoperative pain scores， ovarian reserve function， and the incidence of adverse reactions were all recorded in 2 groups. RESULTS There was no statistically significant difference in short-term total effective rate， 1-year postoperative recurrence rate and the incidence of decreased libido， vaginal dryness， gastrointestinal reactions， rash， or arrhythmia between two groups （P＞0.05）. The natural pregnancy rate of combination group was significantly higher than control group at 1 year after surgery， while the incidence E-mail：wanghuiling0518@126.com of early miscarriage， hot flashes and sweating， emotional fluctuations， insomnia and fatigue， joint muscle pain， dizziness and headache were significantly lower than control group （P＜0.05）. However， at 6 months after surgery， pain scores and the levels of anti-Müllerian hormone， follicle stimulating hormone， luteinizing hormone， estradiol of both groups were significantly lower than before surgery in the same group， while the number of antral follicle count was significantly higher than before surgery in the same group； the levels of anti-Müllerian hormone， luteinizing hormone， estradiol， and the number of antral follicles in the combination group were significantly higher than control group， while pain score and follicle stimulating hormone level were significantly lower than control group （P＜0.05）. CONCLUSIONS The combination of goserelin and estradiol valerate after laparoscopic surgery has a significant therapeutic effect and good safety in the treatment of EMs of childbearing age.

Purpose/Significance To improve the performance of named entity recognition(NER)model of Chinese electronic medi-cal records(EMR)for better organization and mining of medical information.Method/Process The ERNIE-BiGRU-Attention-CRF NER model of Chinese EMR is constructed.Firstly,the ERNIE1.0 pre-training model is used to generate word vectors with semantic features,and then BiGRU is utilized to capture the global semantic features and grammatical structural features,which are fed into the Attention mechanism to further enhance the capture of the semantic features,and finally,the CRF decoding layer is connected to output the label sequences with the maximum global probability.Result/Conclusion Comparison experiments and ablation experiments are car-ried out on the publicly available medical text dataset CCKS2017,and examples analysis is conducted using the generated model.The model proposed in this paper achieves better recognition results.

Objective:To investigate the prevalence of hyperuricemia (HUA) in Bozidun Kirghiz township of Xinjiang Aksu region, and to explore the risk factors for the occurrence of HUA in the local area.Methods:A cross-sectional survey study was conducted by randomly selecting 9 villages in Bozidun Kirgiz Township by the whole-group sampling method and questionnaire were distributed to the households. The questionnaire included: demographic information, history of past illness, personal history, and all subjects were measured for height, weight, blood pressure, abdominal circumference, etc. The diagnostic of HUA if the serum uric acid (SUA) level >420 μmol/L in men or >360 μmol/L in women. The incidences of HUA in different age, sex, food type and life style behavior were analyzed. T test, non-parametric test and Chi-square test were used to analyze the differences among the groups, and logistic regression was used to analyze the risk factors. Results:①A total of 2 138 subjects were surveyed, among which 68 patients were with HUA, the prevalence of HUA in Bozidun Kirghiz township, Aksu region in the general population was 3.18%(68/2 138); the prevalence rate in men was 4.60%(45/978), 45 patients were identified; and the prevalence rate in women was 1.98%(23/1 160), 23 patients were identified. The peak age of HUA in male and female patients was 51~60 years old. ②The prevalence of HUA was lower in those who consumed dairy products ( χ2=6.91, P=0.017), nuts ( χ2=8.43, P=0.038) and eggs ( χ2=7.38, P=0.023), and lower in those who consumed more. Different intake of cereals ( χ2=0.87, P=0.647), meat( χ2=0.82, P=0.662), vegetables and fruits( χ2=5.22, P=0.073) had no effect on the prevalence of HUA.③In terms of different life behaviors, the prevalence of HUA in men who had been smoking was higher than those who had never smoked (57.78%, 28.89%, 13.33%, χ2=8.16, P=0.017). In the relationship between drinking and HUA, the prevalence rates of male always drinking, ever drinking and never drinking were 80.00%, 11.11% and 3.89%, respectively, the difference was statistically significant ( χ2=6.67, P=0.038). ④Multi-factor logistic regression analysis showed that high BMI, old age, high TG, increased Cr and increased WBC were risk factors for the occurrence of HUA [ OR(95% CI)=1.13(1.04, 1.23), 1.03(1.00,1.05),1.39(1.00, 1.93), 1.03(1.02, 1.05), 1.27(1.07, 1.49), all P<0.05]. Conclusion:The prevalence of HUA in Bozidun Kirgiz township in Aksu prefecture of Xinjiang is lower than that in other areas with continental climate. High BMI, old age, high TG, increased Cr and increased WBC count are risk factors for the development of HUA .

Objective:To investigate the positivity rate and high titer of antinuclear antibody (ANA) and anti-dsDNA antibody in healthy Tajik, Kirgiz, and Han Chinese populations in Xinjiang.Methods:A total of 3 687 cases of Tajik residents, 2 140 cases of Kyrgyz residents, and 2 034 cases of Han residents were selected as the study subjects, and ANA and anti-dsDNA antibodies were detected and comparatively analyzed. Data were analyzed using SPSS 22.0 software with χ2 test. Results:The positive rate of ANA in Tajik group was 15.1% [(555/3 687), 10.2%(147/1 445) male, 18.2%(408/2 242) female], of which high titers accounted for 25.8%(143/555). It was 16.7%(357/2 140) in the Kyrgyz group [10.3% male(101/980), 19.4%(256/1 160) female], with high titers accounting for 14.8%; and in the Han group, the positivity rate was 16.6% [9.8%(70/720) male, 19.1%(267/1 314) female], with high titers accounting for 18.4%(62/1 337). There was no significant difference in ANA positivity rate among the three ethnic groups( χ2=3.64, P=0.162), but there were differences in the percentage of high titer of ANA in Tajik ethnic group compared with Han and Kyrgyz ethnic groups(25.8% vs. 18.4%, χ2=6.02, P=0.014; 25.8% vs.14.8%, χ2=14.71, P=0.001), which accounted for a high percentage. The highest number of ANA high titers in all three groups was in the age group of 51~60 years. The ANA karyotype with the highest percentage of high titers in the Tajik and Kyrgyz populations was granular, while it was homogeneous and in the Han it was homogeneous.The positive rate of anti-dsDNA antibody in the Tajik group was 0.71%(26/3 687), of which high titer accounted for 23.1%(6/126); in the Kyrgyz group, it was 0.75%(16/2 034), and high titer accounted for 31.3%(4/14); and in the Han group, the positive rate was 0.69%(14/2 034), of which high titer accounted for 28.6%(4/64), and there was no statistical significance of in the difference in the positive rate of anti-dsDNA antibody and the proportion of high titer among the three groups( χ2=0.06, P=0.972; χ2=0.37, P=0.832). Conclusion:The percentage of ANA and anti-dsDNA antibodies and high titers varied vary among the three ethnic groups in this study, and long-term follow-up is needed to monitor keep an eye on the incidence of autoimmune diseases in people with high autoantibody titers.