ObjectiveTo investigate the independent predictive factors for 90-day mortality in patients with acute-on-chronic liver failure （ACLF）， to establish a risk predictive model， and to assess its predictive efficacy in comparison with MELD， MELD-Na， MELD 3.0， and COSSH-ACLF Ⅱ. MethodsA retrospective analysis was performed for the clinical data of 394 patients with ACLF who were admitted to The Affiliated Hospital of Inner Mongolia Medical University and Hohhot Second Hospital from July 2018 to July 2024， and general information and laboratory markers on admission were collected from all patients. The independent-samples t test or the Mann-Whitney U test was used for comparison of quantitative data between two groups， and the chi-square test or the adjusted chi-square test was used for comparison of qualitative data between two groups. The LASSO regression analysis was used to identify related variables， and the multivariate logistic regression analysis was used to establish a predictive model and generate a nomogram. The receiver operating characteristic （ROC） curve， the area under the ROC curve （AUC）， calibration curve， and clinical decision curve were used to assess the performance of the model. ResultsA total of 394 patients with ACLF were included in this study， with 136 patients in the training set， 58 in the internal validation set， and 200 in the external validation set. The cohort had a mean age of 52.9±11.7 years， among whom male patients accounted for 72.84% （287/394）， the patients with HBV infection accounted for 22.33% （88/394）， the patients with alcohol-related causes accounted for 45.94% （181/394）， and the patients with other causes （including drug-induced and autoimmune diseases） accounted for 31.73% （125/394）. The overall 90-day mortality rate was 27.41% （108/394）. The multivariate logistic regression analysis showed that diabetes （odds ratio ［OR］= 5.831， 95% confidence interval ［CI］： 1.587 — 21.424， P=0.008）， cystatin C （Cys-C） （OR=2.984， 95%CI： 1.501 — 5.933， P=0.002）， and spontaneous peritonitis （SBP） （OR=5.692， 95%CI： 2.150 — 15.071， P<0.001） were independent risk factors， and a nomogram was generated based on these factors. This model had an AUC of 0.836 in the training set， 0.881 in the internal validation set， and 0.878 in the external validation set， showing a good discriminatory ability. The calibration curve showed a good degree of fitting， with a relatively high net clinical benefit. The subgroup analysis based on etiology showed that the model had an AUC of 0.850 in the patients with HBV infection， 0.858 in the patients with alcohol-induced ACLF， and 0.908 in the patients with other etiologies， indicating that the model had a good discriminatory ability across the populations with different etiologies. Compared with traditional scores， the model （AUC=0.836） had a significantly better predictive value than MELD （AUC=0.619， Z=3.197， P=0.001）， MELD-Na （AUC=0.651， Z=2.998， P=0.003）， MELD 3.0 （AUC=0.601， Z=3.682， P<0.001）， and COSSH-ACLF Ⅱ （AUC=0.719， Z=2.396， P=0.017） alone. ConclusionDiabetes， SBP， and Cys-C are independent risk factors for 90-day mortality in patients with ACLF. Compared with MELD， MELD-Na， MELD 3.0， and COSSH-ACLF Ⅱ scores， this model has a higher predictive value for 90-day prognosis in patients with ACLF and is suitable for patients with ACLF caused by various etiologies.

Objective: To investigate the current status of sexual function and its influencing factors among pregnant women, so as to provide the reference for improving sexual health among pregnant women. Methods: From January to July 2025, pregnant women attending regular prenatal check-ups at Shanxi Children's Hospital (Shanxi Maternal and Child Health Hospital), were selected as study participants using a convenience sampling method. Information on sociodemographic, pregnancy-related conditions, and sexual activity during pregnancy was collected through questionnaire surveys. Sexual function status over the past four weeks was assessed using the Chinese version of the Female Sexual Function Index. A multiple linear regression model was employed to analyze the influencing factors for sexual function among pregnant women. Results: A total of 424 pregnant women were surveyed, with the majority aged 30-<35 years (211 cases, 49.76%). Among them, 72 were in the first trimester (16.98%), 200 in the second trimester (47.17%), and 152 in the third trimester (35.85%). The overall sexual function score among pregnant women was (17.85±6.46) points. Scores for the six domains, desire, arousal, lubrication, orgasm, satisfaction, and pain were (3.23±0.78) (2.21±1.20) (2.76±1.63) (2.95±1.68) (4.14±1.08) (2.56±1.96) points, respectively. Multiple linear regression analysis revealed that cohabitation with a companion (β'=0.124), stage of pregnancy (third trimester, β'=-0.360), and changes in sexual practices or positions during pregnancy (β'=0.164) were statistically associated with sexual function scores among pregnant women (all P<0.05). Conclusions Sexual function declines among pregnant women, with mean scores across all domains falling below the critical threshold. Cohabitation with a companion and appropriate adjustments in sexual practices or positions according to the stage of pregnancy may improve sexual function among pregnant women.

Objective:To explore the effects of Xiaoyao Conger Decoction pretreatment on model rats of tinnitus with syndrome of liver-qi stagnation and spleen deficiency (TLSSD) and its preliminary mechanisms.Methods:The rats were divided into four groups: a blank group, a model group, a positive group, and Xiaoyao Conger high- and low-dosage groups, with 7 rats in each group according to random number table method. Except for the blank group, the TLSSD model was prepared by the composite etiological method in all groups of rats. The positive group received a gavage of carbamazepine at 15 mg/kg, while Xiaoyao Conger high- and low-dosage groups were given 30 g/kg and 15 g/kg of Xiaoyao Conger Decoction, respectively. The blank and model groups were administered an equal volume of saline once daily for 4 weeks. The frequency of conditioned avoidance response behaviors in rats was recorded before and at 2 and 4 weeks post-drug administration; TCM syndrome scores were documented before and after treatment; auditory brainstem response (ABR) thresholds were monitored at frequencies of 4, 12, 20, and 28 kHz; IL-1β mRNA expression in the inferior colliculus and cochlea was detected by RT-qPCR; and the levels of γ-aminobutyric acid (GABA) and glutamic acid (Glu) in hippocampal tissues were determined by LC-MS/MS.Results:The model group exhibited symptoms of liver depression, including irritability, yellow fur, and a dark red tongue, along with signs of spleen deficiency such as lethargy, decreased activity, and loose stools. Compared to the model group, rats in the Xiaoyao Conger high- and low-dosage groups demonstrated a reduction in conditioned avoidance response behaviors ( P<0.05 or P<0.01), a decrease in TCM syndrome scores ( P<0.05 or P<0.01), lower ABR thresholds at 12, 20, and 28 kHz ( P<0.01), reduced levels of IL-1β mRNA in the inferior colliculus and cochlea ( P<0.05 or P<0.01), and decreased hippocampal Glu levels ( P<0.01). Conclusion:The therapeutic effect of Xiaoyao Conger Decoction pretreatment on TLSSD rats may be related to its ability to improve the mood disorders and stress, reduce the neuroinflammatory response, regulate the CNS neurotransmitter balance, and correct the overexcitability of the auditory centre, etc.

ObjectiveTo investigate the influence of different diagnostic criteria on the short-term prognosis of patients with acute-on-chronic liver failure （ACLF）. MethodsA total of 115 ACLF patients who were hospitalized in Department of Gastroenterology， The Second Affiliated Hospital of Kunming Medical University， from January 2018 to January 2022 were enrolled， and all patients received internal medical treatment combined with artificial liver therapy. According to the guidelines， the patients were divided into CMA guideline group （Diagnostic and treatment guidelines for liver failure by Chinese Medical Association）（n=100）， APASL guideline group （Consensus statements of Asian Pacific Association for the Study of the Liver）（n=94）， and EASL guideline group （Criteria proposed by European Association for the Study of the Liver）（n=36）. The above three guidelines were compared in terms of 90-day mortality rate. A one-way analysis of variance was used for comprision of continuous date between groups； the chi-square test was used for comprision of categorical date between groups. The receiver operating characteristic （ROC） curve of related variables. ResultsThe 90-day mortality rate was 50.0% in the CMA guideline group， 51.1% in the APASL guideline group， and 77.8% in the EASL guideline group， and the EASL guideline group had a significantly higher 90-day mortality rate than the CMA guideline group （χ²=8.351， P=0.004） and the APASL guideline group （χ²=7.650， P=0.006）. EASL guideline had a sensitivity of 22.2% and a specificity of 92.3% in predicting the risk of short-term mortality， with an area under the ROC curve was 0.576. ConclusionACLF patients who meet EASL guideline tend to have a worse short-term prognosis， and this guideline may help to identify patients at a relatively high risk of short-term death.

ObjectiveTo observe the effect of surface sensation training on walking function of patients after anterior cruciate ligament reconstruction (ACLR). MethodsFrom January to November, 2021, 56 ACLR inpatients in Beijing Rehabilitation Hospital were randomly divided into control group (n = 28) and experimental group (n = 28). The control group received routine rehabilitation training of 45 minutes a time, while the experimental group received routine rehabilitation training of 30 minutes and surface sensation training of 15 minutes a time, for eight weeks. Their toe-out angle and affected side impulse percentage of plantar seven zones were measured before and after intervention. ResultsThe toe-out angle of both the healthy and the affected sides decreased in both groups after intervention (t > 4.615, P < 0.001), and it was less in the affected side in the experimental group (t = 2.263, P < 0.05). The impulse percentage in heel medial and heel lateral areas increased in both groups after intervention (t > 4.221, P < 0.001), and it was more in the experimental group (t > 3.651, P < 0.01); while the impulse percentage in middle foot, foot intermediate and foot lateral areas decreased in both groups (t > 3.174, P < 0.01), and it was less in foot intermediate and foot lateral areas in the experimental group (t > 2.366, P < 0.05); the impulse percentage decreased in foot medial and toe areas in the experimental group (t > 3.508, P < 0.01), but there was no significant difference between two groups (t < 1.608, P > 0.05). ConclusionSurface sensation training can further improve the foot deflection and distribution of impulse of affected side in patients after ACLR during walking, to normalize the load patterns.

Objective:To evaluate the effect of paravertebral nerve block (PVNB) combined with general anesthesia on intraoperative regional cerebral oxygen saturation (rScO 2) in elderly patients undergoing thoracoscopic lobectomy. Methods:Seventy American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients of both sexes, aged 60-85 yr, with body mass index of 18-25 kg/m 2, were divided into 2 groups ( n=35 each) using a random number table method: general anesthesia group (group G) and PVNB combined with general anesthesia group (group PG). PVNB was performed at T 4 and T 6 with 0.5% ropivocaine 10 ml for each site under ultrasound guidance before induction of anesthesia in group PG.After induction of anesthesia, anesthesia was maintained with IV propofol and remifentanil, and a patient-controlled intravenous analgesia pump was connected at the end of operation.The maximum and minimum rScO 2 and cumulative time of rScO 2 below the baseline value were recorded.The rScO 2 was recorded before anesthesia (T 0), at 5 min before one-lung ventilation (T 1), at 5 min after one-lung ventilation (T 2) and at tracheal extubation (T 3). The length of postoperative hospital stay and complications within 30 days after operation were recorded. Results:Compared with group G, the minimum rScO 2 and rScO 2 at T 2 and T 3 were significantly increased, the incidence of postoperative cognitive dysfunction was reduced ( P<0.05), and no significant change was found in the other parameters mentioned above in group PG ( P>0.05). Conclusion:PVNB combined with general anesthesia can improve intraoperative rScO 2 and reduce the development of postoperative cognitive dysfunction in elderly patients undergoing thoracoscopic lobectomy.

Objective:To identify the risk factors for decrease in regional cerebral oxygen saturation (rScO 2) during one-lung ventilation (OLV) in the patients undergoing thoracic surgery. Methods:A total of 175 patients of both sexes, aged ≥55 yr, with expected operation time≥2 h, scheduled for elective thoracic surgery with OLV, were selected in the Fourth Hospital of Hebei Medical University from August 2017 to September 2018.The rScO 2 was continuously monitored from the beginning of anesthesia induction until removal of tracheal intubation.General anesthesia, general anesthesia combined with epidural block or general anesthesia combined with local nerve block were used.The baseline characteristics, previous medical history and history of anesthesia surgery, type of surgery, method of anesthesia, duration of anesthesia, duration of OLV, duration of surgery, and intraoperative adverse events (hypoxemia, hypotension, bradycardia, etc.) were recorded.According to whether a decrease in rScO 2 occurred during OLV (absolute value of rScO 2 was less than 65% or a decrease of more than 20% of the baseline value), the patients were divided into 2 groups: low rScO 2 group and normal rScO 2 group.Multivariate logistic regression analysis was used to identify the risk factors for decrease in rScO 2 during OLV. Results:One hundred and seven patients developed decrease in rScO 2 during OLV, with an incidence of 61.1%.The results of logistic regression analysis showed that hypoxemia was an independent risk factor for decrease in rScO 2, and general anesthesia combined with epidural block was a protective factor for decrease in rScO 2 during OLV. Conclusion:Hypoxemia is an independent risk factor for decrease in rScO 2 during OLV, while general anesthesia combined with epidural block is a protective factor for decrease in rScO 2 in the patients undergoing thoracic surgery.

Objective To evaluate the effectiveness of an activity of nutrition science experience on nutrition and food safety cog-nition among primary and secondary school students .Methods With stratified cluster sampling ,students of grade 5 and 6 in one primary school and students of grade 1 and 2 in one middle school in Chongqing were selected ,and randomly divided into interven-tion group(n= 501) and control group(n= 522) .Only conducted the activity in the intervention group .Baseline data of all the students were investigated before the intervention .Effect evaluation was performed instantly in the intervention group and control group ,and a follow-up survey carried out in the intervention group after 9 months(n= 472) .Results The nutrition knowledge scores of instant intervention group were 9 .03 ± 2 .75 and 14 .70 ± 3 .28 before and after intervention respectively (U=29 .78 ,P<0 .01);the knowledge scores of the nine months later intervention group were 12 .35 ± 2 .89 ,which were lower than instant interven-tion group(U=12 .40 ,P<0 .01) ,but higher than before intervention(U=18 .04 ,P<0 .01) .The food safety scores of instant inter-vention group ,which were higher than control group ,nine months later intervention group and before intervention(P<0 .01) .Con-clusion It is feasible and effective to conduct a nutrition science experience among primary and secondary school students .

Objective To study the effectiveness of personalized rehabilitation treatments based on threedimensional gait analysis (3DGA) for improving the walking function of children with cerebral palsy (CP).MethodsA total of 21 spastic CP children with diplegia or hemiplegia,IQ scores ＞60,and an average age of 8.5 years received 3DGA.They then received personalized rehabilitation treatment designed according to the 3DGA results.After four weeks of treatment the children accepted 3DGA again.Their gait descriptors before and after treatment were compared. ResultsAfter the personalized rehabilitation the subjects'clinical foot dorsiflexion angle,clinical popliteal fossa angle,walking velocity,stride length,step length,peak ankle dorsiflexion in prime stance,peaking ankle plantar flexion in last stance,peak back ground reaction forces (GRFs) and peak vertical GRF in stance all had improved significantly.The cadence,total support time,swing phase,initial double support time,peak knee extension in stance and the peak forward GRF were not,however,significantly different compared with before the personalized rehabilitation treatment.Conclusion Under the guidance of 3DGA,the walking function of spastic CP children improved significantly after 4 weeks of personalized rehabilitation treatment.3DGA can play an important role in formulating personalized rehabilitation protocols and guiding rehabilitation treatment for CP children.

Objective To evaluate the clinical effect of ultrasound-guided botulinum toxin A (BTX-A)injection for upper limb spasticity in children with cerebral palsy.Methods Twenty children with upper limb spasticity resulting from cerebral palsy were divided equally into a BTX-A injection group and a control group. Both groups received standard rehabilitation treatment. For the injection group, color ultrasonography was used to guide the accurate injection of BTX-A into the spastic muscles of the arm. They received rehabilitation training the day after the injection. For all patients, muscle spasticity and upper limb movement and function were evaluated before treatment and 1, 2, 4, 8 and 12 weeks later using a modified Ashworth scale and the Fugl-Meyer assessment.Results After two weeks of treatment, muscle spasticity and upper limb movement and function in the injection group were significantly better than before the injection.The improvement in muscle spasticity was greatest two weeks after the injection. The average therapeutic effect in the injection group was significantly better than among the controls.Conclusion BTX-A injection under ultrasound guidance helps relieve upper limb spasticity in cerebral palsy. It has the advantages of accurate localization and safety and gives superior results compared to rehabilitation treatment alone.