Objective:To investigate the incidence and disease spectrum characteristics of complications of vaginal delivery,and to provide a basis for protecting maternal and child safety and improving obstetric medical quality.Method:Retrospective analysis of obstetric case data from a tertiary hospital in Anhui Province from 2022 to 2024 was performed to identify cases of vaginal delivery complications using International Classification of Diseases 10th Revision codes.Results:A total of 2 644 vaginal deliveries were included,with a decreasing trend in complication rate from 40.9%in 2022 to 17.6%in 2024.Among them,obstetric laceration and postpartum hemorrhage were the main types of complications,with the incidence of obstetric laceration decreasing from 32.2%to 13.8%,and postpartum hemorrhage decreasing from 7.6%to 2.9%,and the changes in both were statistically significant(P＜0.05).Among obstetric lacerations,there were significant differences in the incidence of second-degree perineal lacerations and unspecified perineal lacerations across the years(P＜0.05).Conclusions:Although the incidence of complications in vaginal delivery has decreased,it still needs attention.This study proposes to strengthen the comprehensive prevention and control measures for obstetric lacerations,establish a full-chain management mechanism for postpartum hemorrhage,and implement a data-driven quality improvement strategy in obstetrics further to enhance the quality of obstetric medical care.

Objective:To construct a medical quality evaluation index system for inpatients in public hospitals based on the life cycle theory,starting from the entire process of medical treatment.Method:A comprehensive study was conducted on the screening of medical quality evaluation indicators for hospitalized patients using literature analysis,key informant interviews,and expert inquiry methods.Results:The effective recovery rate of the two rounds of expert consultation was 100%,with high enthusiasm from the experts.The authority coefficient was above 0.7,and Kendall's W coordination coefficient was 0.267(P＜0.05).The evaluation indicators for medical quality of hospitalized patients,including 3 primary indicators,10 secondary indicators,and 51 tertiary indicators,were determined.Conclusions:The medical quality evaluation index system for inpatients in public hospitals based on the life cycle theory has certain scientificity and reliability.However,the weight analysis of the index system has not been carried out and is still in the theoretical exploration stage.Further empirical research is needed for verification and improvement.

Objective To observe the impact factors of vascular heat sink effect during in vitro microwave ablation(MWA)of porcine lung.Methods Simulation models were established using in vitro porcine lung tissue blocks based on isobaric inflation with an air pump and cyclic perfusion of duck blood with a glass tube and peristaltic pump,etc.MWA was performed under 8 different combining conditions(vessel diameter of 3 or 5 mm,blood perfusion of 30 or 50 cm/s,as well as distance between vessel and ablation antenna of 5 or 10 mm)each for 3 times.The highest temperature TV on vessel side and TC on control side during MWA,and ablation depth DV on vessel side and DC on control side after MWA were recorded.Multi-factor linear regression equations were constructed based on simulated vessel diameters,blood perfusion and distance between vessel and ablation antenna,and the impact factors of|TC-TV|and|DC-DV|were screened,respectively.Results Simulated vessel diameter showed linear positive correlation with both|TC-TV|and|DC-DV|(both P＜0.001).Simulated distance between vessel and ablation antenna showed linear negative correlation with both|TC-TV|and|DC-DV|(both P＜0.001),and the latter had more obvious impact on vascular heat sink effect than the former.Meanwhile,no significant linear relationship was found between simulated blood perfusion and|TC-TV|nor|DC-DV|(both P＞0.05).Conclusion Simulated vessel diameter and distance between vessel and ablation antenna were both impact factors of vascular heat sink effect during in vitro MWA of porcine lung,and the latter was more influential,whereas simulated blood perfusion showed no significant impact on it.

Objective:To observe the effectiveness of extracorporeal counterpulsation therapy in patients with heart failure in ischaemic cardiomyopathy.Methods:A total of 112 patients with ischemic cardiomyopathy and heart failure admitted to the Second Affiliated Hospital of Xingtai Medical College from August 2020 to June 2023 were prospectively selected and divided into two groups by random number table method. The control group was treated with conventional drugs and conventional cardiac rehabilitation program, and the observation group was combined with external counterbeating therapy on the basis of the control group. The levels of N-terminal B-type brain natriuretic peptide (NTproBNP), soluble growth stimulation-expression gene-2 protein (sST2), neutrophil gelatinase-associated lipid carrier protein (NGAL), galactin-3 (Gal-3), cardiopulmonary exercise test (CPET) parameters and cardiac ultrasound indexes were compared between the two groups before and after treatment. The curative effect and the rate of re-hospitalization within 6 months were compared between the two groups.Results:After treatment, the levels of NTproBNP, sST2, NGAL and Gal-3 in the observation group were lower than those in the control group: (1941.36 ± 312.59) ng/L vs. (2674.22 ± 404.64) ng/L, (44.78 ± 3.97) ng/L vs. (52.45 ± 4.13) ng/L, (22.63 ± 3.65) μg/L vs. (26.41 ± 3.77) μg/L, (4.63 ± 1.29) ng/L vs. (6.11 ± 1.78) ng/L, there were statistical differences ( P<0.05); the maximum kilogram oxygen uptake (VO 2max/kg), maximum kilogram oxygen uptake as a percentage of predicted value (VO 2max/kg%pred), maximum minute ventilation as a percentage of predicted value (VEmax%pred) in the observation group were higher than those in the control group: (22.41 ± 2.23) ml/(min·kg) vs. (21.35 ± 2.09) ml/(min·kg), (83.79 ± 11.04)% vs. (78.74 ± 10.14)%, (88.95 ± 12.74)% vs. (75.45 ± 11.14)%, there were statistical differences ( P<0.05 or <0.01); the left ventricular ejection fraction (LVEF) in the observation group was higher than that in the control group and the left ventricular posterior wall thickness (LVPWT) and left ventricular posterior wall end-systolic thickness (PWS) were lower than those in the control group: (50.12 ± 3.87)% vs. (48.63 ± 3.74)%, (8.77 ± 1.58) mm vs. (9.63 ± 1.97) mm, (9.34 ± 1.54) mm vs. (10.14 ± 1.79) mm, there were statistical differences ( P<0.05). There was no statistical difference in the total effective rate between the two groups ( P>0.05). The patient readmission rate within 6 months of follow-up in the observation group was lower than that in the control group: 5.45%(3/55) vs. 20.00%(11/55), there was statistical difference( χ2 = 5.24, P<0.05). Conclusions:Extracorporeal counterpulsation therapy for the treatment of heart failure in ischaemic cardiomyopathy can improve the cardiorespiratory function, reduce the expression of NTproBNP, sST2, NGAL and Gal-3, and decrease the patient readmission rate.

Objective To compare the efficacy and safety of CT-guided percutaneous radiofrequency ablation(RFA)and cryoablation(CRYO)combined with synchronous biopsy of pulmonary nodules.Methods Totally 62 patients with pulmonary nodules who underwent CT-guided percutaneous ablation with either RFA(n=30)or argon-helium CRYO(n=32)combined with simultaneous biopsy were enrolled,and the regarding postoperative complication rates and 1-year local control outcomes were compared.Results All patients successfully completed both ablation and biopsy procedures.In RFA group,the mean diameter of lesion was(1.43±0.33)cm,and the biopsy positive rate was 90.00%(27/30).Post-biopsy intrapulmonary hemorrhage extent immediately increased by 0.60(0.28,1.63)cm.Hemoptysis,pneumothorax requiring chest tube placement and infectious cavities observed in 2(2/30,6.67%),6(6/30,20.00%)and 4 cases(4/30,13.33%),respectively,and the 1-year local control rate in RFA group was 90.00%(27/30).In CRYO group,the mean diameter of lesion was(1.59±0.34)cm,and the biopsy positive rate was 100%(32/32).Post-biopsy intrapulmonary hemorrhage extent increased by 1.20(0.60,1.83)cm.Hemoptysis occurred in 7 cases(7/32,21.88%),and pneumothorax requiring chest tube placement was noticed in 8 cases(8/32,25.00%),while no infectious cavity was observed.The 1-year local control rate in CRYO group reached 96.88%(31/32).Statistical difference of infectious cavity was found between groups(P＜0.05).Conclusion Simultaneous biopsy during CT-guided percutaneous RFA and CRYO for lung nodules were both efficient and safe,while the former with relative higher incidence of infectious cavity.

Objective To investigate the relationship between the expression levels of lymphocyte activation gene-3(LAG-3)and pen-traxin-3(PTX3)and the disease severity of the patients with allergic rhinitis(AR).Methods A total of 128 AR patients visited the Department of Otolaryngology,Chengdu Integrated TCM and Western Medicine Hospital from January 2021 to June 2023 were retro-spectively selected as the research subjects(AR group).According to the severity of the condition,the patients were further divided into the mild group(n=40),moderate group(n=42),and severe group(n=46).In addition,80 healthy volunteers who underwent physical examinations in our hospital were selected as the control group.The clinical data such as the gender,age,body mass index(BMI),allergens,and disease onset time of all subjects were recorded and analyzed,and all patients were scored using the Score For Allergic Rhinitis(SFAR).The enzyme linked immunosorbent assay(ELISA)was used to detect the expression levels of serum LAG-3 and PTX3 in all subjects.The correlation between the expression levels of serum LAG-3 and PTX3 was analyzed by the Pearson correla-tion analysis.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of serum LAG-3 and PTX3 levels,both individually and in combination,for AR.Results The expression levels of serum LAG-3 in the AR group(468.74±104.32 μg/L)were significantly lower than that in the control group(691.53±184.65 μg/L,t=7.795,P<0.05),while those of ser-um PTX3 in the AR group(24.83±7.54 ng/L)were significantly higher than that in the control group(17.34±5.37 ng/L,t=7.793,P<0.05).The expression levels of serum LAG-3 in the AR patients with positive immunoglobulin(IgE)and SFAR score≥7 were 442.46±92.37 μg/L and 448.27±103.24 μg/L,respectively,which were significantly lower than that in the AR patients with negative IgE(497.61±115.32 μg/L)and SFAR score<7(498.66±112.76 μg/L,P<0.05).While the expression levels of serum PTX3 in the AR patients with positive IgE and SFAR score≥7 were 28.24±8.17 ng/L and 26.43±8.73 ng/L,respectively,which were significantly higher than that in the AR patients with negative IgE(21.08±6.25 ng/L)and SFAR score<7(22.51±6.89 ng/L,P<0.05).Com-pared with the mild group,the expression levels of serum LAG-3 in both the moderate and severe groups were reduced,and that of ser-um LAG-3 in the severe group was significantly lower than that in the moderate group.While the expression levels of serum PTX3 showed an opposite trend,and the levels of serum PTX3 in the severe group were significantly higher than that in the moderate group(P<0.05).The Pearson correlation results showed a significant negative correlation between serum LAG-3 and PTX3 levels in AR pa-tients(r=-0.402,P=0.000).The analysis of the ROC curve showed that the area under the ROC curve(AUCROC),sensitivity,and specificity of the combination of serum LAG-3 and PTX3 in the diagnosis of AR were 0.881,89.80％,and 73.80％,respectively,which were better than that of serum LAG-3 and PTX3 alone.Conclusion The combined detection of serum LAG-3 and PTX3 for the diagnosis of AR has higher clinical application value and may be used to evaluate the severity of the disease.

Objective:To review the applications of key technologies of 5G+helicopter medical rescue and predict future developments. Literature resource and selection Related literature in this field that was published at home and abroad. Literature quotation Forty articles published at home and abroad. Literature synthesis 5G+helicopter medical rescue is a new medical rescue model that integrates airborne 5G network technology, body area network disease awareness technology and 5G air-ground collaborative rapid diagnosis and treatment technology. It can shorten the time and space distance of medical rescue and improve the efficiency. The clinical applications of 5G+helicopter medical rescue, including the development of rescue schemes, daily and disaster scenarios 5G networking schemes, and air-ground collaborative emergency rescue information sharing platforms, have delivered remarkable results in the field of medical rescue. Despite the challenges facing 5G technology such as high cost and inconsistent technical standards, its development will promote innovation and progress in low-airspace helicopter medical rescue and offer more efficient, more accurate and safer rescue services. Conclusions:It is recommended that 5G network be given more weight, the auto-flight technology of helicopters developed, rescue command and dispatch platforms established, rescue personnel better-trained and supervision and safety guarantee be enhanced.

Objective To compare the efficacy and safety of CT-guided percutaneous radiofrequency ablation(RFA)and cryoablation(CRYO)combined with synchronous biopsy of pulmonary nodules.Methods Totally 62 patients with pulmonary nodules who underwent CT-guided percutaneous ablation with either RFA(n=30)or argon-helium CRYO(n=32)combined with simultaneous biopsy were enrolled,and the regarding postoperative complication rates and 1-year local control outcomes were compared.Results All patients successfully completed both ablation and biopsy procedures.In RFA group,the mean diameter of lesion was(1.43±0.33)cm,and the biopsy positive rate was 90.00%(27/30).Post-biopsy intrapulmonary hemorrhage extent immediately increased by 0.60(0.28,1.63)cm.Hemoptysis,pneumothorax requiring chest tube placement and infectious cavities observed in 2(2/30,6.67%),6(6/30,20.00%)and 4 cases(4/30,13.33%),respectively,and the 1-year local control rate in RFA group was 90.00%(27/30).In CRYO group,the mean diameter of lesion was(1.59±0.34)cm,and the biopsy positive rate was 100%(32/32).Post-biopsy intrapulmonary hemorrhage extent increased by 1.20(0.60,1.83)cm.Hemoptysis occurred in 7 cases(7/32,21.88%),and pneumothorax requiring chest tube placement was noticed in 8 cases(8/32,25.00%),while no infectious cavity was observed.The 1-year local control rate in CRYO group reached 96.88%(31/32).Statistical difference of infectious cavity was found between groups(P＜0.05).Conclusion Simultaneous biopsy during CT-guided percutaneous RFA and CRYO for lung nodules were both efficient and safe,while the former with relative higher incidence of infectious cavity.

OBJECTIVE To explore the ameliorative effect of Tiaozhi Xiaoban Mixture on atherosclerosis and the potential role of long non-coding RNA(Linc RNA)in anti-atherosclerosis.METHODS A model of atherosclerosis was established in SD rats subjec-ted to a high-fat diet.At 4 weeks post-modeling,thoracic aortic tissues from atherosclerotic rats were collected for hematoxylin-eosin(HE)staining to systematically evaluate the anti-atherosclerotic effects of Tiaozhi Xiaoban Mixture at different doses.Biochemical kits were utilized to assess relevant indices related to blood lipid levels as well as liver and kidney function,thereby evaluating the impact of Tiaozhi Xiaoban Mixture on these parameters.Enzyme-linked immunosorbent assay(ELISA)was employed to measure serum inflam-mation markers influenced by Tiaozhi Xiaoban Mixture.Additionally,TUNEL staining and Western blot analysis were conducted to ex-amine the apoptotic effects of Tiaozhi Xiaoban Mixture on thoracic aorta tissue.Finally,qPCR was used to detect the expression levels of Line-HC,MALAT1,etc.,in order to evaluate how Tiaozhi Xiaoban Mixture affecting these specific RNA molecules.RESULTS Following treatment with Tiaozhi Xiaoban Mixture,the blood lipid profiles indicated that total cholesterol(TC),triglycerides(TG),and low-density lipoprotein cholesterol(LDL-C)were significantly down-regulated(P＜0.05,P＜0.01),while high-density lipopro-tein cholesterol(HDL-C)levels were up-regulated in the atherosclerotic rats.Moreover,serum levels of liver and kidney function markers such as aspartate aminotransferase(AST),alanine aminotransferase(ALT),blood urea nitrogen(BUN),and creatinine(Cr)exhibited down-regulation(P＜0.05,P＜0.01).Additionally,pro-inflammatory factors including interleukin-6(IL-6),interleukin-1 beta(IL-1β),tumor necrosis factor-alpha(TNF-α),high-sensitivity C-reactive protein(hs-CRP),and matrix metallopeptidase 9(MMP-9)were also reduced(P＜0.01),whereas the anti-inflammatory factor interleukin-10(IL-10)was found to be elevated(P＜0.01).Furthermore,after oral administration of Tiaozhi Xiaoban Mixture,expression levels of apoptosis-related factors NLRP3,ASC,Cleaved Caspase-1,Cleaved IL-1 β,Puma,Bax,Noxa,and MDM2 in thoracic aorta tissues from the atherosclerotic rats showed sig-nificant down-regulation(P＜0.05,P＜0.01).Notably,following treatment with Tiaozhi Xiaoban Mixture,mRNA levels of Linc-HC decreased while mRNA expression of MALAT1 increased(P＜0.05,P＜0.01).CONCLUSION Tiaozhi Xiaoban Mixture may inhibit the expression of Linc-HC and up-regulate the expression of MALAT1 to reduce the formation of atherosclerotic plaque,improve ab-normal blood lipids and liver and kidney function,alleviate inflammation and inhibit apoptosis.

Objective To analyze the effects of nasal endoscopic low temperature plasma ablation combined with nasal dynamical system-assisted resection on inflammatory markers in peripheral blood of sinonasal inverted papilloma(SINP)and their correlations with recurrence.Methods A retrospective analysis was performed on 60 SINP patients admitted to Chengdu First People's Hospital from May 2021 to May 2023,all of whom were treated with endoscopic low temperature plasma ablation and nasal dynamical system-assisted resection;and another 60 healthy persons who underwent physical examination in the same period were enrolled and set as control group.The changes of peripheral blood inflammatory markers before and at various time points after operation were compared between control group and SINP patients.General data of patients were collected by self-made scales.The recurrence was recorded,and its influence factors were analyzed for further exploring and the correlation between recurrence and levels of peripheral blood inflammatory factors.Results Statistically significant differences between control group and SINP group were found in serum tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),interleukin-6(IL-6),interleukin-8(IL-8),eosinophilic cationic protein(ECP)and eosinophilic granulocytes(EOS)before operation,3 days and 1 month after operation(all P<0.001).Univariate analysis identified that TNF-α,CRP,IL-6,IL-8,mitotic counts,atypical hyperplasia and course of disease were associated with postoperative recurrence in SINP patients.Spearman correlation analysis showed that the postoperative recurrence in SINP patients showed no correlation with IL-6 level(P>0.05),but positively correlated with TNF-α,CRP and IL-8 levels(P<0.05).Conclusion Nasal endoscopic low temperature plasma ablation combined with nasal dynamical system-assisted resection is effective for SINP,with a low postoperative recurrence rate.Moreover,peripheral blood inflammatory markers are closely related to the occurrence and development of SINP,which may be involved in the recurrence,and there is a synergistic effect.