Threatened abortion is a common disease of obstetrics and gynecology and one of the diseases responding specifically to traditional Chinese medicine （TCM）. The China Association of Chinese Medicine organized experts in TCM obstetrics and gynecology， Western medicine obstetrics and gynecology， and pharmacology to deeply discuss the advantages of TCM and integrated Chinese and Western medicine treatment as well as the medication plans for threatened abortion. After discussion， the experts concluded that chromosome， endocrine， and immune abnormalities were the key factors for the occurrence of threatened abortion， and the Qi and blood disorders in thoroughfare and conception vessels were the core pathogenesis. In the treatment of threatened abortion， TCM has advantages in preventing miscarriages， alleviating clinical symptoms and TCM syndromes， relieving anxiety， regulating reproductive endocrine and immune abnormalities， personalized and diversified treatment， enhancing efficiency and reducing toxicity， and preventing the disease before occurrence. The difficulty in diagnosis and treatment of threatened abortion with traditional Chinese and Western medicine lies in identifying the predictors of abortion caused by maternal factors and the treatment of thrombophilia. Recurrent abortion is the breakthrough point of treatment with integrated traditional Chinese and Western medicine. It is urgent to carry out high-quality evidence-based medicine research in the future to improve the modern diagnosis and treatment of threatened abortion with TCM.

Objective:To study the life characteristics and related risk factors of patients with depression in Shandong Province.Methods:Based on the 2015 mental epidemiological survey database in Shandong Province,a total of 832 patients with depression,807 high-risk individuals with depression,and 819 low-risk individuals were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition(DSM-Ⅳ)and the Structured Clinical Interview for DSM-Ⅳ-TR Axis I Disorders,Research Version(SCID-I/P).In 2020,SCID-I/P was used for re diagnosis,and the General Health Questionnaire(GHQ-12),Simple Quality of Life question-naire,Pittsburgh sleep quality index(PSQI),Childhood Trauma Questionnaire(CTQ),Social Support Rating Scale(SSRS),Global Pain Scale(GPS),Montreal Cognitive Assessment(MoCA),Simplified Coping Style Question-naire(SCSQ)were used for evaluation.Compare changes in the quality of life of depression patients and construct a risk factor model.Results:Patients with depression had lower scores on the simple quality of life questionnaire at baseline and at retest after 5 years than those in the high-and low-risk groups,those in remission of depression had higher scores on the simple quality of life questionnaire at baseline and at retest after 5 years than those in non-re-mission,and those with new-onset disorder in the high-and low-risk groups had lower scores on the simple quality of life questionnaire at baseline and at retest after 5 years than those with no-onset disorder(Ps＜0.001).Depres-sion diagnosis and PSQI scale scores at baseline negatively predicted at retest after 5 years(β=-0.06,-0.15),while coping style tendencies at baseline positively predicted(β=0.06).The simple quality of life questionnaire at baseline negatively predicted depression diagnosis at retest after 5 years,GHQ-12 scores at retest after 5 years,and PSQI scale scores at retest after 5 years(β=-0.11,-0.17,-0.09),while the simple quality of life question-naire at baseline positively predicted coping style tendencies at retest after 5 years(β=0.13).Depression diagnosis at retest after 5 years,GHQ-12 scores at retest after 5 years,PSQI scale scores at retest after 5 years,coping style tendencies at retest after 5 years,SSRS scale scores,CTQ scale scores,GPS scale scores,and the simple quality of life questionnaire at baseline all influenced the simple quality of life questionnaire at retest after 5 years through ei-ther direct or indirect pathways.Conclusion:It suggest that the quality of life is lower in patients with depression than in the general population.Depression diagnosis,sleep,mental health,pain,social support,childhood trauma and coping are direct and indirect risk factors affecting life.

Objective:To analyze the efficacy and safety of FOLFOX-hepatic arterial infusion chemotherapy (HAIC) combined with targeted immunotherapy for initial unresectable hepatocellular carcinoma.Methods:A retrospective analysis was conducted on the data of initial unresectable hepatocellular carcinoma patients who visited Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine from June 2022 to June 2023. A total of 51 patients were enrolled, including 47 males and 4 females, with the age of (56.1±10.7) years. All 51 patients received HAIC combined with immune targeted therapy. After each HAIC combined with immune targeted therapy, the efficacy was evaluated according to the modified response evaluation cirteria in solid tumor (mRECIST). Objective response rate and disease control rate were calculuted. The conversion surgery rate and adverse events during treatment were recorded. Follow up patients' disease progression and survival status, and meanwhile analyze prognosis.Results:According to mRECIST assessment, the number of patients with complete remission, partial remission, disease stability, and disease progression were 4 (7.8%), 27 (52.9%), 14 (27.4%), and 6 (11.8%), respectively. The disease remission rate was 60.8%(31/51), and the disease control rate was 88.2%(45/51). After HAIC combined with immune targeted therapy, 13 patients underwent liver cancer resection, with a surgical conversion rate of 25.5%(13/51). The median progression free survival of 51 patients was 14.2 months, and the median overall survival has not yet been reached. The progression free survival rates of 51 patients at 6 and 12 months were 90.2% and 64.7%, respectively, and the cumulative survival rates at 6 and 12 months were 100% and 86.3%, respectively. During the treatment period, all patients experienced various degrees of adverse reactions, 38(75.5%) patients were grade 1-2 adverse accidents, which could be relieved and controlled after corresponding treatment.Conclusion:FOLFOX-HAIC combined with targeted immunotherapy provides an effective and safe treatment option for unresectable hepatocellular carcinoma, offering surgical resection opportunities for unresectable hepatocellular carcinoma patients.

Liver is a unique organ with polyploidy.About 20 to 50 percent of hepatocytes in adult human are polyploid cells,which contain more than two sets of chromosomes.Hepatocytes polyploidization is triggered by the changes in insulin signal during weaning,and regulated by various cell cycle regulator genes to ensure the polyploid cells proportion,ploidy and zonation.The regulation of polyploid hepatocytes is crucial for liver's metabolic and regenerative function,and protecting liver from tumorigenesis.However,in chronic virus hepatitis and nonalcoholic fatty liver disease,the pathological hepatocytes polyploidization can be found in disease progression because of cell cycle checkpoint inhibition and oxidative stress.Distinguishing physiological and pathological hepatocyte polyploidization will be helpful for the understanding the relationship between chronic liver disease and tumorigenesis.

Objective:To construct a prediction model of inadvertent perioperative hypothermia in patients under general anesthesia , and to apply to clinic to verify its performance.Methods:The data of 19 068 surgical patients in a Grade Ⅲ Class A hospital in Zhejiang Province from January 2016 to September 2020 were included. The model was constructed by using artificial intelligence technology based on deep learning, and the prediction effect of the model was tested by using the area under the subject operating characteristic curve and decision curve. Totally 2 157 surgical patients were included from October 2020 to March 2021 to test the prediction accuracy of the model.Results:The incidence of hypothermia was 13.89% (2 649/19 068) in the modeling group and 14.18% (306/2 157) in the validation group. The area under the subject operating characteristic curve of the prediction model was 0.724 (95% CI: 0.707-0.741), the sensitivity was 0.516, the specificity was 0.823, the cut-off value was 0.175, and the accuracy of practical application was 79.54%. Conclusions:This model can stably predict the incidence of perioperative inadvertent hypothermia in patients under general anesthesia, and provide reference for clinical prevention of inadvertent perioperative hypothermia.

Objective To investigate the iodine nutritional status and thyroid function of women in early pregnancy after the implementation of a new standard of iodized salt in Chengde. Methods A total of 136 early pregnancy women who had lived in Chengde were randomly selected in this study from January 2018 to March 2020. A questionnaire survey was conducted. The iodized salt, urine and blood samples of the pregnant women were collected to analyze the salt iodine concentration, serum iodine, urinary iodine, serum thyroid stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4). Results In 2018 and 2019, the iodized salt coverage rates were 96.97% and 98.57%, the non-iodized salt rates were 3.03% and 1.43%, the iodized salt qualification rates were 95.45% and 97.14%, and the qualified iodized salt consumption rates were 93.94% and 92.86%, respectively. In addition, the median of iodized salt consumption was 22.20 mg/kg and 25.51 mg/kg, in 2018 and 2019, respectively. There was a statistically significant difference in the median urine iodine from 2018 to 2019 among women in early pregnancy (P<0.05). The urinary iodine frequency distribution and detection rate of thyroid diseases of women in early pregnancy had no significant difference in 2018 and 2019, and no significant difference was found in the detection rate of thyroid diseases of women in low-iodine group, appropriate iodine group and high-iodine group (P>0.05). Conclusion After the implementation of a new standard of iodized salt in Chengde, the iodine nutritional status of early pregnant women in 2019 was significantly improved, but there was still a small amount of insufficient iodine intake. The incidence of thyroid diseases in early pregnant women with abnormal iodine intake was higher than that in early pregnant women with appropriate iodine intake.

Objective To investigate the status quo of professional autonomy and job satisfaction of specialiized nurses in Operating Room, and analyze the correlation between them.Methods In August 2016, totally 130 nurses of Operating Room in Heilongjiang Province were selected as the research object. Nursing work behavior scale and job satisfaction scale were used to investigate.Results The total score of professional autonomy was (170.21±18.36), and the total score of job satisfaction was (3.35±0.58). There was a positive correlation between professional autonomy and job satisfaction (r=0.390,P<0.05).Conclusions The professional autonomy of the specialized nurse in the Operating Room is at the middle level, the job satisfaction of specialized nurse in Operating Room is at a moderately high level. The nursing administrators take advantage of multiple paths to improve the autonomy of specialized nurse in Operating Room, create a good working environment and improve their job satisfaction.

Objective To investigate the relationship between baseline serum uric acid and the severity of coronary artery disease ( CAD ) in the first-degree relatives or non-first-degree relatives of men with type 2 diabetes. Methods Three hundred and eighty-one men with negative coronary angiography for the first time were divided into diabetes and non-diabetes groups and followed-up for 5 years. The primary outcome was acute coronary syndrome suspected during subsequent 5 years, and the coronary angiography was conducted simultaneously. The severity of CAD was assessed by the coronary stenosis index ( CSI) and the number of coronary lesion vessels. Results In normal blood glucose group, serum uric acid was higher in the first-degree relatives of diabetics compared with non-first-degree relatives(P<0. 01), along with higher morbidity of CAD, CSI, and coronary lesion vessels (all P<0.01). Correlation analysis showed that CSI(r=0. 250, P=0. 041) and coronary lesion vessels(r=0. 252, P=0. 040) in non-diabetics group were associated with baseline levels of serum uric acid. Conclusion The elevation of serum uric acid was closely related to subsequent CAD, especially in first-degree relatives of male with type 2 diabetes, which could be used as an early indicator for CAD prediction.

Objective To investigate the relationship between head nurse's authentic leadership and degree of solidarity among nurses in operating room.Method A total of 120 nurses in the operation room of 3 general hospitals in Jiamusi City were enrolled in the study by way of the questionnaire on authentic leadership and the scale of solidarity.Results The mean score on the head nurse's authentic leadership (41.28 ± 8.48) was above the middle-high level.The mean score on the solidarity (68.67 ± 8.82) was in the middle-high level.There was a positive correlation between the head nurses' authentic leadership and the degree of solidarity among nurses in the operating room.Conclusion Hospital and nursing administrators should take active and effective measures to improve the leadership of head nurses so as to improve the degree of solidarity among nurses in the operating room as well as the quality of nursing.

Aim Todiscusstheapplicationoftissue spontaneous fluorescence in myocardial ischemia injury of rats based on specific fluorescence detection technol-ogy.Methods Thechangeofspontaneousfluores-cence was compared between the myocardial tissue of normal rats and those of rats with myocardial ischemia injury and an quantitative analysis was then made.Re-sult Theresultsshowedthatspontaneousfluorescence of myocardial tissue for myocardial ischemia injury changed significantly.Spontaneous fluorescence signal of injury considerably was enhanced.The fluorescence signal which was quantified by FX Pro had statistical significance compared with normal myocardial tissue,P<0.01orP<0.05.Conclusion Ourresearchshows that spontaneous fluorescence of myocardial tissue can be enhanced obviously after myocardial ischemia inju-ry.Our research provides a method for the research and evaluation of myocardial ischemia injury model in rats which can be used in positioning,qualitative and quan-titative comparative study and in pathological,physio-logical,pharmacological and mechanism study.