Objective To compare the diagnostic value of transvaginal ultrasound(TVS)and thin-section oblique axial T2WI in deep infiltrating endometriosis(DIE)of uterosacral ligaments(USL).Methods Retrospective analysis was conducted on preoperative TVS and MRI images from 74 patients with USL-DIE.The diagnostic efficacy of TVS and thin-section oblique axial T2WI for USL-DIE was evaluated using receiver operating characteristic(ROC)curve based on pathological findings,and area under the curve(AUC),sensitivity,specificity,accuracy,positive predictive value(PPV)and negative predictive value(NPV)were further calculated.The McNemar two-tailed test was used to analyze the difference in diagnostic accuracy between the two methods for USL-DIE.Results The AUCs of TVS and thin-section oblique axial T2WI for diagnosing left and right USL-DIE were 0.721 vs 0.842 and 0.640 vs 0.901,respectively.Thin-section oblique axial T2WI demonstrated higher sensitivity,accuracy,PPV,and NPV compared to TVS in diagnosing USL-DIE.The diagnostic accuracy was found to be statistically different between the two methods(Pleft =0.026,χ2=4.966;Pright<0.001,χ2=16.531).Conclusion Thin-section oblique axial T2WI outperformed TVS in terms of diagnostic value for USL-DIE,providing valuable imaging support for accurate clinical diagnosis.

BACKGROUND:Mesenchymal stem cells are susceptible to senescence during in vitro expansion,which greatly hinders their application in vivo and in vitro.How to improve the replicative senescence of mesenchymal stem cells is an urgent problem to be solved in tissue engineering. OBJECTIVE:To determine whether vascular endothelial growth factor combined with basic fibroblast growth factor can improve the aging of bone marrow mesenchymal stem cells caused by replicative passage. METHODS:Rat bone marrow mesenchymal stem cells were extracted by whole bone marrow adhesion method.Passage 2 cells were selected as normal control group.Passage 7 and later algebraic cells were selected as aging model group.Vascular endothelial growth factor(50 μg/L),basic fibroblast growth factor(10 μg/L),and their combination were administered.Cell proliferation was detected by CCK-8 assay.Cell senescence was observed by β-galactosidase activity staining.Cytoskeleton size and colony formation ability were observed by phalloidine staining and Giemsa staining,respectively,and the levels of senescence-related genes P16,P21,and P53 were detected by qRT-PCR.Gene expression levels of P16,P21,and P53 were tested by qRT-PCR. RESULTS AND CONCLUSION:(1)Vascular endothelial growth factor combined with basic fibroblast growth factor could promote the proliferation of aged bone marrow mesenchymal stem cells,which began to enter the plateau stage on day 9,and the absorbance value of the combined intervention group was significantly higher than that of the model group on day 9(P<0.05).(2)The phenotypic markers of the cells in the combined intervention group did not change,and the cell morphology changed from broad to slender.(3)Compared with the model group,the positive rate of β-galactosidase was significantly decreased(P<0.01);the number of nuclei increased(P<0.001);the total area of cytoskeleton increased(P<0.01);colony formation ability was enhanced(P<0.05);expression level of P16 was decreased(P<0.01)in the combined intervention group.These results indicate that vascular endothelial growth factor combined with basic fibroblast growth factor can improve the senescence of bone marrow mesenchymal stem cells caused by replicative passage without changing the cell phenotype.

Objective:To evaluate the value of 18F-FDG PET metabolic parameters in predicting histopathological grade of soft tissue sarcoma (STS). Methods:From December 2012 to December 2021, 51 patients (26 males, 25 females, age range: 32-84 years) who underwent 18F-FDG PET/CT imaging before treatment and confirmed STS pathologically in the First Affiliated Hospital of Dalian Medical University were retrospectively collected. 18F-FDG PET metabolic parameters SUV max, metabolic tumor volume (MTV), total lesion glycolysis (TLG) and intertumoral FDG uptake heterogeneity (IFH) were measured. Kruskal-Wallis rank sum test was used to analyze the differences in metabolic parameters among different groups and Spearman rank correlation analysis was used to analyze the correlation of each metabolic parameter and histological grade. Logistic regression was used to screen and construct the prediction model for high-grade STS. ROC curve was plotted and Delong test was used to analyze the differences among AUCs. Results:The metabolic parameters SUV max, MTV, TLG and IFH were significantly different among French Federation of Cancer Centers Sarcoma Group (FNCLCC)Ⅰ( n=8), Ⅱ( n=10) and Ⅲ ( n=33) grade groups ( H values: 16.24, 10.52, 19.29 and 16.99, all P<0.05), and each metabolic parameter was positively correlated with histological grade ( rs values: 0.58, 0.45, 0.52, and 0.62, all P<0.05). Multivariate logistic regression analysis showed that SUV max(odds ratio ( OR)=1.27, 95% CI: 1.06-1.51, P=0.009) and IFH ( OR=6.83, 95% CI: 1.44-32.27, P=0.015) were independent risk indicators for high-grade STS. The prediction model constructed by combining SUV max and IFH had better diagnostic efficacy for differentiating high-grade STS with the AUC of 0.93, and the sensitivity of 93.9%(31/33) and the specificity of 16/18, respectively. The AUC of prediction model was significant different from SUV max, MTV, TLG and IFH (AUCs: 0.81, 0.78, 0.86 and 0.85; z values: 2.69, 2.53, 1.94 and 1.97, all P<0.05). Conclusions:The metabolic parameters SUV max, MTV, TLG and IFH are valuable predictors for histological grade of STS. The combination of SUV max and IFH may be a more meaningful method than using each of the above metabolic parameters alone.

Acute leukemia（AL）is a common hematological malignancy in children and adolescents. Chemotherapy is currently the primary treatment for AL.Alternative therapies，such as hematopoietic stem cell transplantation（HSCT），targeted therapy，and immunotherapy also offer greater hope for the survival of refractory/relapsed patients. Chemotherapeutic drugs，radiotherapy，targeted drugs and immunotherapeutic drugs are well-applied clinically，meanwhile posing threats to non-target systems. The adverse effects on the reproductive system may lead to the dilemma of infertility，thus reducing the long-term quality of life. As the survival rate of AL patients keeps increasing continuously，the influence of different treatments on the gonad function needs to be clarified. With the help of targeted fertility prevention，the patient′s quality of life can be enhanced in parallel with life span. This article aims to review the impact of AL treatment on ovarian function in female children and adolescents and provide ideas for the long-term fertility protection of leukemia patients.

Objective To investigate the relationship between vitamin K2,insulin-like growth factor bind-ing protein 3(IGFBP-3),Omentin-1 and the therapeutic effect on children with idiopathic short stature(ISS),and to build a prediction model.Methods A total of 242 ISS children in Jinan Second Maternal and Child Health Hospital from 2019 to 2021 were selected.All of them received recombinant human growth hormone(rhGH)treatment and were divided into effective group and ineffective group according to the therapeutic effect after 12 months of treatment.The general data,vitamin K2,IGFBP-3 and Omentin-1 in the two groups were analyzed.The influencing factors of ISS children's therapeutic effect were analyzed by Logistic regression model and decision tree model.The predictive performance of two models was analyzed by using receiver oper-ating characteristic(ROC)curve.Results There were statistically significant differences in 25-hydroxy vita-min D[25(OH)D],parathyroid hormone(PTH),thyroid stimulating hormone(TSH),vitamin K2,IGFBP-3,Omentin-1,rhGH dosage and weekly outdoor exercise time between the two groups(P＜0.05).Logistic re-gression showed that PTH(OR=7.011,95％CI:2.456-20.014),vitamin K2(OR=0.605,95％CI:.0.465-0.788),IGFBP-3(OR=0.458,95％CI:0.321-0.654),Omentin-1(OR=0.514,95％CI:0.389-0.679)and rhGH dose(OR=0.563,95％CI:0.445-0.712)]were the influential factors for treatment ineffectiveness in ISS children(P＜0.05).The decision tree model showed that vitamin K2,IGFBP-3 and Omentin-1 were the factors influencing the therapeutic effect of ISS,and IGFBP-3 had the most significant impact.ROC curve re-sults showed that the area under the curve of decision tree model and Logistic regression model were 0.922 and 0.908,respectively,with good classification effect.Conclusion The therapeutic effect of ISS children is in-fluenced by factors such as vitamin K2,IGFBP-3,Omentin-1,and so on,and IGFBP-3 has the most significant impact.Logistic regression model and decision tree model could complement each other so as to provide refer-ence for improving the therapeutic effect of ISS children from different aspects.

Objective The risk evaluation indicators for the occurrence of diaphragm dysfunction in ICU patients was constructed to provide a reference for the establishment of the disease risk evaluation tools for diaphragm dysfunction.Methods The literature related to diaphragm dysfunction from CNKI,Wanfang Data,PubMed,Embase and Web of Science from the establishment of databases to November 11 th,2022 was systematically searched.After the first draft was determined through the literature review method,the first draft of the indicators was revised by brainstorming,with the opinions of 10 medical and nursing experts from May to June 2023.From June to July 2023,the content and weight of risk evaluation indicators of diaphragmatic dysfunction in ICU patients were determined through expert letter inquiry and hierarchical analysis.Results 35 experts completed the first round of letter inquiry,and 34 experts completed the second round of letter inquiry.The recovery rates of the valid questionnaires in the 2 rounds of expert correspondence were 92.1％and 97.1％,respectively,and the expert authority coefficients were 0.884 and 0.904,respectively,and the Kendall harmony coefficients of all indicators were 0.356～0.570 and 0.369～0.604,respectively(all P＜0.001).The final constructed risk evaluation indicators of diaphragm dysfunction in ICU patients includes 7 first-level indicators,34 secondary indicators and 34 tertiary indicators.Conclusion The risk evaluation index of diaphragm dysfunction in ICU patients constructed in this study is comprehensive,specific,scientific and applicable,which can guide medical staff to conduct early risk evaluation of diaphragm function in ICU patients,and provide references for the establishment of disease risk assessment tools for diaphragm function.

Objective To compare anesthetic effects between erector spinae plane block(ESPB)and intercostal nerve block(ICNB)in thoracoscopic lung wedge resection guided by surgical pleth index(SPI).Methods A total of 46 patients who underwent thoracoscopic lung wedge resection in Wenzhou People's Hospital from July 2020 to June 2022 were selected and divided into ICNB group and ESPB group according to random number table method,with 23 cases in each group.Remifentanil infusion rate,propofol dosage and intraoperative vital signs were compared between two groups.Results The intraoperative remifentanil infusion rate in ESPB group was significantly lower than that in ICNB group(P<0.05).There was no significant difference in intraoperative propofol dosage between two groups(P>0.05).The SPI,bispectral index and mean arterial pressure in ESPB group during lung wedge resection were significantly lower than those in ICNB group(P<0.05).There was no significant difference in heart rate between two groups(P>0.05).Conclusion Under the guidance of SPI,patients undergoing thoracoscopic lung wedge resection with preoperative ESPB had low opioid consumption and stable vital signs.

【Objective】 To explore the effectiveness of intraovarian injection of platelet-rich plasma(PRP) in the treatment of patients with diminished ovarian reserve(DOR), aiming to provide new diagnostic and therapeutic ideas for the treatment. 【Methods】 A total of 22 patients with DOR who underwent autologous PRP ovarian injection at the Reproductive Medical and Genetic Center of Qinzhou Maternal and Child Health Hospital from January 2021 to December 2023 were collected. Among them, 12 patients underwent assisted reproductive technology for pregnancy. The patient′s anti-Müllerian hormone (AMH), antral follicle count (AFC), basal follicle-stimulating hormone (FSH), basal luteinizing hormone (LH) and basal estradiol (E2) levels were observed. 【Results】 The levels of AMH, AFC, basal FSH, basal LH and basal E2 in 22 patients improved after treatment compared with those before treatment. Of the 12 patients who received assisted reproduction, 2 had IVF cycle canceled due to poor ovarian reaction. Ten patients obtained embryos, of which 5 obtained high-quality embryos. 【Conclusion】 Intraovarian injection of autologous PRP can effectively improve ovarian reserve function in patients with DOR.

Objective: To analyze the relationship between Toll like receptor ( TLR ) 9 and TLR 7 gene polymorphisms among children with hand-foot-mouth disease in a medical institution of Jinan City from 2020 to 2023, so as to provide reference for prevention of hand-foot-mouth disease. Methods: Data of 284 preschool children aged 3-6 with hand-foot-mouth disease, including the season pattern, clinical manifestations, pathogen distribution, were collected in department of pediatric infectious diseases of the Second Children & Women s Healthcare of Jinan from 2020 to 2023. The distribution conditions of TLR 9 and TLR 7 genotypes of enterovirus 71 (EV71) subtype and coxsackievirus A16 (CA16) subtype were compared by Chi square test. Hardy Weinberg equilibrium test was used to characteristic sample population distribution, and Logistic regression analysis in the additive genetic model was adopted to evaluate the relationship between TLR 9 and TLR 7 gene polymorphisms with hand-foot-mouth disease subtype. Results: The time to admission after symptom onset with hand-foot-mouth disease among 284 children was mostly >2-4 d ( 45.42% ), followed by ≤2 d ( 44.72% ). The season pattern was mostly in summer (58.10%). The severity was mostly mild ( 69.72% ), and the main clinical manifestations were skin rash (100.00%) and fever (65.49%). The majority pathogen was EV71 (60.56%). Hardy Weinberg equilibrium test showed good population representation ( P >0.05). Logistic regression analysis was applied to analyze the relationship between TLR9 rs 187084 locus and hand-foot-mouth disease subtypes under the additive genetic model after adjusting for age and gender of the study population, and it was found that compared with those without C allele, each additional C allele increased the risk of CA16 subtype hand-foot-mouth disease by 109% ( OR=2.09, 95%CI =1.13-3.27). Analysis of relationship between TLR 7 rs 3853839 locus and hand-foot-mouth disease subtype showed that compared with those without C allele, the risk of EV71 subtype hand-foot-mouth disease increased by 57% for each additional C allele ( OR=1.57, 95%CI = 1.10 -2.11) ( P <0.05). Conclusions From 2020 to 2023, children with hand-foot-mouth disease in a medical institution of Jinan City is mostly mild and caused by EV71 infection. The polymorphism of rs 3853839 locus of TLR 7 may be related to EV71 infection in children with hand-foot-mouth disease, and the polymorphism of rs 187084 locus of TLR 9 may be related to CA16 infection.

This paper interprets the background, content overview and characteristics, clinical practice significance and disciplinary development of Nursing Standards for Clinical Operation Techniques in Critical Care Ultrasound (hereinafter referred to as the Standards) and puts forward reflections on the clinical application of the Standards, aiming to improve the critical care ultrasound techniques of clinical nursing staff, solve nursing challenges and make clinical nursing ultrasound techniques more scientific, standardized and homogenized.