OBJECTIVE To evaluate the safety of fondaparinux in pregnancy and provide reference for its rational clinical application. METHODS A search was conducted in databases including CNKI， Wanfang， PubMed， Embase， and Elsevier （the search time was from the construction of the database to December 17， 2024） to collect case report literature on fondaparinux use during pregnancy. Patient demographic information， fondaparinux use during pregnancy， concomitant medications， clinical manifestations， and treatment details were extracted for descriptive statistical analysis. RESULTS A total of 17 case reports regarding the use of fondaparinux during pregnancy were collected， involving 42 patients from 11 countries and 47 pregnancy records. Among these， 20 cases involved the use of fondaparinux for the prevention of pregnancy-related venous thromboembolism （VTE）， while 27 cases were fondaparinux treatment due to related conditions. A total of 29 occurrences of the patients were treated with fondaparinux due to a （family） history of VTE. Nine occurrences of complicated pregnancies were reported， and 35 patients had records of comorbidities or relevant medical histories. The adverse events that occurred during pregnancy with the use of fondaparinux include postpartum hemorrhage （7 cases） and excessive anticoagulation caused by inappropriate dosage （1 case）. Among the 7 cases of postpartum hemorrhage， 3 cases had a blood loss of no less than 1 000 mL （including 2 cases with uterine atony）， 3 cases had a drug discontinuation time of ≤12 h. CONCLUSIONS Based on the existing literature， the safety of fondaparinux during pregnancy is generally manageable， with the main adverse event being postpartum hemorrhage. The dosage， interval between discontinuation，comorbidities/medical history， and concomitant medications of fondaparinux may be the main causes of its adverse events.

In January 2023,the American Heart Association(AHA)released A Scientific Statement:Cancer Therapy Related Hypertension,provided an overview of the mechanisms and clinical management of anticancer therapy related hypertension.Contemporary anticancer drugs are mostly at the expense of cardiovascular toxicities,one of the most common side effects is hypertension,especially vascular endothelial growth factor inhibitors,as well as tyrosine kinase inhibitors and proteasome inhibitors.Cancer therapy related hypertension is often dose limiting,and is usually reversible after interruption or discontinuation of treatment.The exact molecular mechanisms underlying hypertension are unclear,recent discoveries indicate an important role for decreased nitric oxide,increased endothelin-1,endothelial dysfunction,increased sympathetic outflow,and microvascular rarefaction.Based on the International Cardio Oncology Society(IC-OS),this article provides an interpretation of the diagnosis and management of hypertension related to cancer treatment.Insufficient evidence exists supporting an antihypertensive medication strategy specific to patients with anticancer therapy induced hypertension,therefore,antihypertensive management should follow current guidelines for the general population..Multidisciplinary cooperation is needed to optimize management to ensure the optimal therapeutic effect from cancer treatment while minimizing competing cardiovascular toxicities.

Patients with gastric cancer are at high risk for venous thromboembolism(VTE)and bleeding,and patients who develop VTE are often associated with poor outcomes,making it clinically challenging to identify and manage the risk of thrombosis in patients with gastric cancer.Risk factors for VTE in gastric cancer patients include age,obesity,surgery,chemotherapy,etc.It is essential to identify high-risk patients and adopt aggressive prevention strategies.The main strategy to prevent and treat VTE is the use of anticoagulant drugs.This article discusses guidelines and recent studies for the prevention and treatment of VTE in patients with gastric cancer to help clinicians make individualized decisions for their patients and maximize clinical outcomes for their patients.

Patients with primary membranous nephropathy(PMN)tend to develop thrombosis,especially in the early phase of the disease.The pathogenesis of thrombosis is multifactorial,with hypoalbuminemia being widely regarded as an inde-pendent risk factor.Other factors include proteinuria,M-type phospholipase A2 receptor antibody,and D-dimer.Although prophy-lactic anticoagulation therapy is frequently used in clinical practice to prevent thrombosis in PMN patients,there are still many un-resolved issues regarding the optimal prevention of thrombosis in this condition.The timing of prophylactic anticoagulation,the threshold of serum albumin level,and the choice of treatment regimen are still lacking consensus.This article reviewed the relevant literature on these topics,aiming to establish a standard for thrombosis prevention and treatment for this population in the future and provide guidance for clinical practice.

In order to strengthen the supervision of the use of drugs in hospitals，the Sichuan Academy of Medical Sciences· Sichuan Provincial People’s Hospital took the lead in compiling the Principles for the Rational Use of National Key Monitoring Drugs （the Second Batch） with a number of experts from multiple medical units in accordance with the Second Batch of National Key Monitoring Rational Drug Use List （hereinafter referred to as “the List”） issued by the National Health Commission. According to the method of the WHO Guidelines Development Manual， the writing team used the Delphi method to unify expert opinions by reading and summarizing the domestic and foreign literature evidence of related drugs， and applied the evaluation， formulation and evaluation method of recommendation grading （GRADE） to evaluate the quality of evidence formed， focusing on more than 30 drugs in the List about the evaluation of off-label indications of drugs， key points of rational drug use and key points of pharmaceutical monitoring. It aims to promote the scientific standardization and effective management of clinical medication， further improve the quality of medical services， reduce the risk of adverse drug reactions and drug abuse， promote rational drug use， and improve public health.

Objective:To investigate the effect of the problem-based learning (PBL)-case-based learning (CBL) integrated teaching model in the training of clinical professional postgraduates on rotation in endocrinology.Methods:A total of 80 clinical professional postgraduates on rotation in endocrinology were randomly divided into experimental group (using PBL-CBL integrated teaching) and control group (using traditional teaching), with 40 students in each group, and the rotation period was 3 months. Professional examination scores were recorded for the two groups at the time of enrollment and graduation, and a questionnaire survey was performed to investigate their self-confidence, learning initiative, and interpersonal skills. SPSS 20.0 was used to perform the t-test and the chi-square test. Results:The two groups had similar conditions at baseline. After three months of rotation, the experimental group showed significant improvements in department examination scores, self-confidence, learning initiative, and interpersonal skills ( P<0.001). Conclusion:The PBL-CBL integrated teaching model has a better effect than traditional teaching and can help to improve the learning ability and performance of clinical professional postgraduates on rotation in endocrinology, and therefore, it holds promise for further application.

Objective:To observe the effect of virtual reality (VR) balance training on the balance and ability in the activities of daily living (ADL) of children with cerebral palsy.Methods:Forty children with spastic cerebral palsy were divided at random into an intervention group (21 cases) and a control group (19 cases). All received 30 minutes of daily routine rehabilitation training, including therapeutic exercise, occupational therapy and home rehabilitation training. Everyone also received 20 minutes of balance training 5 days a week for 3 months. That included sitting and standing balance training and training in transferring the center of gravity. Beyond that the intervention group additionally trained on the Biomaster virtual reality training system doing image matching, playing football and skiing. Before the experiment and after 1 and 3 months, both groups′ balance trajectory length, peripheral area, and the unit area the trajectory length were documented and also using the Berg balance scale (BBS). ADL ability was quantified using the modified Barthel index (MBI).Results:①After the 3 months of training there was a significant improvement in the average trajectory length, peripheral area and unit area trajectory length of both groups sitting and standing. The average values of the intervention group were, however, significantly superior to the control group′s averages. ②After the 3 months there were also significant improvements in the groups′ average BBS and MBI scores, again with significantly greater improvement in the intervention group.Conclusion:Virtual reality balance training can significantly improve the balance function and ADL ability of children with cerebral palsy.

Implantable bone-conduction devices are characterized by the fact that the vibration is transmitted through bone conduction. The technology and surgical techniques in the application of implantable bone-conduction devices have developed considerably in recent years, experiencing a transformation from percutaneous to transcutaneous implantation. This article reviewed current developments in the types, surgical indications, and complications, as well as compared between the various bone-conduction devices to provid references for clinical application.

Objective To investigate the speech recognition in noise in patients with unilateral conductive or mixed hearing impaired using Sophonotron Alpha 2 softband.Methods A total of 12 patients (12 ears) with unilateral conductive or mixed hearing loss participated in the survey and fitted with Sophonotron Alpha 2.The aided hearing threshold test and speech recognition test in noise were evaluated in both unaided and aided conditions.Results The average aided hearing threshold using Sophonotron Alpha 2 softband was 35.0±10.8 dB HL,showing significant improvement compared to that of unaided(P＜0.05).The average signal-to noise ratio loss was 5.9± 6.1 dB using Sophonotron Alpha 2 softband in noise,showing a more significant benefit than that of the unaided (13.6±10.9 dB).Conclusion The Sophonotron Alpha 2 softband can significantly improve speech recognition in noise for the patients with unilateral conductive or mixed hearing loss.

Multi-source satellite remote sensing technology can be used to monitor the distribution and growth status of aquatic plant species on a large scale.In this paper,C,aoyou Lake was selected as the research area.Aquatic medicine material Euryaleferox Salisb was used as the research object.The spectral characteristics of plants in Euryaleferox Salisb growing area were analyzed by ASD portable spectrometer and the remote sensing image of Pléiades and GF-1.The spectral range of species was obtained.And the decision tree algorithm model was constructed,which were used to extract the information of Euryale ferox Salisb from remote sensing images.Through verification,the results showed that the accuracy of comprehensive classification was 83％.It was concluded that multi-source satellite remote sensing image and GIS spatial analysis technology can accurately reflect the area and distribution of aquatic medicine material Euryale ferox Salisb.