Objective:To analyze the clinical value of ultrasound monitoring of endometrial thickness in assessing pregnancy rate improvement after estrogen administration following a missed abortion.Methods:A retrospective study was conducted on 86 patients who underwent surgical abortion at Cixi Maternal and Child Health Hospital from January 2022 to June 2023. Based on the treatment received, the patients were divided into two groups: a control group and an observation group, with 43 patients in each group. The control group received only routine postoperative care without any medication, while the observation group received estrogen treatment after surgery. The clinical efficacy, endometrial thickness, intrauterine adhesion and re-pregnancy rate were compared between the two groups.Results:In the observation group, there was significant difference in endometrial thickness in terms of intergroup, group-by-time interaction, and time effect ( Fintergroup =129.49, Finteraction =14.25, Ftime =146.64, all P < 0.001). Intrauterine adhesions were less severe in the observation group compared with the control group ( χ2 = 4.34, P < 0.05). The clinical effective rate was significantly higher in the observation group than in the control group [88.37% (38/43) vs. 69.76% (30/43), Z = 2.35, P = 0.019]. Additionally, the rate of re-pregnancy was significantly higher in the observation group than in the control group [46.54% (20/43) vs. 13.95% (6/43), χ2 = 10.81, P < 0.05]. Conclusion:Patients who have retained abortion can benefit from ultrasound examination to assess endometrial thickness after estrogen administration. This approach significantly enhances endometrial thickness, promotes menstrual recovery, and reduces intrauterine adhesions. It also improves the rate of re-pregnancy and is highly valuable in clinical settings.

Objective To explore the influencing factors of pregnancy outcome after re-pregnancy in patients with unexplained recurrent spontaneous abortion based on ultrasound endometrial receptability parameters and lymphocyte immunophenotype.Methods A total of 166 re-pregnant patients with unexplained recurrent spon-taneous abortion admitted to Nantong Maternal and Child Health Hospital from April to August 2022 were included in the study.According to the pregnancy outcome,the patients were divided into the delivery group and the abortion group.The endometrial receptability parameters and peripheral blood T lymphocytes were detected to screen the influencing factors of abortion.Results Among 166 patients,102 cases(61.45%)had successful delivery and 64 cases(38.55%)had abortion again.The delivery group showed thicker endometrial thickness,larger endometrial volume,and higher VFI,but lower CD4+ and CD4+/CD8+ compared to the abortion group(P<0.05).CD4+ and CD4+/CD8+ were observed to be the risk factors for pregnancy failure(P<0.05),and endometrial thickness,endo-metrial volume,and vascularized flow index(VFI)were found to be the protective factors for pregnancy failure(P<0.05).Conclusion The pregnancy outcome of patients with unexplained recurrent spontaneous abortion is related to endometrial thickness,endometrial volume,VFI,CD4+,and CD4+/CD8+.

Objective To explore the risk factors of aspiration during hospitalization in patients with ischemic stroke (IS) and establish a predictive model. Methods Based on the case-control design, clinical materials of 316 IS patients treated in the Department of Neurology of Suzhou Ninth Hospital Affiliated to Soochow University from March 2022 to October 2023 were retrospectively collected. According to incidence of aspiration during hospitalization, the patients were divided into case group with 89 cases (aspiration occurred during hospitalization) and control group with 227 cases (no aspiration occurred during hospitalization). Univariate and multivariate Logistic regression analyses were performed in both groups to screen out the risk factors of aspiration during hospitalization in IS patients. R software was used to extract 70 % of the data from the two groups as the training set (establishing a Nomogram model), and the remaining 30 % data was used as test set. Value of predictive model was evaluated by area under the curve (AUC) of the receiver operating characteristic (ROC) curve, calibration curve, and decision curve. Results There were significant differences in the terms of age, the National Institutes of Health Stroke Scale (NIHSS) score, number of lesions, homocysteine (Hcy) level, spontaneous cough, and grading of Wada drinking water test between the case group and the control group (P < 0.05). Multivariate Logistic analysis showed that large age (OR=2.201, 95 %CI, 1.254 to 3.865), high NIHSS score (OR=4.816, 95 %CI, 1.652 to 14.041), multiple lesions (OR=2.649, 95 %CI, 1.249 to 5.613), high level of Hcy (OR=1.501, 95 %CI, 1.044 to 2.158), weakened or absent spontaneous cough (OR=3.384, 95 %CI, 1.639 to 6.987), and high grading of Wada drinking water test (OR=2.878, 95 %CI, 1.422 to 5.783) were the risk factors of aspiration during hospitalization in IS patients (P < 0.05). In the training set, the AUC of the Nomogram model for predicting aspiration during hospitalization in IS patients was 0.872 (95 %CI, 0.827 to 0.919), and was 0.859 (95 %CI, 0.807 to 0.904) in the test set. The calibration curve analysis showed that P value was 0.869 in the training set and 0.898 in the test set. The decision curve analysis for both the training set and test set showed that the Nomogram model was of good clinical applicability. Conclusion The risk of aspiration during hospitalization in IS patients is related to large age, high NIHSS score, multiple lesions, high level of Hcy, weakened or absent spontaneous cough, and high grading of Wada drinking water test. The Nomogram predictive model established on these factors can effectively evaluate the risk of aspiration during hospitalization in IS patients.

ObjectiveTo understand the use of antibiotics in inpatients and the incidence and trend of hospital infections， to explore the implementation effect of comprehensive management measures， and to provide reference for hospitals to use antibiotics reasonably. MethodsBased on the hospital infection monitoring and management system， a retrospective analysis and comparison were conducted on the use of antibiotics， submission of microbial test samples， and incidence of hospital infections among inpatients in a tertiary hospital from 2012 to 2021. ResultsFrom 2012 to 2021， the use of antibiotics showed a downward trend， from 50.82% in 2012 to 41.29% in 2021. At the same time， the use rate of restricted and special antibiotics had also decreased， and the use rate of restricted and special antibiotics in patients without hospital infection was significantly lower than that in patients with hospital infection， and the microbial testing rate was also on the rise. The annual incidence rate of hospital infection was 0.69%‒1.92%， and the annual case-time prevalence rate was 0.79%‒2.17%. The annual average rate of the above two in 10 years was 1.18% and 1.34%， respectively. The results of the exponential smoothing model also showed that the utilization rate of antibiotics was decreasing and the incidence of nosocomial infection was stable. ConclusionLarge general hospitals took comprehensive management measures to strengthen the management of rational use of antibiotics， which led to a decline in the use rate of antibacterial drugs for inpatients and an increase in the rate of microbial examination. At the same time， the overall incidence of hospital infection was relatively stable， suggesting that the comprehensive management measures of antibacterial drugs in hospitals had achieved certain results. The current measures need to be optimized in the future to continuously improve the management level of rational use of antibacterial drugs.

Aim To investigate the protective effect of remimazolam(Re)combined with thoracic sympathetic nerve block(TSNB)on myocardial ischemia/reperfusion(MI/R)rats.Methods Rats were randomly separated into control group,MI/R group,Re group,TSNB group,and Re+TSNB group,with 12 rats in each group.Except for the control group,the remaining rats were subjected to left anterior descending coronary artery(LAD)ligation to construct an MI/R model.In the Re group,20 mg/kg Re was intraperitoneally injected 30 min before ischemia.In TSNB group,0.2％ropivacaine 50 μL was injected into the thoracic epidural catheter 30 min before ischemia.In the Re+TSNB group,20 mg/kg Re was intraperitoneally injected and 0.2％ropivacaine 50 μL was injected into the thoracic epidural catheter 30 min before ischemia.The control group and MI/R group were injected with normal saline only.Rats in each group were evaluated for cardiac function and infarct size.HE staining and TUNEL staining were applied to observe pathological changes in myocardial tissue and myocardial cell apoptosis.Serum myocardial injury markers creatine kinase(CK)and aspartate transaminase(AST),cardiac troponin(cTnⅠ),myocardial inflammatory factors interleukin-8(IL-8),tumor nec-rosis factor-α(TNF-α),and oxidative stress factors malondialdehyde(MDA),superoxide dismutase(SOD)were detec-ted.Western blot was applied to detect the expression of IL-8,TNF-α,B lymphoblastoma-2-associated X protein(Bax),and B-lymphoblastoma-2(Bcl-2)in myocardial tissue.Results Compared with the control group,the myocardial cells of rats showed edema and myocardial fiber disorder in the MI/R group,the left ventricular developmental pressure(LVDP),maximal left ventricular pressure rising rate(+dp/dtmax),maximal left ventricular pressure decreasing rate(-dp/dtmax),SOD activity,and level of Bcl-2 were significantly reduced,the myocardial infarction area,cell apoptosis rate,levels of cTnⅠ,CK,AST,IL-8,TNF-α,MDA,and Bax were increased(P＜0.05).Compared with the MI/R group,the morphology of myocardial fibers and myocardial cells was significantly improved in the Re group,TSNB group and Re+TSNB group,the LVDP,±dp/dtmax,SOD activity,and level of Bcl-2 were significantly increased,the myocardial infarction area,cell apoptosis rate,levels of cTnI,CK,AST,IL-8,TNF-α,MDA,and Bax were significantly decreased(P＜0.05).Compared with the Re group and TSNB group,the LVDP,±dp/dtmax,SOD activity,and level of Bcl-2 were significantly increased in the Re+TSNB group,the myocardial infarction area,cell apoptosis rate,levels of cTnⅠ,CK,AST,IL-8,TNF-α,MDA,and Bax were significantly decreased(all P＜0.05).Conclusion The combination of Re and TSNB may protect against MI/R injury by reducing myocardial infarction and myocardial cell apoptosis,and inhibiting inflammatory response and oxidative stress.

Hemichorea associated with non-ketotic hyperglycemia(HC-NH)is a rare complication of diabetes mellitus. It is characterized by sudden and spontaneous non-repeating movements. Clinically, it presents as irregular dance-like movements in the distal parts of one limb, with unilateral involvement being more common and bilateral involvement being rare. Early diagnosis and treatment could improve the prognosis. We report a patient with hyperglycemia who developed bilateral involvement. It highlights the need to consider this condition in diabetic patients who present with secondary involuntary limb movements. Early treatment may lead to reversal of the symptoms.

Objective:Based on the principle of neuroplasticity, to explore the effect of square dancing on elderly patients with subjective cognitive decline (SCD).Methods:SCD patients in the main urban area of Nanjing were selected in this quasi experimental research from March to September 2022 and divided into experimental group and control group according to whether the subjects were willing to participate in square dance intervention, with 30 cases in each group. The experimental group received 6 months of square dancing intervention, and the control group received routine nursing. The differences of cognition, memory, language, executive ability, daily living ability and anxiety and depression were compared between the two groups.Results:Twenty-seven cases in the experimental group and 28 cases in the control group completed the intervention. After intervention, the scores of Montreal Cognitive Assessment Scale-15, the Geriatric Depression Scale, Hamilton Anxiety Scale and Trail Making Test B were 27.0(26.0, 28.0), 2.0(1.0, 4.0), (4.30 ± 2.04) points and (112.48 ± 25.42) seconds, respectively. Compared with the control group of 26.0 (24.0, 27.0), 4.0 (2.0, 5.8), (5.89 ± 1.45) points and (133.21 ± 32.39) seconds, the differences were statistically significant ( Z = -2.24, -2.72, t = - 2.05, -2.64, all P<0.05). Conclusions:Square dancing can improve the cognitive function of elderly patients with SCD, promote the improvement of memory, language, executive function and daily living ability, and effectively relieve anxiety and depression symptoms.

Objective To investigate the mediating effect of mindfulness on the relations between FCR and QOL.Methods A total of 240 lung cancer patients who were admitted to 3 hospitals in Shanxi Province,from January 2022 to January 2023,were enrolled in the study by convinient sampling.The fear of progression questionnaire-short form(FoP-Q-SF),mindfulness attention awareness scale(MAAS)in Chinese and the European Organisation for Research and Treatment for Cancer Quality of life questionnaire(EORTC QLQ)were employed in the cross-sectional survey.Multiple linear regression was used to analyse the association between FCR and QOL,and Bootstrap Model was adopted to analyse the mediating effect of mindfulness between FCR and QOL.Results A total of 240 questionnaires were distributed and 217 of them were retrieved,with an effective retrieval rate of 96.42%.FCR was found at a moderate level in all lung cancer patients,and it was negatively associated with the mindfulness and QOL(r=-0.348,P<0.01:r=-0.331,P<0.01).Bootstrap analysis revealed that the changes in mindfulness score acted as an intermediate variable between FCR and QOL,mediating 25.68%of the relationship.Conclusions FCR in lung cancer patients is negatively associated with QOL.This association may be explained by the reduction in mindfulness experienced by the patients.

Objective:To observe the clinical curative effects of Huo-long comprehensive moxibustion and Kegal exercise in the treatment of mild to moderate postpartum stress urinary incontinence (PSUI) .Methods:A total of 90 patients with postpartum stress urinary incontinence who were admitted to Outpatient Department of Obstetrics and Gynecology in Suzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2021 to December 2022 were selected as the research objects by the convenient sampling method. They were divided into the control group ( n=45) and the observation group ( n=45) by the random number table method. The control group received Kegal exercise, while the observation group was given Huo-long comprehensive moxibustion on the basis of the treatment of the control group. Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-SF) score, 24-hour urinary leakage frequency and Incontinence Quality of Life Questionnaire (I-QOL) score were compared between the two groups. Results:After 4 and 8 weeks of treatment, the ICIQ-SF score and 24-hour urine leakage frequency of PSUI patients of the two groups were lower than those before treatment, and those of the observation group were lower than the control group, and the differences were statistically significant ( P<0.05). The I-QOL score of PSUI patients of both groups were higher than those before treatment, and the observation group were higher than the control group, and the differences were statistically significant ( P<0.05). No adverse reactions occurred in both groups during treatment. Conclusions:The combination of Huo-long comprehensive moxibustion and Kegal exercise can effectively reduce the frequency of urinary leakage, alleviate adverse symptoms of urinary incontinence and improve quality of life, which has good safety in the treatment of mild to moderate postpartum stress urinary incontinence.

OBJECTIVE To study the effects of self-assembled nanoparticles from Shaoy ao gancao decoction （SGD-SAN）on the in vitro release and intestinal absorption of the main components of Glycyrrhiza uralensis . METHODS Gancao single decoction （GSD），Shaoyao single decoction （SSD），mixed suspension of Shaoyao and Gancao single decoction （MSSGD）and SGD （i.e. Shaoyao-Gancao decoction ）were prepared ，and SAN was characterized. HPLC method was adopted to determine the contents of 7 main components （liquiritin apioside ， liquiritin， isoliquiritin apioside ， isoliquiritin， liquiritigenin， glycyrrhizic acid ， isoliquiritigenin）in G. uralensis . The dialysis bag method was used to investigate the effects of the formation of SGD-SAN on in vitro release of 7 main components in G. uralensis with pH 1.2 HCl solution and pH 6.8 phosphate buffered solution （PBS）as release media. Single-pass intestinal perfusion study was performed to investigate the effects of the formation of SGD-SAN on the intestinal absorption of 7 main components from G. uralensis . RESULTS SAN with particle size of 200-300 nm and polydispersity index of 0.3-0.5 was found in GSD ，MSSGD and SGD. GSD-SAN and MSSGD-SAN were in rod shape while SGD-SAN was irregularly spherical under transmission electron microscope. The results of in vitro release study showed that the formation of SGD-SAN could significantly increase in vitro release of liquiritigenin ，isoliquiritigenin and glycyrrhizic acid ，and had no effect on other components of G. uralensis in pH 1.2 HCl solution. The formation of SGD-SAN also had no effect on the release of each component from G. uralensis in pH 6.8 PBS. The results of intestinal perfusion experiments showed that the formation of SGD-SAN could significantly promote the absorption of each component from G. uralensis in the ileum. CONCLUSIONS- The formation of SGD-SAN significantly improves the in vitro release of poorly soluble components from G. uralensis and promotes the intestinal absorption of main components from G. uralensis ，which is the physical structure basis for the compatibility and synergy of Paeonia lactiflora and G. uralensis .