Objective:To explore the current status and influencing factors of fertility intention to have a third child among childbearing age women in Heilongjiang Province under three-child policy.Methods:From January to April 2023, convenience sampling was used to select 10 600 women of childbearing age from ten districts and counties in five cities in Heilongjiang Province (Jiamusi, Qiqihar, Harbin, Heihe, Suihua) as research subjects. The Fertility Intention to Have a Third Child Questionnaire among Childbearing Age Women in Heilongjiang Province was used to investigate women of childbearing age. Multi-class Logistic regression was used to explore the influencing factors of fertility intention of childbearing age women to have a third child.Results:A total of 10 600 questionnaires were distributed, and 9 554 valid questionnaires were collected, with a valid response rate of 90.13% (9 554/10 600). Among 9 554 women of childbearing age, 2 248 had the intention to have a third child, 5 036 had no intention, and 2 270 were uncertain. Multi-class Logistic regression analysis showed that age, education level, per capita monthly income of the family, occupation, fertility status, pregnancy complications, economic pressure to have a third child, parents' attitudes towards having a third child, and satisfaction with childcare services were the influencing factors of the fertility intention of childbearing age women in Heilongjiang Province to have a third child ( P<0.05) . Conclusions:Under the three-child policy, women of childbearing age in Heilongjiang Province have a low intention to have a third child. Relevant departments should formulate policies based on the influencing factors.

Objective:To explore the effects of the Otago Exercise Program (OEP) in aged patients diagnosed with sarcopenia.Methods:Totally 80 sarcopenic patients admitted to the Department of Geriatric Diseases at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine between January 2022 and January 2023 were selected by convenience sampling. Using a random number table, patients were allocated into control and intervention groups, each containing 40 individuals. The control group underwent routine follow-ups, while the intervention group received a 12-week OEP in addition to the regular follow-up. Measures were taken before and after the intervention for muscle strength (grip strength, 5-times sit-to-stand test time) , muscle mass (skeletal muscle mass index) , physical function (6 m walking speed, Short Physical Performance Battery, SPBB) , and quality of life (Sarcopenia Quality of Life, SarQoL) .Results:Post-intervention, the 5-times sit-to-stand test time was lower in the intervention group compared to the control group ( P<0.05) . Moreover, the 6 m walking speed, SPBB scores, and SarQoL scores were higher in the intervention group ( P<0.05) . However, no significant statistical differences were found between the two groups regarding grip strength and skeletal muscle mass index ( P>0.05) . Conclusions:The OEP can enhance lower limb muscle strength, improve physical function, and elevate the quality of life in aged sarcopenic patients. This provides medical professionals with a reference for designing exercise plans for these individuals.

Immune therapy has become the fourth approach after surgery, chemotherapy, and radiotherapy in cancer treatment. Many immune checkpoints were identified in the last decade since ipilimumab, which is the first immune checkpoint inhibitor to cytotoxic T-lymphocyte associated protein 4, had been approved by the US Food and Drug Administration (FDA) for the treatment of unresectable or metastatic melanoma in 2011. The use of several antibody drugs that target PD1/PD-L1 for various cancer treatments has been approved by the FDA. However, fewer people are benefitting from immune checkpoint inhibitor treatment in solid cancers. Approximately 80% of patients do not respond appropriately because of primary or acquired therapeutic resistance. Along with the characterization of more immune checkpoints, the combinatory treatment of multiimmune checkpoint inhibitors becomes a new option when monotherapy could not receive a good response. In this work, the author focuses on the combination therapy of multiple immune checkpoints (does not include targeted therapy of oncogenes or chemotherapy), introduces the current progression of multiple immune checkpoints and their related inhibitors, and discusses the advantages of combination therapy, as well as the risk of immune-related adverse events.
Combined Modality Therapy ; Humans ; Immune Checkpoint Inhibitors ; Immunotherapy ; Melanoma/drug therapy* ; Tumor Escape

The exacerbation of progressive multiple sclerosis (MS) is closely associated with obstruction of the differentiation of oligodendrocyte progenitor cells (OPCs). To discover novel therapeutic compounds for enhancing remyelination by endogenous OPCs, we screened for myelin basic protein expression using cultured rat OPCs and a library of small-molecule compounds. One of the most effective drugs was pinocembrin, which remarkably promoted OPC differentiation and maturation without affecting cell proliferation and survival. Based on these in vitro effects, we further assessed the therapeutic effects of pinocembrin in animal models of demyelinating diseases. We demonstrated that pinocembrin significantly ameliorated the progression of experimental autoimmune encephalomyelitis (EAE) and enhanced the repair of demyelination in lysolectin-induced lesions. Further studies indicated that pinocembrin increased the phosphorylation level of mammalian target of rapamycin (mTOR). Taken together, our results demonstrated that pinocembrin promotes OPC differentiation and remyelination through the phosphorylated mTOR pathway, and suggest a novel therapeutic prospect for this natural flavonoid product in treating demyelinating diseases.
Animals ; Cell Differentiation ; Flavanones ; Mice ; Mice, Inbred C57BL ; Myelin Sheath/metabolism* ; Oligodendroglia/metabolism* ; Rats ; Remyelination ; Signal Transduction ; TOR Serine-Threonine Kinases/metabolism*

The exacerbation of progressive multiple sclerosis (MS) is closely associated with obstruction of the differentiation of oligodendrocyte progenitor cells (OPCs). To discover novel therapeutic compounds for enhancing remyelination by endogenous OPCs, we screened for myelin basic protein expression using cultured rat OPCs and a library of small-molecule compounds. One of the most effective drugs was pinocembrin, which remarkably promoted OPC differentiation and maturation without affecting cell proliferation and survival. Based on these in vitro effects, we further assessed the therapeutic effects of pinocembrin in animal models of demyelinating diseases. We demonstrated that pinocembrin significantly ameliorated the progression of experimental autoimmune encephalomyelitis (EAE) and enhanced the repair of demyelination in lysolectin-induced lesions. Further studies indicated that pinocembrin increased the phosphorylation level of mammalian target of rapamycin (mTOR). Taken together, our results demonstrated that pinocembrin promotes OPC differentiation and remyelination through the phosphorylated mTOR pathway, and suggest a novel therapeutic prospect for this natural flavonoid product in treating demyelinating diseases.

Objective: The purpose of our study was to investigate the predictive abilities of clinical and computed tomography (CT)features for outcome prediction in patients with coronavirus disease (COVID-19). Materials and Methods: The clinical and CT data of 238 patients with laboratory-confirmed COVID-19 in our two hospitalswere retrospectively analyzed. One hundred sixty-six patients (103 males; age 43.8 ± 12.3 years) were allocated in thetraining cohort and 72 patients (38 males; age 45.1 ± 15.8 years) from another independent hospital were assigned in thevalidation cohort. The primary composite endpoint was admission to an intensive care unit, use of mechanical ventilation, ordeath. Univariate and multivariate Cox proportional hazard analyses were performed to identify independent predictors. Anomogram was constructed based on the combination of clinical and CT features, and its prognostic performance wasexternally tested in the validation group. The predictive value of the combined model was compared with models built on theclinical and radiological attributes alone. Results: Overall, 35 infected patients (21.1%) in the training cohort and 10 patients (13.9%) in the validation cohortexperienced adverse outcomes. Underlying comorbidity (hazard ratio [HR], 3.35; 95% confidence interval [CI], 1.67–6.71;p < 0.001), lymphocyte count (HR, 0.12; 95% CI, 0.04–0.38; p < 0.001) and crazy-paving sign (HR, 2.15; 95% CI, 1.03–4.48;p = 0.042) were the independent factors. The nomogram displayed a concordance index (C-index) of 0.82 (95% CI, 0.76–0.88),and its prognostic value was confirmed in the validation cohort with a C-index of 0.89 (95% CI, 0.82–0.96). The combinedmodel provided the best performance over the clinical or radiological model (p < 0.050). Conclusion Underlying comorbidity, lymphocyte count and crazy-paving sign were independent predictors of adverseoutcomes. The prognostic nomogram based on the combination of clinical and CT features could be a useful tool for predictingadverse outcomes of patients with COVID-19.

The rapid development of computer technologies brings us great changes in daily life and work. Artificial intelligence is a branch of computer science, which is to allow computers to exercise activities that are normally confined to intelligent life. The broad sense of artificial intelligence includes machine learning and robots. This article mainly focuses on machine learning and related medical fields, and deep learning is an artificial neural network in machine learning. Convolutional neural network (CNN) is a type of deep neural network, that is developed on the basis of deep neural network, further imitating the structure of the visual cortex of the brain and the principle of visual activity. The current machine learning method used in medical big data analysis is mainly CNN. In the next few years, it is the developing trend that artificial intelligence as a conventional tool will enter the relevant departments of medical image interpretation. In addition, this article also shares the progress of the integration of artificial intelligence and biomedicine combined with actual cases, and mainly introduces the current status of CNN application research in pathological diagnosis, imaging diagnosis and endoscopic diagnosis for gastrointestinal diseases.

Immune checkpoint inhibitors are a promising strategy in the treatment of cancer, especially advanced types. However, not all patients are responsive to immune checkpoint inhibitors. The response rate depends on the immune microenvironment, tumor mutational burden (TMB), expression level of immune checkpoint proteins, and molecular subtypes of cancers. Along with the Cancer Genome Project, various open access databases, including The Cancer Genome Atlas and Gene Expression Omnibus, provide large volumes of data, which allow researchers to explore responsive or resistant biomarkers of immune checkpoint inhibitors. In this review, we introduced some methodologies on database selection, biomarker screening, current progress of immune checkpoint blockade in solid tumor treatment, possible mechanisms of drug resistance, strategies of overcoming resistance, and indications for immune checkpoint inhibitor therapy.
Biomarkers, Tumor ; blood ; immunology ; Data Mining ; Drug Resistance, Neoplasm ; Humans ; Immunotherapy ; Mutation ; Neoplasms ; genetics ; therapy ; Tumor Microenvironment

Objective To establish the community sustainable nutrition management path of patients with gestational diabetes mellitus (GDM) and explore the effect in the tertiary prevention of GDM.Methods The number of pregnant women who delivered in the Jiangdong district of Ningbo city during January 2013 to December 2016 was 1 028.512 patients with GDM who delivered were enrolled in control group and 516 patients in study group.Prevalence rate of GDM,blood glucose,glycosylated hemoglobin (HbAlc),weight gain during pregnancy,pregnancy outcomes,satisfaction rate of blood glucose control were compared between two groups.Data was analyzed by SPSS 13.0 statistical software.Results Prevalence rate of GDM in study group was 7.69％,lower than control groupl 1.1％.Fasting blood glucose (FPG),1 hour blood glucose (1 h PG),macrosomia,low birth weight in study group were better than control group.Fetal distress,Intrauterine infection,Hydramnios,Amniotic fluid embolism,Placental abruption,pregnancy weight gain were similar in two groups.Conclusions The sustainable nutrition management path of the community has good effect in the tertiary prevention of gestational diabetes mellitus.

On May 23, 2017, the US Food and Drug Administration (FDA) approved a treatment for cancer patients with positive microsatellite instability-high (MSI-H) markers or mismatch repair deficient (dMMR) markers. This approach is the first approved tumor treatment using a common biomarker rather than specified tumor locations in the body. FDA previously approved Keytruda for treatment of several types of malignancies, such as metastatic melanoma, metastatic non-small-cell lung cancer, recurrent or metastatic head and neck cancer, refractory Hodgkin lymphoma, and urothelial carcinoma, all of which carry positive programmed death-1/programmed death-ligand 1 biomarkers. Therefore, indications of Keytruda significantly expanded. Several types of malignancies are disclosed by MSI-H status due to dMMR and characterized by increased neoantigen load, which elicits intense host immune response in tumor microenvironment, including portions of colorectal and gastric carcinomas. Currently, biomarker-based patient selection remains a challenge. Pathologists play important roles in evaluating histology and biomarker results and establishing detection methods. Taking gastric cancer as an example, its molecular classification is built on genome abnormalities, but it lacks acceptable clinical characteristics. Pathologists are expected to act as "genetic interpreters" or "genetic translators" and build a link between molecular subtypes with tumor histological features. Subsequently, by using their findings, oncologists will carry out targeted therapy based on molecular classification.
Antibodies, Monoclonal, Humanized ; adverse effects ; therapeutic use ; Antineoplastic Agents, Immunological ; adverse effects ; therapeutic use ; Biomarkers, Tumor ; Humans ; Neoplasms ; drug therapy ; Precision Medicine ; Programmed Cell Death 1 Receptor ; antagonists & inhibitors ; Treatment Outcome ; United States